Health and Development Journal

Health and Development Journal

Out-of-Pocket Payments in Iran Before and After the Health Transformation Plan: A Systematic Review and Meta-analysis

Document Type : Original Article

Authors
Saman Najafi
Reza Goudarzi
Mahdiyeh Eskandari kia
Zeinab Shaker
10.34172/jhad.92395
Abstract
Background: Out-of-pocket (OOP) payments are among the least efficient and simplest methods of financing healthcare which prevent access to health services. In response to these challenges, reforms were made to enhance efficiency, equity, and effectiveness while reducing OOP payments. Accordingly, this systematic review and meta-analysis was conducted to analyze OOP expenditures before and after the implementation of the Health Transformation Plan (HTP) in Iran.
Methods: Relevant data were collected using specific keywords, including “Health system”, “Health Transformation Plan”, “Out-of-Pocket Payment”, and “Iran”. A comprehensive search was conducted across multiple databases, including PubMed, Scopus, SID, Google Scholar, IranMedex, and Medline. Persian and English articles were extracted and screened according to the STROBE checklist and PRISMA protocol as well as the inclusion and exclusion criteria, focusing on studies published from May 2014 to May 2021. The studies selected for meta-analysis were analyzed using Stata 13 software.
Results: A total of 758 records were identified across all databases, of which 38 were duplicates. Quality assessment led to the inclusion of 6 articles eligible for systematic review, 3 of which were included in synthesis and meta-analysis. Findings showed that OOP was 19.33% before the HTP and 6.54% post-implementation, indicating a significant reduction in OOP expenditure due to the HTP.
Conclusion: The results suggested that OOP payments in Iran were high before the HTP and decreased following its implementation. As the plan was shown to reduce the economic burden on individuals, it is recommended that policymakers continue to support the initiatives in the HTP to prevent imposing substantial costs on the population.
Keywords
Health system
Health transformation plan
Out-of-pocket payments
Iran
Subjects
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Health and Development Journal
Volume 13, Issue 3
Summer 2024
Pages 102-109

  • Receive Date 05 August 2024
  • Revise Date 02 September 2024
  • Accept Date 15 September 2024