Investigating Socio-economic Factors Affecting the Health Expendiures of Households in East Azarbayjan Province - the Heckman Regression Model

Abstract Introduction: Direct payments for health services are one of the types of household expenses, whose socio-economic conditions, as well as government policies in the field of health, including medical insurance, are effective factors in determining its amount. Therefore, the analysis of factors affecting direct payments is one of the basic issues in health sector financing policies. Therefore, the present study was conducted with the aim of investigating the socio-economic factors influencing the health expenditures of households living in East Azerbaijan province in 2017 and using the Heckman regression model. Material and Methods: A cross-sectional descriptive study was conducted on 3000 households during June and July 2017 in the form of provincial health accounts. A stratified multi-stage sampling method was used to select the sample. The tool for collecting data was the household income-expenditure questionnaire, which had been prepared and used by Iranian Statistics. Data on socio-economic and demographic characteristics were collected and analyzed using Stata 14 software. Results: The results of the descriptive findings showed that the most type of insurance among the people studied was social security insurance (40% of households) and the least was insurance of the relief committee (less than 1% of households). About 400 households (12% of households) lack basic insurance. Out of the total population participating in this study, 34% of households had supplementary insurance. Also, based on the inferential findings of socio-economic factors such as having health insurance, not having supplementary insurance, the age of the head of the household, university education, the head of the household being married, the size of the household and the presence of a child seven or under seven years old in the household lead to an increase in household health expenses. became Female-headed households had lower health expenditures. Conclusion: Considering the existence of a positive and significant relationship between the consumption of health services (outpatient and inpatient services) and the direct payment of households for the aforementioned services, it is suggested to measure the indicators related to the financial participation of households in health in all the provinces of the country on a regular and annual basis. and in this way, the impact of each program in the field of health in terms of reducing people's share of health costs and increasing justice in fair financial participation in health can be measured.