The COVID‐19 Pandemic Economic Implications in Iran: A National Survey Assessing Catastrophic Health Expenditures

<b>Introduction:</b> The COVID-19 pandemic caused many financial crises in households worldwide. This study aimed to quantify the COVID-19-related catastrophic costs (CCC) in Iran during the pandemic. <b>Methods:</b> In this national survey, a total of 2006 households from 10 provinces of Iran were selected using a multistage random cluster sampling. The data were collected on COVID-19 prevention, inpatient, outpatient, and income loss costs, and the household income and wealth information using a validated researcher-constructed questionnaire in 2022. We calculated the probability of the CCC with and without coping strategies. We analyzed data using logistic regression models and estimated the CCC for other provinces using the 2021 Household Income and Expenditures Survey. <b>Results:</b> The CCC was 3.19% with coping strategies and 5.38% without coping strategies. The CCC positively correlated with the COVID-19 inpatient (<i>β</i> = 2.324, 95% CI [1.65 to 2.997]) and outpatient (<i>β</i> = 1.797, 95% CI [1.165 to 2.430]) service utilization. Access to the basic (<i>β</i> = -0.687, 95% CI [-1.248 to -0.109]) and complementary (<i>β</i> = -1.201, 95% CI [-2.612 to 0.210]) health insurance decreased the risk of the CCC. The highest and lowest probabilities of estimated CCC were observed in Sistan and Baluchistan (8.57%) and Tehran (2.1%) provinces, respectively. <b>Conclusion:</b> The COVID-19 pandemic imposed an additional financial burden on households. The pandemic provided important lessons for health policymakers about the effectiveness of the health financing protection system during the crisis and the scarcity of health resources. Supply and demand of services are unbalanced in the outbreaks, and insurance systems might fall into failure due to the shortage of services, black markets, and price inflation.

Authors

Institutions

Publication Details

Journal
Interdisciplinary Perspectives on Infectious Diseases
Published
2025-01-01
DOI
https://doi.org/10.1155/ipid/8854646
Primary Topic
Healthcare Systems and Reforms
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

The COVID‐19 Pandemic Economic Implications in Iran: A National Survey Assessing Catastrophic Health Expenditures

Mandana Saki, Hakimeh Mostafavi, Mohammad Hajizadeh, Bakhtiar Piroozi et al.
Interdisciplinary Perspectives on Infectious Diseases
Healthcare Systems and Reforms
article

The COVID‐19 Pandemic Economic Implications in Iran: A National Survey Assessing Catastrophic Health Expenditures

Mandana Saki, Hakimeh Mostafavi, Mohammad Hajizadeh, Bakhtiar Piroozi, Enayatollah Homaie Rad, Mahmood Karimy, Shahrokh Yousefzadeh-Chabok, Masoud Lotfizadeh, Hedayat Salari, Sajad Delavari, Hamed Zandian, Vahid Yazdi‐Feyzabadi, Leila Kouchakinejad–Eramsadati, Atefeh Esfandiari, Reza Esmaeili, Fatemeh Keihanian, Masoud Arefnezhad
article en

Abstract

<b>Introduction:</b> The COVID-19 pandemic caused many financial crises in households worldwide. This study aimed to quantify the COVID-19-related catastrophic costs (CCC) in Iran during the pandemic. <b>Methods:</b> In this national survey, a total of 2006 households from 10 provinces of Iran were selected using a multistage random cluster sampling. The data were collected on COVID-19 prevention, inpatient, outpatient, and income loss costs, and the household income and wealth information using a validated researcher-constructed questionnaire in 2022. We calculated the probability of the CCC with and without coping strategies. We analyzed data using logistic regression models and estimated the CCC for other provinces using the 2021 Household Income and Expenditures Survey. <b>Results:</b> The CCC was 3.19% with coping strategies and 5.38% without coping strategies. The CCC positively correlated with the COVID-19 inpatient (<i>β</i> = 2.324, 95% CI [1.65 to 2.997]) and outpatient (<i>β</i> = 1.797, 95% CI [1.165 to 2.430]) service utilization. Access to the basic (<i>β</i> = -0.687, 95% CI [-1.248 to -0.109]) and complementary (<i>β</i> = -1.201, 95% CI [-2.612 to 0.210]) health insurance decreased the risk of the CCC. The highest and lowest probabilities of estimated CCC were observed in Sistan and Baluchistan (8.57%) and Tehran (2.1%) provinces, respectively. <b>Conclusion:</b> The COVID-19 pandemic imposed an additional financial burden on households. The pandemic provided important lessons for health policymakers about the effectiveness of the health financing protection system during the crisis and the scarcity of health resources. Supply and demand of services are unbalanced in the outbreaks, and insurance systems might fall into failure due to the shortage of services, black markets, and price inflation.

Interdisciplinary Perspectives on Infectious DiseasesVol. 2025(1)
Dalhousie University (CA), Iran University of Medical Sciences (IR), Shahrekord University of Medical Sciences (IR), University of the West of England (GB), Shiraz University of Medical Sciences (IR), Guilan University of Medical Sciences (IR), Kerman University of Medical Sciences (IR), Zabol University of Medical Sciences (IR), Lorestan University of Medical Sciences (IR), Kurdistan University of Medical Sciences (IR), Ardabil University of Medical Sciences (IR), Gonabad University of Medical Sciences (IR), Saveh University of Medical Sciences (IR), Bushehr University of Medical Sciences (IR), Tehran University of Medical Sciences (IR)
National Institute for Medical Research Development
No poverty
Openalex Percentile: Top 76%
Healthcare Systems and Reforms
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.