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
1397
11
1
gregorian
2019
2
1
33
1
online
1
fulltext
en
Horizontal inequity in the utilization of cataract surgery in Iran: Shahroud Eye Cohort Study, 2009-2014
Epidemiology
Epidemiology
Original Research
Original Research
<strong>Background: </strong>Since there was no evidence about economic inequity in utilization of cataract surgery in developing countries, such as Iran, this study was designed to measure horizontal inequity in the utilization of cataract surgery and its changes in an Iranian middle-aged population in 2009 and 2014.<br>
<strong>Methods:</strong> Using data from the first and second phases of Shahroud Eye Cohort Study (2009-2014), the economic inequity in the utilization of cataract surgery in an Iranian middle-aged population aged 40-64 years in 2009 and 2014 was evaluated. The horizontal inequity index (HI) was determined using the indirect standardization method based on a nonlinear (probit) model and the concentration index (C) was decomposed into the contribution of each factor. The analyses were performed using STATA software version 12/SE, and significance level was set at less than 0.05.<br>
<strong>Results:</strong> The HI in the utilization of cataract surgery increased from 0.080 (95% CI: 0.011-0.098) in 2009 to 0.166 (95% CI: 0.0821-0.228) in 2014. Decomposition of changes in the concentration index showed that among need and non-need variables, older age and economic status (being among the wealthiest 20%) were the greatest contributors, with shares of 67.5% and 57.5%%, respectively, which led to pro-rich inequity during the study periods.<br>
<strong>Conclusion:</strong> The present study demonstrated that utilization of cataract surgery did not have an equal distribution among economic quintiles, despite considering equal needs based on cataract severity. Results demonstrated that older age and economic status were the greatest contributors to HI increase in 2009 and 2014.<br>
Horizontal inequity index, Concentration index, Cataract surgery utilization, Middle-aged population, Iran
693
701
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-4818-1&slc_lang=en&sid=1
Maedeh
Raznahan
maraznahan@gmail.com
200319475328460062360
200319475328460062360
No
Noor Ophthalmology Research Center, Noor Eye Hospital & Deputy of Research, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Hassan
Emamian
emamian@shmu.ac.ir
200319475328460062361
200319475328460062361
No
Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
Fateme
Alipour
shiva_mehrdad@yahoo.com
200319475328460062362
200319475328460062362
No
Eye Research Center, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Hassan
Hashemi
hashemi@noorvision.com
200319475328460062363
200319475328460062363
No
Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
Hojjat
Zeraati
zeraatih@tums.ac.ir
200319475328460062364
200319475328460062364
No
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Akbar
Fotouhi
afotouhi@tums.ac.ir
200319475328460062365
200319475328460062365
Yes
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran