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Alvandi R, Harirchi I, Abdi Z, Abdalmaleki E, Mirzaei H, Goharimehr M et al . Trend of Share of Health Expenditures on Total Household Expenditures Based on Expenditure Deciles (2009 – 2016). Hakim 2018; 21 (2) :64-70
URL: http://hakim.tums.ac.ir/article-1-1789-en.html

Abstract
Background: A significant portion of household’s expenses is allocated to health services. This study aimed to investigate the share of health expenditure in total households’ expenditure during 2009 - 2016 and capture the changing patterns of health expenditure associated to the implantation of the Health Transformation Plan.
Methods: The study relied on data from the Household, Expenditure and Income survey, which the sample size is about 38000 households per year. The average annual out-of-pocket (OOP) expenses paid by households as well as the ratio of necessary expenditure in total consumption expenditure were calculated in order to study the trend of health expenditure.
Results: Out of pocket payment among all households has a slow decreasing trend. The ratio of health expenditure to total consumption expenditure in the 10th and 1st declines of urban and rural population was 26% and 1.3%, respectively; the national level was 7% in this period. The difference in OOP between the 1st and 10th decline in urban and rural households was 29942534 Rials and 15441113 Rials, respectively in 2016.
Conclusions: The results indicate that there is a considerable difference between OOP paid by the poorest and the richest households. However, the share of health expenditure in total households’ expenditure was almost stable during these years. Despite, the increased coverage of universal health insurance in recent years, the difference between health expenditures among income groups is almost considerable. Nevertheless, health expenditure represents a lower share of total households’ expenditure compared with other expenditures among all expenditure deciles.

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