Analysis of national health accounts in Iran (2002–2020) - Payesh (Health Monitor)
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Volume 24, Issue 1 (January-February 2025)                   Payesh 2025, 24(1): 7-19 | Back to browse issues page


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Mousavi A, Mokhtari-Payam M, Fazaeli A, Bakhtiari Aliabad M. Analysis of national health accounts in Iran (2002–2020). Payesh 2025; 24 (1) :7-19
URL: http://payeshjournal.ir/article-1-2452-en.html
1- Department of Health, Islamic Parliament Research Center, Tehran, Iran
2- Heath Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (768 Views)
Objective (s): Comprehensive data on health expenditures is crucial not only for effective policymaking but also for achieving universal health coverage and health-related sustainable development goals. This study provides a detailed analysis of Iran's national health accounts from 2002 to 2020, offering insights into trends and patterns in healthcare spending during this period.
Methods: This descriptive study utilizes data from Iran’s national health accounts to examine health expenditures across various dimensions, including health functions, healthcare service providers, financing agents, and funding sources, covering the period from 2002 to 2020. Descriptive statistics were employed to analyze the data.
Results: Total health expenditures experienced a substantial rise, increasing from 53,351 billion Rials in 2002 to 2,372,718 billion Rials in 2020, giving a 44.5-fold increase. However, when adjusted for constant values, the results decreased to a 2.7-fold increase. During the period from 2002 to 2020, curative care accounted for the largest share of expenditures at 57.3%, followed by pharmaceuticals and other medical goods dispensed to outpatients at 17.1%. The majority of health expenditures were allocated to hospital providers, ambulatory care providers, and pharmacies, along with other retailers of medical goods, representing 39.6%, 30.2%, and 16.4%, respectively. The share of out-of-pocket (OOP) payments decreased from 50.6% to 35%. Furthermore, 30% of expenditures were financed by the public sector, while the private sector covered the remaining 70%.
Conclusion: In Iran's healthcare system, a substantial proportion of expenditures is allocated to curative care, with hospitals serving as the primary recipients of these funds. Moreover, a significant share of healthcare expenses is financed through OOP payments, which increases the risk of catastrophic health expenditures for households. Consequently, it is essential to reduce these payments by expanding insurance coverage and enhancing the existing prepayment methods. Furthermore, prioritizing sustainable financing and enhancing financial resources within the health system is crucial for ensuring equitable access to healthcare services.
 
Full-Text [PDF 1706 kb]   (443 Downloads)    
type of study: Descriptive | Subject: Health Economic
Received: 2024/02/23 | Accepted: 2024/11/12 | ePublished ahead of print: 2025/01/21 | Published: 2025/03/1

