Catastrophic healthcare expenditures among Iranian households: a systematic review and meta-analysis
International Journal of Human Rights in Healthcare
ISSN: 2056-4902
Article publication date: 20 August 2018
Issue publication date: 9 April 2019
Abstract
Purpose
Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled estimate of the prevalence of catastrophic healthcare expenditures (CHE) among households in Iran.
Design/methodology/approach
Both international (PubMed, Scopus and Clarivate Analytics (previously known as the Institute for Scientific Information)) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases were searched for published studies on CHE among Iranian households. The following keywords in Persian and English language were used as keywords for the search: “catastrophic healthcare costs,” “catastrophic health costs,” “impoverishment due to health costs,” “fair financial contribution,” “prevalence,” “frequency” and “Iran” with and without “health system”. The I2-test and χ2-based Q-test suggested heterogeneity in the reported prevalence among the qualified studies; thus, a random-effects model was used to estimate the overall prevalence of CHE among households in Iran.
Findings
A total of 24 studies with a cumulative sample of 301,097 households were included in the study. The estimated pooled prevalence of CHE among households was 7 percent (95 percent confidence interval: 6–8 percent). Meta-regression analysis indicated that the prevalence of CHE was inversely related to the sample size (p<0.05). The results did not suggest a significant association between the prevalence of CHE and the year of data collection.
Originality/value
The findings revealed that the prevalence of CHE among Iranian households is significantly higher than 1 percent, which is the goal set out in Iran’s fourth five-year development plan. This warrants further policy interventions to protect households from incurring CHE in Iran.
Keywords
Acknowledgements
The authors gratefully acknowledge the research council of Kermanshah University of Medical Sciences for providing financial support. This study was extracted from an approved project by Kermanshah University of Medical Sciences (KUMS) and was funded and supported by the Research Deputy of KUMS (Grant No. 96419).
Citation
Rezaei, S., Woldemichael, A., Hajizadeh, M. and Kazemi Karyani, A. (2019), "Catastrophic healthcare expenditures among Iranian households: a systematic review and meta-analysis", International Journal of Human Rights in Healthcare, Vol. 12 No. 2, pp. 105-115. https://doi.org/10.1108/IJHRH-02-2018-0017
Publisher
:Emerald Publishing Limited
Copyright © 2018, Emerald Publishing Limited