Abstract
The projection of levels and composition of financial resources for the healthcare expenditure (HCE) and relevant trends can provide a basis for future health financing reforms. This study aimed to project Iran's HCEs by the sources of funds until 2030. The structural macro-econometric modeling in the EViews 9 software was employed to simulate and project Iran's HCE by the sources of funds (government health expenditure [GHCE], social security organization health expenditure [SOHCE], out-of-pocket [OOP] payments, and prepaid private health expenditure [PPHCE]). The behavioral equations were estimated by autoregressive distributed lag (ARDL) approach. If there is a 5%-increase in Iran's oil revenues, the mean growth rate of gross domestic product (GDP) is about 2% until 2030. By this scenario, the total HCE (THCE), GHCE, SOHCE, OOP, and PPHCE increases about 30.5%, 25.9%, 34.4%, 31.2%, and 33.9%, respectively. Therefore, the THCE as a percentage of the GDP will increase from 9.6% in 2016 to 10.7% in 2030. It is predicted that Iran's THCE will cover 22.2%, 23.3%, 40%, and 14.5% by the government, social security organization (SSO), households OOP, and other private sources, respectively, in 2030. Until 2030, Iran's health expenditures will grow faster than the GDP, government revenues, and non-health spending. Despite the increase in GHCE and total government expenditure, the share of the GHCE from THCE has a decreasing trend. OOP payments remain among the major sources of financing for Iran's HCE.
Highlights
The healthcare system is one of the determinants of health that participates with other factors in promoting population health
The total healthcare expenditure (THCE) was divided into two components, ie, public health expenditure and the private health expenditure
This study aims to project Iran’s healthcare expenditure (HCE) until 2030 through a macro-econometrics model
Summary
The healthcare system is one of the determinants of health that participates with other factors in promoting population health. It is predicted to remain the main source of total healthcare expenditure (THCE) financing. These values are 12.7%, 29.6%, 51.2%, and 39.2% in high-income, upper-middle-income, lower-middleincome, and low-income countries, respectively, until 2050. In Iran, OOP payment was 37.6% in 2016 and 38.9% in 2050.9 Increased health expenditure along with an increased share of the THCE from gross domestic product (GDP) due to factors including technological advancement, demographic transition, increased expectations of consumers, and resources limitations resulted in the inability or unwillingness of the governments to increase spending on healthcare services which may threaten sustainable financing of health systems in the future.[10]
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