Document Type : Research Paper

Authors

1 Associate Professor, Department of Public Administration, Faculty of Management, Islamic Azad University, West Tehran Branch, Iran

2 Assistant Professor, Department of Management, Faculty of Humanities, Islamic Azad University, Saveh Branch, Iran

Abstract

Managing health care costs and financing the health sector is an important issue for all countries. In Iran, the main burden of financing the health sector is on households, and this is an unfair practice. One of the goals of health officials is to replace more equitable methods. The aim of this study is to investigate the factors affecting the decision of Iranian households to enter the health market. The theoretical framework includes the study of Grassman's view of human capital in the field of health expenditures at the micro level. Given the nature of the problem and its data in the category of quantitative research, the data and variables used in the research will be collected in the form of numbers and the results will be reported in the same way. Deprived and included 22,264 households in deprived and relatively deprived areas (including 47% of rural households and 53% of urban households) were estimated as examples. Increasing income, education, women's proportions, health development, and the number of members increase spending and insurance coverage and tobacco use also increase spending on health. Families with spouses who have never been married have the highest and lowest health expenditures, respectively. The study insists that households benefit from insurance support plans and measures to improve the socio-economic situation, especially for large families and rural residents.
 
 

Keywords

- احمدی، علی‌محمد؛ پاک‌روان، ناصری، علیرضا و عصاری، عباس. (1393). «عوامل مؤثر در پرداخت‌های مستقیم خانوارها در نظام سلامت ایران با استفاده از مدل رگرسیون دوبخشی». مدیریت سلامت (مدیریت و اطلاع‌رسانی پزشکی)، دوره 17 شماره 56: 18-7.
- اسماعیلی، معصومه؛ عسکری، علی؛ امینی سابق، زین‌العابدین و ساده، احسان (1398). «بررسی تأثیر عوامل اقتصادی و اجتماعی بر ورود خانوارها به بازار سلامت و میزان مخارج  (مطالعه خانوارهای شهری و روستایی ساکن استان تهران و استان‌های هم‌جوار)»، فصلنامه بیمه سلامت ایران، دوره ۲، شماره ۱: 30-39.
- پناهی، حسین؛ فلاحی، فیروز؛ محمدزاده، پرویز؛ جنتی، علی؛ نریمانی، محمدرضا و صباغی زاده، لاله. (1393). «عوامل مؤثر بر پرداخت نقدی در بیمارستان‌های ایران: مطالعه موردی شهر تبریز». مدیریت اطلاعات سلامت، دوره 11 شماره 2: 207-199.
- حسینی نسب، ابراهیم و ورهرامی، ویدا. (1389). «بررسی عوامل مؤثر بر مخارج مراقبت‌های درمانی خانواده‌ها در استان یزد». مدیریت سلامت، دوره 13 شماره 40: 79-73.
- ساوجی‌پور، سهیلا؛ عصاری آرانی، عباس؛ عاقلی، لطفعلی و حسن‌زاده، علی. (1397). «بررسی عوامل مؤثر بر مخارج سلامت خانوارهای شهری». سیاست‌گذاری اقتصادی، دوره 10(19)، 52-25.
- ضرابی، اصغر و شیخ بیگلو، رعنا. (1390). «سطح‌بندی شاخص‌‌های توسعه سلامت استان‌‌های ایران». مجله رفاه اجتماعی، دوره 11 شماره 42: 128-107.
- عبادی فرد آذر، فربد؛ رضاپور، عزیز؛ راهبر، احمد؛ حسینی شکوه، سیدمرتضی و باقری فردانبه، سعید. (1392). «برآورد تابع تقاضای دارو در جمهوری اسلامی ایران». مجله طب نظامی، دوره 1 شماره 2: 168-163.
- مرکز آمار ایران. پرسشنامه طرح آمارگیری هزینه و درآمد خانوارهای شهری و روستایی 1390.
- وطن‌خواه نوغانی آتنا؛ قاسمی، مریم و جوان، جعفر. (1397) «شناسایی مهم‌ترین اثرات مهاجرت انفرادی مردان سرپرست خانوار بر زنان روستایی (موردمطالعه: شهرستان مشهد)»، فصلنامه پژوهش‌های روستایی، دوره 9، شماره 1: 58-71.
 
