Catastrophic health expenditures in Iran: A review of the literature

Objective (s): The aim of this study was to review literature on studies that estimate catastrophic health expenditures (CHE) for assessing equity in health financing in Iran. The PRISMA guideline was followed and several search engines including Google Scholar, Pubmed, Scopus, Magiran and SID were examined to restive relevant studies. We used health catastrophicexpenditure, catastrophic payment, equity, health and Iran as keywords. Literature review was conducted without time limitation in Persian and English documents. The initial search yielded 116 studies. After excluding duplicates and non-relevant studies, 38 articles were selected for full text analysis and finally 19 papers selected for this review. 21.1 % of the studies estimated catastrophic health expenditures in patients groups and others considered the whole populations in a distinct area. Estimation ranged from 2.5% to 72.5%. The range of estimations was very wide. It seems that CHE was influenced by the socioeconomic status of population studied, burden of diseases in different areas and sample size. The exact estimation of CHE is recommended in order to define and implement best solutions in improving the present situation.