References
1. Mehrolhassani MH, Yazdi-Feyzabadi V, Lashkari M. Measuring inequalities in the selected indicators of National Health Accounts from 2008 to 2016: evidence from Iran. Cost Effectiveness and Resource Allocation 2020; 18:1-13 [DOI:10.1186/s12962-020-00235-7]
2. Saleh MH, Alkhawaldeh RS, Jaber JJ. A predictive modeling for health expenditure using neural networks strategies. Journal of Open Innovation: Technology, Market, and Complexity 2023;9:100132 [DOI:10.1016/j.joitmc.2023.100132]
3. Raeissi P, Rajabi MR, Mousavi A, Vahedi S, Khalilabad TH. Investigating the determinants of healthcare expenditures in different healthcare systems. Shiraz E-Medical Journal 2019; 20:1-6 [DOI:10.5812/semj.86506]
4. Chang AY, Cowling K, Micah AE, Chapin A, Chen CS, Ikilezi G, et al. Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. The Lancet 2019; 393:2233-60 [DOI:10.1016/S0140-6736(19)30841-4]
5. Schneider MT, Chang AY, Chapin A, Chen CS, Crosby SW, Harle AC, et al. Health expenditures by services and providers for 195 countries, 2000-2017. BMJ Global Health 2021; 6:1-10 [DOI:10.1136/bmjgh-2021-005799]
6. Bui AL, Lavado RF, Johnson EK, Brooks BP, Freeman MK, Graves CM, et al. National health accounts data from 1996 to 2010: a systematic review. Bulletin of the World Health Organization 2015; 93:566-76 [DOI:10.2471/BLT.14.145235]
7. Zakeri M, Olyaeemanesh A, Zanganeh M, Kazemian M, Rashidian A, Abouhalaj M, Tofighi S. The financing of the health system in the Islamic Republic of Iran: A National Health Account (NHA) approach. Medical Journal of the Islamic Republic of Iran 2015; 29:1-8
8. Rahimisadegh R, Mehrolhassani MH, Jafari Sirizi M, Noori Hekmat S. The analysis of national health accounts and financial communications network in Iran health insurance ecosystem. BMC Health Services Research 2022; 22:1-11 [DOI:10.1186/s12913-022-08921-3]
9. Guide to producing national health accounts: with special applications for low-income and middle-income countries. World Health Organization: Geneva, 2003. Available at: https:// https://iris.who.int/handle/10665/42711 [Access date 2024 July 1]
10. Iranian Statistics Center. Available at: https://www.amar.org.ir/statistical-information [Access date 2023 Nov 1] [In Persian]
11. The World Bank. Available at: https://databank.worldbank.org/reports.aspx?source=2&series=SH.XPD.OOPC.CH.ZS&country [Access date 2023 Nov 1]
12. Wang F, Wang J-D, Huang Y-X. Health expenditures spent for prevention, economic performance, and social welfare. Health Economics Review 2016; 6:1-10 [DOI:10.1186/s13561-016-0119-1]
13. Saksena P, Hsu J, Evans DB. Financial risk protection and universal health coverage: evidence and measurement challenges. PLoS Medicine 2014; 11:1-11 [DOI:10.1371/journal.pmed.1001701]
14. Darvishi A, Sefiddashti SE, Rajabi M, Mehrolhassani MH, Yazdi-Feyzabadi V. Investigating appropriate threshold for measuring the occurrence and intensity of households' exposure to catastrophic health expenditure in Iran. Iranian Journal of Epidemiology 2021; 17:34-46
15. Hedayati M, Masoudi Asl I, Maleki M, Fazaeli AA, Goharinezhad S. Policy analysis of the protection of Iranian households against catastrophic health expenditures: a qualitative analysis. BMC Health Services Research 2023; 23:1-21 [DOI:10.1186/s12913-023-09275-0]
16. Rashidian A, Soofi M. Methodology of the assessment of financial protection against health costs. Iranian Journal of Epidemiology 2015; 11:82-93 [In Persian]
17. The concept of catastrophic health expenditures and policies for financial protection in Iran, Islamic parliament research center of IRAN. [ Access date 2024 november 1] Available from: https://rc.majlis.ir/fa/news/show/1798707.
18. Ramezanian M, Haghdoost AA, Mehrolhassani MH, Abolhallaje M, Dehnavieh R, Najafi B, Fazaeli AA. Forecasting health expenditures in Iran using the ARIMA model (2016-2020). Medical Journal of the Islamic Republic of Iran 2019; 33:1-4 [DOI:10.47176/mjiri.33.24]
19. Doshmangir L, Yousefi M, Hasanpoor E, Eshtiagh B, Haghparast-Bidgoli H. Determinants of catastrophic health expenditures in Iran: a systematic review and meta-analysis. Cost Effectiveness and Resource Allocation 2020; 18:1-21 [DOI:10.1186/s12962-020-00212-0]
20. Yazdi-Feyzabadi V, Mehrolhassani MH, Darvishi A. Measuring catastrophic health expenditures and its inequality: evidence from Iran's Health Transformation Program. Health Policy and Planning 2019; 34:316-25 [DOI:10.1093/heapol/czz031]
21. Mousavi A, Lotfi F, Alipour S, Fazaeli A, Bayati M. Prevalence and determinants of catastrophic healthcare expenditures in Iran from 2013 to 2019. Journal of Preventive Medicine and Public Health 2024; 57:65-72 [DOI:10.3961/jpmph.23.291]

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