IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v36y2021i3p656-667.html
   My bibliography  Save this article

Decomposition of gendered socioeconomic‐related inequality in outpatient health care utilization: A cross‐sectional study from Iran

Author

Listed:
  • Sajad Vahedi
  • Vajiheh Ramezani‐Doroh
  • Mohammad Shamsadiny
  • Aziz Rezapour

Abstract

Introduction Unequal access to required health care services could deteriorate inequality in health outcomes and increase mortality and morbidity, especially among disadvantaged groups. One of the most debated factors in shaping health care inequalities is gender. This study aimed to measure and explains gendered socioeconomic‐related inequality in outpatient health care utilization in Iran. Methods This is a cross‐sectional research conducted at a national level in Iran. The required data was obtained from an Iranian health care utilization household survey conducted in 2015. Erreygers Concentration Index (ECI) was used to measure the socioeconomic inequality in outpatient health care utilization. A regression‐based decomposition analysis was also used to explain socioeconomic‐related inequalities. Results There was a significant pro‐rich inequality in outpatient health care utilization between males (ECI = 0.115, SE = 0.014) and females (ECI = 0.083 SE = 0.011) indicating that utilization of these services was concentrated on the better‐offs. The decomposition analysis revealed that economic status (males = 50.58%, females = 37.42%) was the main contributor to the observed inequality. Location of residence, health insurance and education were other main driver of these inequalities. Conclusions Different factors have different contribution to socioeconomic‐related inequality in utilization of outpatient health care services and these could be diversified considering gender. Hence, it seems that policy makers could be able to address these inequalities effectively through gender‐oriented policies.

Suggested Citation

  • Sajad Vahedi & Vajiheh Ramezani‐Doroh & Mohammad Shamsadiny & Aziz Rezapour, 2021. "Decomposition of gendered socioeconomic‐related inequality in outpatient health care utilization: A cross‐sectional study from Iran," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 656-667, May.
  • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:3:p:656-667
    DOI: 10.1002/hpm.3109
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3109
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hpm.3109?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mohammad Hajizadeh & Luke B. Connelly & James R.G. Butler & Aredshir Khosravi, 2012. "Unmet need and met unneed in health care utilisation in Iran," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 39(6), pages 400-422, May.
    2. Tayebeh Moradi & Seyran Naghdi & Heather Brown & Hesam Ghiasvand & Mohammadreza Mobinizadeh, 2018. "Decomposing inequality in financial protection situation in Iran after implementing the health reform plan: What does the evidence show based on national survey of households' budget?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 652-661, July.
    3. Adam Wagstaff & Eddy van Doorslaer, 2000. "Measuring and Testing for Inequity in the Delivery of Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 35(4), pages 716-733.
    4. Nina L. Hall & Sophie Matthews & Arabella Hickson & Peter S. Hill, 2019. "Health and the Sustainable Development Goals: Challenges for four Pacific countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 844-859, January.
    5. Macintyre, Sally & Hunt, Kate & Sweeting, Helen, 1996. "Gender differences in health: Are things really as simple as they seem?," Social Science & Medicine, Elsevier, vol. 42(4), pages 617-624, February.
    6. Dilek Başar & Selcen Öztürk, 2020. "Assessing Horizontal Equity in the Utilization of Mental Healthcare Services in Turkey: A Gender Perspective," Applied Health Economics and Health Policy, Springer, vol. 18(2), pages 299-309, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    2. Thomas Leoni, 2011. "Fehlzeitenreport 2011. Krankheits- und unfallbedingte Fehlzeiten in Österreich," WIFO Studies, WIFO, number 42691.
    3. Kankaanranta, Terhi & Nummi, Tapio & Vainiomaki, Jari & Halila, Hannu & Hyppola, Harri & Isokoski, Mauri & Kujala, Santero & Kumpusalo, Esko & Mattila, Kari & Virjo, Irma & Vanska, Jukka & Rissanen, P, 2007. "The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private," Health Policy, Elsevier, vol. 83(1), pages 50-64, September.
    4. Das, Jishnu & Hammer, Jeffrey & Sánchez-Paramo, Carolina, 2012. "The impact of recall periods on reported morbidity and health seeking behavior," Journal of Development Economics, Elsevier, vol. 98(1), pages 76-88.
    5. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    6. Tavares, Lara Patrício & Zantomio, Francesca, 2017. "Inequity in healthcare use among older people after 2008: The case of southern European countries," Health Policy, Elsevier, vol. 121(10), pages 1063-1071.
    7. Missinne, Sarah & Colman, Elien & Bracke, Piet, 2013. "Spousal influence on mammography screening: A life course perspective," Social Science & Medicine, Elsevier, vol. 98(C), pages 63-70.
    8. Johannes Hagen, 2018. "The effects of increasing the normal retirement age on health care utilization and mortality," Journal of Population Economics, Springer;European Society for Population Economics, vol. 31(1), pages 193-234, January.
    9. Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related inequalities in health care utilization in Switzerland over time," Diskussionsschriften dp0413, Universitaet Bern, Departement Volkswirtschaft.
    10. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.
    11. Evelyn Forget & Raisa Deber & Leslie Roos & Randy Walld, 2005. "Canadian Health Reform: A Gender Analysis," Feminist Economics, Taylor & Francis Journals, vol. 11(1), pages 123-141.
    12. Orfila, Francesc & Ferrer, Montserrat & Lamarca, Rosa & Tebe, Cristian & Domingo-Salvany, Antonia & Alonso, Jordi, 2006. "Gender differences in health-related quality of life among the elderly: The role of objective functional capacity and chronic conditions," Social Science & Medicine, Elsevier, vol. 63(9), pages 2367-2380, November.
    13. Pulok, Mohammad Habibullah & van Gool, Kees & Hall, Jane, 2020. "Horizontal inequity in the utilisation of healthcare services in Australia," Health Policy, Elsevier, vol. 124(11), pages 1263-1271.
    14. Enzo Grossi & Angelo Compare & Cristina Lonardi & Renata Cerutti & Edward Callus & Mauro Niero, 2013. "Gender-related Effect of Cultural Participation in Psychological Well-being: Indications from the Well-being Project in the Municipality of Milan," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 114(2), pages 255-271, November.
    15. Teresa Bago d'Uva & Maarten Lindeboom & Owen O'Donnell & Eddy van Doorslaer, 2011. "Education‐related inequity in healthcare with heterogeneous reporting of health," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(3), pages 639-664, July.
    16. Leu, Robert E. & Schellhorn, Martin, 2004. "The Evolution of Income-Related Inequalities in Health Care Utilization in Switzerland over Time," IZA Discussion Papers 1316, Institute of Labor Economics (IZA).
    17. Cinzia Di Novi & Anna Marenzi & Dino Rizzi, 2018. "Do healthcare tax credits help poor-health individuals on low incomes?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 293-307, March.
    18. M. Dolores Montoya Diaz, 2002. "Socio‐economic health inequalities in Brazil: gender and age effects," Health Economics, John Wiley & Sons, Ltd., vol. 11(2), pages 141-154, March.
    19. Matthias Pannhorst & Florian Dost, 2022. "A Life-Course View on Ageing Consumers: Old-Age Trajectories and Gender Differences," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 17(2), pages 1157-1180, April.
    20. Sveréus, Sofia & Kjellsson, Gustav & Rehnberg, Clas, 2018. "Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden," Health Policy, Elsevier, vol. 122(9), pages 949-956.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:36:y:2021:i:3:p:656-667. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.