en Public Administration & Health management and economics Public Administration & Health management and economics Original Research Original Research <p dir="ltr" style="text-align: justify"><strong>Background: </strong>Health inequalitymonitoring especially in Health care financing field is very important. Hence, this study tends to assess the inequality in household&#39s capacity to pay and out-of-pocket health carepaymentsin Tehran metropolis.</p> <p dir="ltr" style="text-align: justify"><strong>Methods</strong>: This cross-sectional study was performed in 2013.Thestudy population was selected by stratified cluster sampling, and they constitute the typical households living in Tehran (2200 households). The required data were collected through questionnaires and analyzed using Excel and Stata v.11. Concentration Index on inequality wasused for measuring inequality status in capacity to pay and household payments for health care expenses and also the concentration index for out-of-pocket payments and capacity to pay was used to determine the extent of inequality. The recall period for inpatient care was one year and 1 month for outpatient.</p> <p dir="ltr" style="text-align: justify"><strong>Results</strong>: The average of out-of-pocket payments for receiving the outpatient services was determined to be 44.33US$ and for each inpatient1861.11 US$. Concentration index for household&#39s out-of-pocket payments for inpatient health care, out-of-pocket payments for outpatient health care and health prepayments werecalculated 0.13, -0.10 and -0.11, respectively. Also, concentration index in household’s capacity to pay was estimated to be 0.11whichindicatedinequality to the benefit of the rich. The households used financing strategies like savings, borrowing or lending to pay their health care expenditures.</p> <p dir="ltr" style="text-align: justify"><strong>Conclusion</strong>: According to this study, the poor spend a greater portion of their capacity to pay for outpatient and inpatient health care costs and prepayment, in comparison to the rich. Thus, supporting the vulnerable groups of the society to decrease out-of-pocket payments and increasing the household’s capacity to pay through government support in order to improve the household economic potential, must be considered very important.</p> Health inequality, Healthcare financing, Out-of-pocket payment, Capacity to pay. 674 684 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-909&slc_lang=en&sid=1 Aziz Rezapour rezapour_a57@yahoo.com 200319475328460019255 200319475328460019255 No Department of Health Economics, School of Health Management and information Sciences& Health management and Economics Research Center &Center of Excellence in Health Management and Economics, Iran University of Medical Sciences. Tehran, Iran. Farbod Ebadifard Azar dr.febadi@yahoo.com 200319475328460019256 200319475328460019256 No Department of Health Education and promotion, School of Health &Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. Saber Azami Aghdash 200319475328460019257 200319475328460019257 No School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Asghar Tanoomand tanomanda@yahoo.com 200319475328460019258 200319475328460019258 No Department of Microbiology, Faculty of Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran. Nahal Ahmadzadeh nahalmadzadeh@yahoo.com 200319475328460019259 200319475328460019259 No the Deputy of Health in Social Affairs, Management and Planning Organization, Tehran, Iran. Ali Sarabi Asiabar sarabi.a@iums.ac.ir 200319475328460019260 200319475328460019260 Yes Health Management and Economics Research Center, Iran university of Medical Sciences, Tehran, Iran.