Equity in distribution of financial burden of expenditure in the Iranian healthcare sector

The Iranian health transformation plan was commenced in May 2014, with regard to the 20-year National Vision and the general health policies imparted by the Supreme Leader. The goal of the implementation of this plan is to establish equity in financing and to benefit from health care systems, to improve quality services, to maintain and protect the health of patients, and to minimize the share of people in direct payments for health care services. This study aims to investigate the costs of health care during 2002-2015 and determine the households’ exposure to catastrophic expenditure in 2014. The results show that after the implementation of the plan, the real out-of-pocket payments of households increased by almost 16%, despite the reduction in households' share in the financing of healthcare and insurance costs to 46%. In 2014, about 5 percent of urban households and 8 percent of rural households, on average, faced with catastrophic expenditure. In addition, exposure to catastrophic expenditure within the first deciles of rural and urban households is almost 9 and 13 percent, respectively