Inequities in health and health care between provinces of Iran : promoting equitable health care resource allocation

Babaie, MH

Abstract

Investigation of the influence of public expenditure on health lends support to the opinion that
equitable distribution of financial resources would help to reduce inequities in health. This
thesis set out to establish inequities in access to health care and health outcomes across the
provinces of Iran and explore equitable resource allocation models to contribute to the reduction
of health inequities. Inequities were measured based on the relationship between a range of health
indicators and socioeconomic status in the provinces. Information on mortality, morbidity, and
socioeconomic factors were taken respectively from the Death Registration System, Health Profile in
Iran (2003), and Iran's 2006 census. There were significant relationships between mortality and
socioeconomic indicators across the provinces, with the larger rates of mortality in the worst-off
provinces. Coronary risk factors (diabetes, high serum cholesterol) were significantly associated
with socioeconomic factors; with higher prevalence of the risk factors in the well-off provinces.
There were also significant relationships between access to health services (hospital delivery and
vaccination) and socioeconomic status; with lower access in the worst-off provinces. The resource
allocation models based on population size and age/sex structure changed the health expenditure in
favour of the well-off provinces to contribute to the reduction of inequities in morbidities.
However, models based on mortality and deprivation changed the expenditure towards the worst-off
provinces, in order to bridge the inequities in mortality and access to health services. Equity
targets set, based on a combination of age/sex, mortality, and deprivation, indicated that nineteen
provinces had received a share of expenditure higher than the equity target, with the largest in
Mazanderan and seven provinces received a share lower than the target, with the largest in Tehran.
A five-year plan was developed to move the expenditure from the hyper-financed provinces to the
under- financed ones.

Citation

Babaie, M. Inequities in health and health care between provinces of Iran : promoting equitable health care resource allocation. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: May 16, 2014
• Publicly Available Date: May 16, 2014
• Award Date: Jan 1, 2012