Assessment of equity in public health care financing in 2013

Financing in the health system will be equitable when the costs of health care for households in based on their ability to pay rather than on the disease risk are were distributed. The aim of this study was to assess equity in the public health care financing based on two main sources of funding include direct payments by households for public health care and public health budget is distributed.
This study was descriptive analytic study, and the registration statistics of the Ministry of Health and Medical Education Statistics Center of Iran in 2013 was used. The main variables studied including direct payments by households for public health care, public health budgets and household income distribution were studied separatelyin the provinces of the country. For data analysis, Excel as calculation software was used. Indicators used in this study to assess equity in health cost financing include the Gini coefficient, concentration index and the Kakwani progressive index.
In 2013, the Gini index of income distribution among households and the concentration index of direct payments by households for public health care in the provinces were 0.387 and 0.056, respectively. On this basis, Kakwani progressive index and the concentration index of public health budget in the provinces were obtained -0.331 and -0.05, respectively. Accordingly, Kakwani progressive index, equivalent to -0.337 percent was calculated.
The assessment made based on the Gini coefficient, concentration index, and the Kakwani progressive index show that the distribution of the public budget in the provinces of country and direct payments by households for public health care, based on the household income variable, is inequitable.