:: Volume 9, Issue 2 (Summer 2021) ::
Iran J Health Educ Health Promot 2021, 9(2): 133-144 Back to browse issues page
Determinants of health expenditures of female-headed households in urban areas of Iran
Mahdi Shahraki , Simin Ghaderi *
Abstract:   (2158 Views)
Background and Objective: With the increase of female-headed households and the vulnerability of the mental and physical health of these households, as well as the need to control and manage the health expenditures of female-headed households, this study aimed to investigate the determinants of health expenditures of female-headed households in urban areas of Iran.

Materials and Methods: This descriptive-analytical and applied study was conducted cross-sectional with the microeconomics approach. The sample size included 2645 female-headed households, which were randomly selected based on three-stage sampling method, city, block and household selection, and data were collected by the Statistics Center of Iran using the cost and income questionnaire of urban households. The models were estimated in Stata 14 software using the two-step Hackman method.

Results: The results showed that the monthly health expenditures of the female-headed households were increased by an increase in income, insurance expenses and head household’s age by 0.099, 0.71 and 16046 Rials, respectively. Also, these expenditures with having a child under seven years old and an elderly person over 60 years old were increased by 737587 and 691909 Rials, respectively. Increasing in the female-headed households’ education level led to a decrease in monthly household health expenditures by 37,839 Rials.

Conclusion: Female-headed households with children or the elderly had higher health expenditures than other female-headed households, so it is recommended to increase insurance coverage for healthcare and services to reduce health expenditures and not face to catastrophic health expenditures. These households also allocated a large share of the increased income on health expenditures, so policies to increase the income of female-headed households through employment, increase in grants, and health subsidies are proposed.

