Health status of societies is among the basic indices of economic and social development and hence, investment in this section directly impacts on social welfare and economic growth. Low quality of health care and inequality in health care expenditure contributions can lead to different forms of social and economic consequences. This is the main concern of the public policy makers, in particular those who are engaged with health care services. Hence, monitoring households' health expenditures, which can reflect socio-economic inequality, can provide valuable information for the health policy makers.
The concentration index and the extended concentration index introduced by Wgstaff (2002) is used to estimate inequality in health expenditures of urban households. Also, the household’s expenditures in Iran are disaggregated into expenditure quintiles through selected years from 1989 (i.e. beginning of the development programs in Iran after the revolution) till 2014. To this end, Iran’s annual household’s survey data produced by Iran statistic center is used.
The concentration index has upward trend in 1989 to 2005, and after that it has fluctuating trend. Fifth quintile has the highest income inequality and the most inequality in health expenditures, because there are some households with high health expenditures in this group; while they are not rich in fact. The extended concentration index has been light fluctuation in the selected years. Increasing the extended concentration index represents the increasing inequalities in health expenditures, so increase in this indicator is a sign of the worsening health situation in the country.
Despite of the improvements in some key health indices such as the rate of maternal mortality, the under five years mortality, life expectancy of women and men, the findings of this study shows that the households' expenditure inequality increases in favor of the higher income groups, and on the other, the public policy in health has not been effective as expected. Moreover, the results of the study indicates that higher degree of inequality aversion parameter, the lower disparity between the average households' health expenditures and its average at the "perfect equality". This result shows that the capability of the individuals, and particularly the lower income groups, has been weakened.
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