Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1395
10
1
gregorian
2017
1
1
31
1
online
1
fulltext
en
Out-of-pocket and informal payments in Iran's health care system: A systematic review and meta-analysis
Health Management and Information Sciences
Health Management and Information Sciences
Original Research
Original Research
<p><strong>Background: </strong>Out-of-pocket and informal payments are considered as 2 most important topics for equity in health care financing. Therfore, this study was conducted to systematically review and meta-analyze the status of these payments in Iran's health care system.<br>
<strong> Methods:</strong> Required data were collected through searching the following key terms: "Unofficial", "Informal Payment", "Iran", "Health Financing", "Health expenditure", and "Out-of-pocket" on Scopus, PubMed, IranMedex, SID, and Google Scholar databases. After extracting and screening previous studies, data were collected from the articles using PRISMA pattern. To perform the meta-analysis, Comprehensive Meta-Analysis (CMA: 2) software was used. <br>
<strong> Results:</strong> A total of 15 studies were entered in this review. Overall, the rate of out-of-pocket payments was estimated to be 50% (95% CI: 45-57%). A significant correlation was found between gender and the rate of out-of-pocket payments (p≤0.05). Moreover, the overall rate of informal payments was found to be 35%. Most of the informal payments were in form of cash, and the main reasons for informal payments were appreciating the staff and medical team as well as requests made by the hospital staff. Length of stay, marital status, employment status, income, and insurance coverage were key factors in the field of informal payments. <br>
<strong> Conclusion:</strong> According to the results of the present study, out-of-pocket and informal payments are more prevalent in Iran. Considering the negative effects of these payments on the health care system, it is of prime importance to implement extensive interventions to reduce or even prevent these payments. <br>
</p>
Out-of-pocket, Informal payments, Health financing, Health system, Equity
401
409
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-3315-1&slc_lang=en&sid=1
Seyed Abbas
Mirabedini
mirabedini110@yahoo.com
200319475328460034071
200319475328460034071
Yes
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Seyed Mohammad Esmaeil
Fazl Hashemi
ma.hashemy@gmail.com
200319475328460034072
200319475328460034072
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Ali
Sarabi Asiabar
sarabi.a@iums.ac.ir
200319475328460034073
200319475328460034073
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Aziz
Rezapour
rezapoor_a57@yahoo.com
200319475328460034074
200319475328460034074
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Saber
Azami-Aghdash
saberazami@yahoo.com
200319475328460034075
200319475328460034075
No
Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Hassan
Hosseini Amnab
hhoseinia@yahoo.com
200319475328460034076
200319475328460034076
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.