Journal of

Background and Aim: The World Health Organization (WHO) has placed special emphasis on the protection of families against the costs of health services. Patients suffer not only from the burden of a disease, but also from the burden of their health costs. The aim of this study was to estimate out-of-pocket costs and to identify the factors that affect catastrophic expenditures among patients with cardiovascular diseases in Khuzestan Province. 
Materials and Methods: In this descriptive-analytic study, 100 cardiovascular patients having referred to educational hospitals in Ahwaz, Khuzestan Province, were considered. Out-of-pocket costs were estimated and using Econometrics Logit model, factors affecting catastrophic expenditures among households were identified. All analyses were performed using SPSS and Stata.
Results: The average out-of-pocket cost was 16,008,936 rials per patient during one year. Also, 55% of patients faced with catastrophic expenditures. Income level and family size had a significant negative impact; however, patients’ employment status had a positive but insignificant effect on catastrophic expenditures.
Conclusion: Hospital inpatient expenses and drug costs cover most of out-of-pocket expenditures and should be considered by policymakers. By increasing the income level and family size, families will encounter catastrophic expenditures less. The out-of-pocket costs among patients with cardiovascular diseases can be reduced by boosting the insurance coverage and government help.

Background and Aim: Health and equal access to quality care regardless of age, gender, race and location is health systems' goal in all countries. This study aimed to determine inequality in healthcare services distribution and development level of cities in Guilan province.
Materials and Methods: This descriptive, cross-sectional study assessed the distribution state of 13 healthcare indicators in all cities of Guilan (n=16) in year 2011 and 2013. In order to collect data, the database of Statistical Center of Iran (SCI) was used as reference. The taxonomy technique was employed to determine the degree of development of different cities. In addition, indicators were weighed by Shannon’s entropy. Finally, TOPSIS was used to rank the cities in term of access to health sector resources.
Results: Taxonomy technique in 2 years showed that Rudbar, Rudsar and Lahidjan were of most developed cities and Talesh, Rezvanshahr and Amlash were the most under-developed cities respectively. After weighting indicators and according to Shannon entropy, the number of specialists and paramedics gained the most and the least weight, respectively.
Conclusion: Due to the inequality in distribution of health resources in Guilan province, attention to underdeveloped cities in this province should be a priority. To achieve equitable health resources in Guilan, it is recommended that the plannings be based on state of development of cities.