Economic Inequality in Outpatient Healthcare Utilization: The Case of Iran.

BACKGROUND: One of important goals of any health system is to reduce healthcare inequalities in its jurisdiction. We aimed to track economic inequality in outpatient health care utilization after the healthcare transformation plan in Iran.

STUDY DESIGN: A cross-sectional study.

METHODS: The data obtained from the Iranian healthcare utilization household survey conducted in 2015. The inequality in health care utilization was assessed through concentrating index, concentration curve, and odds ratio. GIS analysis also was used to show provincial concentration index in the map of Iran. The analysis was performed on more than 14000 subjects aged 15 yr or higher reported outpatient health care service's needs.

RESULTS: The richest to poorest odds ratio of outpatient health care utilization was 1.14 (95%CI: 1.11, 1.17). The concentration index of outpatient healthcare utilization was obtained 0.094 (95%CI: 0.77, 0.11). Although the concentration indices of rural and urban residents were significantly different, there was no significant difference between male and female subject. Provincial and GIS analysis showed that inequality in outpatient healthcare utilization was spatially distributed in Iran.

CONCLUSIONS: Findings of current study indicate that after the healthcare transformation plan, economic inequality in outpatient healthcare utilization still were pro-rich in Iran as a whole and in some of its provinces.