-  Aristei, D. & Perali, F. & Pieroni, L. (2008). Cohort, age and time effects in alcohol consumption by Italian households: a double-hurdle approach. Empirical Economics.
-  Balarajan Y, Selvaraj S, Subramanian S. Health care and equity in India. The Lancet. (2011). 377(9764):505-15.
-  Brown, S. & Hole, A. R. & Kilic, D. (2014). Out-of-pocket health care expenditure in Turkey: Analysis of the 2003–2008 Household Budget Surveys. Economic Modelling, 41, 211–218.
-  Cameron, A.C. & Trivedi, P.K. (2005). Microeconometrics: Methods and Applications. New York: CambridgeUniversity Press.
-  Carmen, G.M. & Matilde, A. (2003). Econometric Models of Private and Public Health Expenditure in OECD countries, 1970-96. Applied Econometrics and International Development, 3(3), 49-60.
-  CucklerGA, Sisko AM, Poisal JA, Keehan SP, SmithSD, Madison AJ, et al. (2018). National health expenditure projections, 2017–26: despite uncertainty, fundamentals primarily drive spending growth. Health Affairs. 37(3):482-92.
-  Fayissa, B. & Gutema, P. (2005). Estimating a health production function for Sub-Saharan Africa. Applied Economics, 37(2), 155 -164.
-  Giammanco M, Gitto L. (2019). Health expenditure and FDI in Europe. Economic Analysis and Policy. 62:255-67.
-  Grossman, M. (1972). On the Concept of Health Capital and the Demand for Health. Political Economy, 80(2), 223-255.
-  habesh, S. & Himanshu, S. R. (2007). Determinants Of Household Health Expenditure: Case Of Urban Orissa. Utkal Economic Papers, XIII(1), 17-23. 
-  Haque, M.S.&Barman, S.D. (2010). Determinants of Household Healthcare Expenditure in Chittagong, Bangladesh. IUP Journal of Applied Economics, 9(2), 5-13.
-  Huang LL, Lazard A, Pepper J, Noar S, Ranney L, Goldstein A. (2017). Impact of the real cost campaign on adolescents’ recall, attitudes, and risk perceptions about tobacco use: a national study. International Journal of Environmental Research and Public Health. 14(1).
-  Jones, A.M. (2007). Applied Econometrics for Health Economists: A Practical Guide. Oxford: Radcliffe Medical Publishing.
-  Jones, A.M. (2010). Models For Health Care. HEDG Working Paper No. 10/01. Department of Economics and Related Studies, University of York.
-  Kapur, K. & Rogowski, J.A. & Freedman, V. A. & Wickstrom, S.L. & Adams, J.L. & Escarce, J.J. (2006). Socioeconomic status and medical care expenditures in medicare managed care. Journal of Health Care for the Poor and Underserved, 17(4), 876-98.
-  Langlois, E. V., Campbell, K. … & Daszak, P. (2012). Towards a better integration of global health and biodiversity in the new sustainable development goals beyond Rio+ 20. EcoHealth, 9(4), 381-385.
-  Lee, W. & Jiang, L. & Phillips, C.D. & Ohsfeldt, R.L. (2014), Rural-Urban Differences in Health Care Expenditures: Empirical Data from US Households. Advances in Public Health, Volume 2014, 435780
-  Lisboa C.M. & de Paula, J.S. & Bovi Ambrosano, G.M. & Pereira, A.C. & Meneghim M.C. & Cortellazzi, K.L. & Vazquez, F.L. & Mialhe, F.L. (2013). Socioeconomic and family influences on dental treatment needs among Brazilian underprivileged schoolchildren participating in a dental health program. BMC Oral Health, 13(1):56.
-  Maclean, J. C., Webber, D. A., French, M. T., & Ettner, S. L. (2015). The health consequences of adverse labor market events: Evidence from panel data. Industrial Relations: A Journal of Economy and Society, 54(3), 478-498.
-  Malik, A. M. & Azam Syed, S. I. (2012). Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan. International Journal for Equity in Health, 11:51.
-  Mullahy, J. (2009). Econometric Modeling of Health Care Costs and Expenditures: A Survey of Analytical Issues and Related Policy Considerations. Medical Care, 47(7), 104-108.
-  Jacobson, L. (2000). The family as producer of health — an extended Grossman model. Journal of Health Economics, 19(5), 611-637.
-  Okunade, A. A. & Suraratdecha, C. & Benson, D. A. (2010). Determinants of Thailand household healthcare expenditure: the relevance of permanent resources and other correlates. Journal of Health Economics, 19(3), 365-376.
-  O’Donnell, O. & van Doorslaer, E. & Wagstaff, A. & Lindelow, M. (2008). Analyzing Health Equity Using Household Survey DataA Guide to Techniques and Their Implementation, Washington D.C.: World Bank.
-  Parker, W. S. & Wong, R. (1997). Household income and health care expenditures in Mexico. Health Policy, 40(3), 237-255.
-  Phua K H. (2018). Governance Issues in Health Financing. Reference Module in Biomedical Sciences. 330-41.
-  Sanwald, A. & Theurl, E. (2015). Out-of-pocket payments in the Austrian healthcare system – a distributional analysis. International Journal for Equity in Health, 14:94.
-  Waite, L.J. & Lehrer, E.L. (2003). The benefits from marriage and religion in the United States: Acomparative analysis. Population and development review, 29(2), 255-275.
-  Zimmermann, A.C. & Easterlin, R.A. (2006). Happily ever after? Cohabitation, marriage, divorce, and happiness in Germany. Population and Development Review, 32(3), 511–528.