title: Measuring equity in household's health care payments (Tehran-Iran 2013): technical points for health policy decision makers.
abstract: BACKGROUND
  Households' financial protection against health payments and expenditures and equity in utilization of health care services are of the most important tasks of governments. This study aims to measuring equity in household's health care payments according to fairness in financial contribution (FFC) and Kakwani indices in Tehran-Iran, 2013.
  
  
  METHODS
  This cross-sectional study was conducted in 2014.The study sample size was estimated to be 2200 households. Households were selected using stratified-cluster sampling including typical families who reside in the city of Tehran. The data were analyzed through Excel and Stata v.11software. Recall period for the inpatient care was 1 year and for outpatient1 month.
  
  
  RESULTS
  The indicator of FFC for households in health financing was estimated to be 0.68 and the trend of the indicator was ascending by the rise in the ranking of households' financial level. The Kakwani index was estimated to be a negative number (-0.00125) which indicated the descending trend of health financing system. By redistribution of incomes or the exempt of the poorest quintiles from health payments, Kakwani index was estimated to be a positive number (0.090555) which indicated the ascending trend of health financing system.
  
  
  CONCLUSIONS
  According to this study, the equity indices in health care financing denote injustice and a descending trend in the health care financing system. This finding clearly shows that deliberate policy making in health financing by national health authorities and protecting low-income households against health expenditures are required to improve the equity in health.
authors.affiliation: PhD, 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. rezapour_a57@yahoo.com.
authors.forename: Aziz
authors.initials: A
authors.lastname: Rezapour
authors.affiliation: PhD, Department of Health Education and promotion, School of Health &Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. dr.febadi@yahoo.com.
authors.forename: Farbod
authors.initials: F
authors.lastname: Ebadifard Azar
authors.affiliation: PhD Candidate in Health Policy, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. saberazami@yahoo.com.
authors.forename: Saber
authors.initials: S
authors.lastname: Azami Aghdash
authors.affiliation: PhD, Department of Microbiology, Faculty of Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran. tanomanda@yahoo.com.
authors.forename: Asghar
authors.initials: A
authors.lastname: Tanoomand
authors.affiliation: PhD Candidate in Health Economics, Department of Health Management and Economics, School of Health, Tehran University of Medical Sciences. Tehran, Iran. hosainysh.morteza@gmail.com.
authors.forename: Seyed Morteza
authors.initials: SM
authors.lastname: Hosseini Shokouh
authors.affiliation: Msc in Health Management, School of Health, Tehran University of Medical Sciences. Tehran, Iran. yousefzadeh.negar@gmail.com.
authors.forename: Negar
authors.initials: N
authors.lastname: Yousefzadeh
authors.affiliation: MSc in Clinical Psychology, Head of Outsourcing Group, Health Management and Economics Research Center, Iran university of Medical Sciences, Tehran, Iran. pezhman_ata@yahoo.com.
authors.forename: Pezhman
authors.initials: P
authors.lastname: Atefi Manesh
authors.affiliation: Msc in Public Administration, Health Management and Economics Research Center, Iran university of Medical Sciences, Tehran, Iran. sarabi.a@iums.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Sarabi Asiabar
keywords: Equity; Equity indices; Fairness in financial contribution (FFC); Health care financing; Kakwani index