Keywords: Health Expenditures, Socioeconomic Factors, Selection Bias
Full-Text [PDF 505 kb]   (695 Downloads)    
Type of Study: Research | Subject: Health Education & Health Promotion
Received: 2020/11/17 | Accepted: 2021/03/14
1. Rezaei S, Dindar A, Rezapour A. Health Care Expenditures and their Determinants: Iran Provinces (2006-2011). Journal of Health Administration. 2015;19(63):81-90
2. Shahraki M, Ghaderi S. Investigating the effect of socioeconomic factors on household health expenditures: Hackman two-step method. Payavard Salamat. 2019;13(2):160-71.
3. Shahraki M, Agheli L, Assari Arani A, Sadeqi H, Ghaderi S. The relationship between mother's socioeconomic status and child health. Journal of Research and Health. 2018;8(2):143-51. [DOI:10.29252/jrh.8.2.143]
4. Ahmadi A, Nikravan A, Naseri A, Asari A. Effective determinants in Household Out of Packet Payments in Health System of Iran, Using Two Part Regression Model. Journal of Health Administration. 2014;17(56):7-18 .
5. Sirajul Haque M, Deb Barman S. Determinants of Household Healthcare Expenditure in Chittagong, Bangladesh. The IUP Journal of Applied Economics. 2010;9(2):5-13.
6. Brown S, Hole A, Kilic D. Out-of-pocket health care expenditure in Turkey: Analysis of the 2003-2008 Household Budget Surveys. Economic Modelling 2014;41:211-8. [DOI:10.1016/j.econmod.2014.05.012]
7. Namazi A, Rafiey H, Mousavi M, Setareh Forouzan A, Ghaed Amini G. A systematic review of studies on the factors affecting the quality of life in the general population of Iran. Journal of Health Literacy. 2021;5(4):17-30..
8. Rajaei SA, Ziyari K, Zanganeh Shahraki S, Shahsavary MS. Spatial analysis of city size changes with the level of social vulnerability (Case study: Cities over 10,000 populations in Iran). Spatial Planning. 2019;9(3):1-22.
9. Fotros MH, Ghodsi S. Comparing multidimensional poverty of female and men headed households in urban and rural areas in iran by alkire-foster method. Social Welfare. 2018;18(68):185-227 . [DOI:10.29252/refahj.18.69.227]
10. Ajorlou S, Abbasi M, Rashvand M. A comparative study on the attention to health and medical care among women in charge of the family and other women. Journal of Bioethics. 2012;2(5):67-97.
11. Barati MA, Ebrahimi Salari T. Factors Affecting the Poverty through the Female-Headed Households in Iran. Social Welfare. 2018;18(68):43-85.
12. Gholam Niarami A, Ansari E. A Sociological Study of Factors Influencing the Social Security of Female Headed Households. Social Development and Welfare Planning. 2016;7(26):25-60.
13. Nejatian M, Tehrani H, Momeniyan V, Jafari A. A modified version of the mental health literacy scale (MHLS) in Iranian people. BMC psychiatry. 2021;21(1):1-11. [DOI:10.1186/s12888-021-03050-3] [PMID] [PMCID]
14. Solhi M, Shabani Hamedan M, Salehi M. The Effect of Educational Intervention Based on PRECEDE-PROCEED Model on the Life Quality of Women-Headed Households Covered By Tehran Welfare Organization. Iranian Journal of Health Education and Health Promotion. 2017;4(4):259-70. [DOI:10.18869/acadpub.ihepsaj.4.4.259]
15. savojipour s, assari arani a, Agheli L, hasanzadeh a. Modeling Healthcare Expenditure among Iranian Households. Quarterly Journal of Economic Growth and Development Research. 2017;8(29):97-110 .
16. Ranson MK. Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges. Bulletin of the World Health Organization. 2002;80(8):613-21.
17. da Silva MT, Barros AJD, Bertoldi AD, de Andrade Jacinto P, Matijasevich A, Santos IS, et al. Determinants of out-of-pocket health expenditure on children: an analysis of the 2004 Pelotas Birth Cohort. International journal for equity in health. 2015;14:53-. [DOI:10.1186/s12939-015-0180-0] [PMID] [PMCID]
18. Sanwald A, Theurl E. Out-of-pocket payments in the Austrian healthcare system - a distributional analysis. International journal for equity in health. 2015;14:1-12. [DOI:10.1186/s12939-015-0230-7] [PMID] [PMCID]
19. Muhammad Malik A, Azam Syed SI. Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan. International journal for equity in health. 2012;11:1-7. [DOI:10.1186/1475-9276-11-51] [PMID] [PMCID]
20. Rezapoor A, Baghi A, Adham D, Ebadifard Azar F, Bagheri Faradonbeh S, Orumiei N, et al. Inequality in Health Expenditure and Impoverishment Impacts Resulting from It in Kerman. Journal of Health. 2016;7(2):146-57.
21. Karami M, Najafi F, Karami Matin B. Catastrophic health expenditures in kermanshah, west of iran: magnitude and distribution. J Res Health Sci. 2009;9(2):36-40.
22. Shahraki M, Ghaderi S. The Impact of medical Insurances on out-of-pocket payments among urban households in Iran: A Double-Sample selection Model. Journal of Health Administration. 2019;22(2):42-54.
23. Ghiasvand H, Gorji A, Maleki M, Hadian M. Catastrophic Health Expenditure Among Iranian Rural and Urban Households, 2013 - 2014. Iran Red Crescent Med J. 2015;17(9):e30974. [DOI:10.5812/ircmj.30974] [PMID] [PMCID]
24. Panahi H FF, Mohammadzadeh P, Janati A, Narimani MR, Sabaghizadeh L. Factors Influencing the Out -of-Pocket Payments by Patients in the Hospital in Tabriz-Iran. Health Inf
25. Manage. 2014;11(2):199-207 .
26. Rezaei H, Alizadeh M, Nademi Y. Effective Factors on Per Capita Healthcare Expenditure: A Comparison of Spatial Models in Selected Developing Countries. Quarterly Journal of Applied Theories of Economics. 2017;4(2):1-26 .
27. Samadi A, Homaie Rad E. Determinants of Healthcare Expenditure in Economic Cooperation Organization (ECO) Countries: Evidence from Panel Cointegration Tests. Int J Health Policy Manag. 2013;1(1):63-8. [DOI:10.15171/ijhpm.2013.10] [PMID] [PMCID]
28. Bayati M, Akbarian R, Kavosi Z, Sadraei Javaheri A, Amini Rarani M, Delavari S. Socioeconomic Determinants of Health in Western Pacific Region: A Panel Data Analysis. Social Welfare. 2013;12(47):111-30.
29. Pellegrino G, Piva M, Vivarelli M. Young firms and innovation: A microeconometric analysis. Structural Change and Economic Dynamics. 2012;23(4):329-40. [DOI:10.1016/j.strueco.2011.10.003]
30. Heckman J. The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models. Annals of Economic and Social Measurement. 5. Cambridge: National Bureau of Economic Research, Inc; 1976. p. 475-92.
31. Heckman JJ. Sample Selection Bias as a Specification Error. Econometrica. 1979;47(1):153-61. [DOI:10.2307/1912352]
32. Genius M, Strazzera E. Applying the Copula Approach to Sample Selection Modelling. Applied Economics. 2008;40(11):1443-55. [DOI:10.1080/00036840600794348]
33. Lee MJ. Micro-Econometrics: Methods of Moments and Limited Dependent Variables. New York: Springer; 2010.
34. Olasehinde N, Olaniyan O. Determinants of household health expenditure in Nigeria. International Journal of Social Economics. 2017;44(12):1694-709. [DOI:10.1108/IJSE-12-2015-0324]
35. Okunade AA, Suraratdecha C, Benson DA. Determinants of Thailand household healthcare expenditure: the relevance of permanent resources and other correlates. Health Econ. 2010;19(3):365-76. [DOI:10.1002/hec.1471] [PMID]
36. Savojipour S, Assari Arani A, Agheli L, Hassanzadeh A. The Determinants of Urban Families' Health Expenditure. The Journal of Economic Policy. 2018;10(19):25-52. [DOI:10.29252/jep.10.18.25]
37. shahraki m, ghaderi s. Investigating the Factors Affecting Hospital Expenditures of Iranian Urban Households: Emphasis on Maternal Education. Journal of Health Management & Informatics. 2020;7(2):76-83.
38. Ghiasi A, Baghi A, Rezapour A, Alipour V, Ahadinezhad B, Mahmoudi M, et al. Health Insurance, Medicine Expenses and Catastrophic Health Expenditures. Journal of Health Administration. 2016;18(62):64-74.
39. Mohammadzadeh Y. Determinants of Impoverishing Health Expenditure in Iran's Health Sector. Journal of Iran's Economic Essays. 2014;11(22):117-54
40. Hosseininasab S.E, Varahrami V. Determinant Factors on Households Health Care Expenditures in Yazd, Iran. Journal of Health Administration. 2010;13(40):73-9

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