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Title

Out-of-pocket and informal payments in Iran's health care system: A systematic review and meta-analysis

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Abstract

 Background: Out-of-pocket and Informal payments are considered as 2 most important topics for Equity in health care financing. Therfore, this study was conducted to systematically review and meta-analyze the status of these payments in Iran's health care system. Methods: Required data were collected through searching the following key terms: "Unofficial", "Informal Payment", "Iran", "Health financing", "Health expenditure", and "Out-of-pocket" on Scopus, PubMed, IranMedex, SID, and Google Scholar databases. After extracting and screening previous studies, data were collected from the articles using PRISMA pattern. To perform the metaanalysis, Comprehensive Meta-Analysis (CMA: 2) software was used. Results: A total of 15 studies were entered in this review. Overall, the rate of Out-of-pocket payments was estimated to be 50% (95% CI: 45-57%). A significant correlation was found between gender and the rate of Out-of-pocket payments (p≤ 0. 05). Moreover, the overall rate of Informal payments was found to be 35%. Most of the Informal payments were in form of cash, and the main reasons for Informal payments were appreciating the staff and medical team as well as requests made by the hospital staff. Length of stay, marital status, employment status, income, and insurance coverage were key factors in the field of Informal payments. Conclusion: According to the results of the present study, Out-of-pocket and Informal payments are more prevalent in Iran. Considering the negative effects of these payments on the health care system, it is of prime importance to implement extensive interventions to reduce or even prevent these payments.

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    APA: Copy

    Mirabedini, Seyed Abbas, Fazl Hashemi, Seyed Mohammad Esmaeil, SARABI ASIABAR, ALI, REZAPOUR, AZIZ, AZAMI AGHDASH, SABER, & Hosseini Amnab, Hassan. (2017). Out-of-pocket and informal payments in Iran's health care system: A systematic review and meta-analysis. MEDICAL JOURNAL OF THE ISLAMIC REPUBLIC OF IRAN (MJIRI), 31(1), 0-0. SID. https://sid.ir/paper/294786/en

    Vancouver: Copy

    Mirabedini Seyed Abbas, Fazl Hashemi Seyed Mohammad Esmaeil, SARABI ASIABAR ALI, REZAPOUR AZIZ, AZAMI AGHDASH SABER, Hosseini Amnab Hassan. Out-of-pocket and informal payments in Iran's health care system: A systematic review and meta-analysis. MEDICAL JOURNAL OF THE ISLAMIC REPUBLIC OF IRAN (MJIRI)[Internet]. 2017;31(1):0-0. Available from: https://sid.ir/paper/294786/en

    IEEE: Copy

    Seyed Abbas Mirabedini, Seyed Mohammad Esmaeil Fazl Hashemi, ALI SARABI ASIABAR, AZIZ REZAPOUR, SABER AZAMI AGHDASH, and Hassan Hosseini Amnab, “Out-of-pocket and informal payments in Iran's health care system: A systematic review and meta-analysis,” MEDICAL JOURNAL OF THE ISLAMIC REPUBLIC OF IRAN (MJIRI), vol. 31, no. 1, pp. 0–0, 2017, [Online]. Available: https://sid.ir/paper/294786/en

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