Household catastrophic health expenditure

Fairness in financial contribution for health was determined by WHO [World Health Report, 2000] as the third goal of health systems which is measured by fairness in financial contribution index [FFCI]. The aim of this study was to estimate FFCI and quantify extent of catastrophic household heath expenditures. We conducted a descriptive study during May 2008. Subjects were chosen by "Systematic Random sampling" among residents of Maskan's population-based research center [Maskan Center] in Kermanshah, Iran. After completing informed consent form, we collected data using a questionnaire by interview with head of family. In order to describing data and estimating FFCI, we used descriptive statistics and WHO methodology, respectively. Households with catastrophic expenditures and impoverished households were defined as those with health expenditures over 40% and 50% of their ability to pay, respectively. The mean age of head of families was 48.96 +/- 12.86 years. From 189; 12.7% of household's heads were female. 75.1% of households were covered by at least one health insurance scheme. FFCI was 0.57. The proportion of households facing catastrophic health expenditures was 22.2% [95% CI=16.3%-28.1%]. The rate of FFCI among participants implied an inequality in health financing contribution. In addition, many of households [22.2%] faced catastrophic health expenditures while according to WHO estimation, the figure in the whole country was 2% in 1999. Our study revealed the importance of protecting households against the costs of ill-health

[Achieving the goals of integration of medical education and health service delivery systems from the viewpoint of the faculty members of Kermanshah university of medical sciences]

Plan of integration of the schools of medicine and health systems was approved in 1985. Considering the importance of the opinion the faculty members on achieving success on this issue, we decided to perform this study. We used a questionnaire consisted of 27 questions in various fields. Also the questions were categorized in the education, research, treatment, health and social fields. After completing the questionnaire, score of every question was determined. According to demographic information of the participants, scores of the different fields and also between different fields were analyzed by means of ANOVA, Friedman and paired T test. From the viewpoint of the faculty members, achievement of the goals of integration on the average was 52.37 +/- 1.07 [Mean +/- SEM] percent of the maximum scores. The highest scores belonged to health services and health indicators [59.87% +/- 1.21] and the least scores were related to research facilities and activities and social purposes of integration plan [49.19% +/- 1.20] [P=0.0001]. From the viewpoint of the faculty members, success in achieving integration plan goals is still far from ideal state. Success of this plan in the health field was significantly higher than that of education and treatment fields. Also the success of this plan in the research and social fields [such as changing the sociological insight of the graduates and faculty members] was significantly lower, compared with the other fields. These differences may be due to a failure in the current system to achieve some of its goals. Similar studies on this subject, in other centers are recommended