title: Catastrophic Health Expenditure Among Iranian Rural and Urban Households, 2013 - 2014.
abstract: BACKGROUND
  During the last two decades, the trend of out-of-pocket payments (OOP) for health services by Iranian households has been a matter of concern and it has exposed a significant proportion of them to catastrophic and impoverishing health expenditures.
  
  
  OBJECTIVE
  The current study aimed to investigate three objectives: First, the mean of out-of-pocket payments among Iranian households for health services; second, the headcount and overshoot measures of catastrophic health expenditure; and finally the level of inequality in its distribution.
  
  
  METHODS
  This descriptive study on Iranian rural and urban households was conducted from April to June 2015. The sample sizes were 19437 rural and 18888 urban households that Iranian Statistical Centre (ISC) selected them through a three -step randomized clustered sampling. The headcount and overshoot measures for catastrophic health expenditure were calculated. Also, the concentration index was calculated in order to investigate the inequality in distribution of the mentioned measures.
  
  
  RESULTS
  The catastrophic health expenditure headcount ratio varied from 0.5% to 14.3% and from 0.48% to 13.27% for rural and urban households, respectively. Also, the overshoot of catastrophic health expenditure varied from 9.62% to 18.72% and from 8.8% to 17.74% for rural and urban households, respectively.
  
  
  CONCLUSIONS
  Considering Iran's economic condition during the last five years, the catastrophic health expenditure headcount ratio was more than 2% in Iran.
authors.affiliation: Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hesam
authors.initials: H
authors.lastname: Ghiasvand
authors.affiliation: Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran ; Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Abolghasem Gorji
authors.affiliation: Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Maleki
authors.affiliation: Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hadian
keywords: Catastrophic Health Expenditures; Concentration Index; Financial Risk Protection; Out-of-Pocket Expenditure