Inequities in health and health care between provinces of Iran: promoting equitable health care resource allocation
Year: 2014
Type: dissertation
Abstract: Investigation of the influence of public expenditure on health lends support to the opinion that \nequitable distribution of financial resources would help to reduce inequities in health. This \nthesis set out to establish inequities in access to health care and health outcomes across the \nprovinces of Iran and explore equitable resource allocation models to contribute to the reduction \nof health inequities. Inequities were measured based on the relationship between a range of health \nindicators and socioeconomic status in the provinces. Information on mortality, morbidity, and \nsocioeconomic factors were taken respectively from the Death Registration System, Health Profile in \nIran (2003), and Iran's 2006 census. There were significant relationships between mortality and \nsocioeconomic indicators across the provinces, with the larger rates of mortality in the worst-off \nprovinces. Coronary risk factors (diabetes, high serum cholesterol) were significantly associated \nwith socioeconomic factors; with higher prevalence of the risk factors in the well-off provinces. \nThere were also significant relationships between access to health services (hospital delivery and \nvaccination) and socioeconomic status; with lower access in the worst-off provinces. The resource \nallocation models based on population size and age/sex structure changed the health expenditure in \nfavour of the well-off provinces to contribute to the reduction of inequities in morbidities. \nHowever, models based on mortality and deprivation changed the expenditure towards the worst-off \nprovinces, in order to bridge the inequities in mortality and access to health services. Equity \ntargets set, based on a combination of age/sex, mortality, and deprivation, indicated that nineteen \nprovinces had received a share of expenditure higher than the equity target, with the largest in \nMazanderan and seven provinces received a share lower than the target, with the largest in Tehran. \nA five-year plan was developed to move the expenditure from the hyper-financed provinces to the \nunder- financed ones.
Author: MH Babaie
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2118285910