Socioeconomic factors affecting health expenditure in 2021: Iranian household budget survey

Abstract

Abstract Introduction: The out-of-pocket (OOP) payments in Iran's health system and the impact of socioeconomic inequalities are huge burdens on the populace. This study investigates socioeconomic factors affecting household health expenditures in 2021. Methods: This is a community-based cross-sectional analytical study. Descriptive statistics were used for OPP payments in each subgroup (based on the explanatory variables). Also, inferential tests were used to examine the relationships between the explanatory variables and OOP payments. Multivariable generalized linear models (GLM) with a log link were used. The data was prepared in Excel spreadsheet software version 2019 and analyzed with Stata 14 software. The significance level in all tests was 0.05. Results: In this study, 37988 households were examined. More than 50% of the studied population (19,618 households) lived in the city. The heads of 84.63% of the households were male. The findings related to the gamma regression estimation showed that the income and expenses of health insurance have a significant positive but small effect on household health expenses. Also, the level of education of the head of the household had a significant positive effect on health expenditures. Conclusion: The study found that the average cost of healthcare expenditure is directly influenced positively by demographic factors related to household heads such as male gender, employment, higher education, being married, and households without seniors or children under five. Iran's health system should implement advance payments, stronger insurance infrastructures, and earmarked taxes to reduce the high share of OOP payments in its health financing system.