Iran's Health Reform Plan: Measuring Changes in Equity Indices

Area of Science:

• Health economics
• Public health policy
• Health equity research

Background:

• The Health Sector Evolution Plan (HSEP) was implemented to improve healthcare access and affordability.
• Evaluating the HSEP's impact on health equity is crucial for policy refinement.

Purpose of the Study:

• To assess the effects of the Health Sector Evolution Plan (HSEP) on key health equity indices.
• To identify specific areas of improvement and challenges in health financing and equity post-HSEP.

Main Methods:

• Assessed Out-of-Pocket (OOP) health expenditures.
• Evaluated the Fairness in Financial Contribution (FFC) index.
• Measured households' Catastrophic Health Expenditure (CHE) and Impoverishing Health Expenditure (IHE) headcount ratio.

Main Results:

• Total health service costs per capita decreased, with greater reductions in rural areas due to lower inpatient costs.
• The Catastrophic Health Expenditure (CHE) index improved from 2.9% to 2.3%.
• Fairness in Financial Contribution (FFC) worsened (0.79 to 0.76), and Impoverishing Health Expenditure (IHE) deteriorated (0.34 to 0.50).

Conclusions:

• The HSEP significantly reduced catastrophic hospital costs for low-income populations by approximately 26%.
• Worsening Impoverishing Health Expenditure (IHE) and Fairness in Financial Contribution (FFC) highlight persistent equity issues.
• The plan's success in mitigating catastrophic costs contrasts with challenges in overall financial fairness and impoverishment due to health spending.