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Sara Emamgholipour, Ali Akbari Sari , Sara Geravandi , Hoda Mazrae ,
Volume 11, Issue 3 (9-2017)
Abstract

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.

Sara Emamgholipour, Vahid Saberzadeh, Hossein Dargahi,
Volume 14, Issue 1 (3-2020)
Abstract

Background and Aim: Given the rising trend of ageing and the vulnerability of the aged group to diseases and health costs, it is important to determine the exposure of elderly households to the burdensome costs of health.
Materials and Methods: The incidence and severity of elderly costs at provincial level and income quintiles were calculated; besides, chi-square test was used to determine the relationship between household socioeconomic variables and exposure levels. The sample included 9103 elderly people aged 65 and over, and the data of their own and their households were extracted from the statistical center in 2016. Data analysis was performed using SPSS16 software.
Results: The exposure rate of households with rural elderly people (9.74%) was higher than urban ones (6.2%), and the intensity of exposure was higher in rural areas than urban. In both groups, the highest exposure was in the second and the lowest in the fifth quintiles. The elderly households in Hormozgan province had the highest and in Kohgiluyeh and Boyer-Ahmad had the lowest exposure. Number of elderly people in family, place of residence, employment status, household dimension, costs of chemotherapy, addiction abandonment, orthopedics, special medications, household spending and out-of-pocket payment for health services were significantly correlated with exposure. However, elderly person's literacy, insurance, marital status and the presence of persons under 12 years in the family did not show a significant relationship with the amount of exposure.
Conclusion: The exposure rate and its intensity is higher among rural elderly people than urban ones, and the exposure of poorer elderly people is higher; these points indicate that the distribution of financial resources in the health system is not fair and requires  purposeful policymaking decisions for these groups.


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