Analysis of Iranian household financial participation in the health system: Decomposition of the concentration index approach

Introduction: The status of financial participation of individuals in health financing is one of the challenging issues in assessing the performance of health systems in the world. The concern about the financing of the health system and its consequences on Iranian households from about a decade ago is a turning point in attracting the attention of researchers and policymakers to this area. This study has been calculated financial contribution of people in Iran health system in 2015. Materials and Methods: Using cost-income information of 38252 Iranian households collected by the Statistical Center of Iran in 2015, the distribution of health expenditures of households based on the income approach is calculated and factors influencing the concentration index are measured. Results: The results showed that the concentration index of health care expenditures in Iran was 0.3318. This is indicative of the progressive status of household participation in financing the health system. Also, dental expenditures with the index of 0.496 have the highest inequality in the distribution of health care expenditures. Payment for hospital services and dental care services had the highest share in increasing the coefficient index. Conclusion: Having insurance coverage as one of the most important policy tools to achieve the desired model of household financial participation has a significant effect on the distribution of financial participation of households and the most important factor in reducing the coefficient of concentration index Keywords: Concentration Index, Out of Pocket, Fair Financial Contribution