Main Determinants of Catastrophic Health Expenditures: A Bayesian Logit Approach on Iranian Household Survey Data (2010)

BACKGROUND: During recent decades, increase in both health care expenditures and improvement of the awareness as well as health expectations have created some problems with regard to finance healthcare expenditures so that the issue of health financing by households has been determined as a major challenge in health sector. According to the definition by the World Health Organization, catastrophic health expenditure is considered if financial contribution for health service is more than 40% of income remaining after subsistence needs have been met.

OBJECTIVES: The purpose of our study was determination of Main factors on catastrophic health expenditures in Iranian households.

PATIENTS and METHODS: In this study, using an econometrics Bayesian logit model, determinants of the appearance of catastrophic health expenditure based on household budget data collected in 2010 were evaluated.

RESULTS: Among Iranian households, the following groups were more likely to encounter with unsustainable health expenditures: rural households, households with the numbers of the elderly more than 65 years, illiterate householders, unemployed householders, households with some unemployed persons, households in upper rank and households with larger equivalent household size were higher than the average of community could significantly predict catastrophic health expenditures.

CONCLUSIONS: About 2.1% of households were faced with catastrophic health expenditures in 2010. Thus, the implemented policies could not make considerable and significant change in improving justice in financing in health systems.