| چکیده انگلیسی مقاله |
Introduction: Health is a fundamental and indisputable right of every human being and is considered as an important factor in the socio-economic field. Health can be used as a starting point for social change and for achieving a high-priority objective such as justice. The impact of poverty and inequality mechanism in the field of health is so that the economic inequalities cause inequality in accessing the health services by making a social slope. Therefore, the importance and necessity of studying factors affecting health inequalitiesis due to the fact that health is a universal right. Therefore, the purpose of this study is to examine the socioeconomic factors causing health inequality as well as the current situation of each of the variables in Iranian society. Because Justice is one of the main principles of ethics in the healthcare system, and its establishment at macro level depends on formulation of appropriate policies by policy-makers and healthcare providers. Health care policies and payment and reimbursement systems have a significant impact on health systems'efficiency and cost control. BecauseEquity in health implies that all the individuals who need healthcare services must be able to access them timely and adequately.Inequality in health expenditures depend on some predisposing variable that were shown in this study and with improving socio-economic variable can reduce the inequality in health expenditures and their impoverishment effects. Method: This is a descriptive-analytic study. In terms of purpose, this study is an applied study. In addition to illustrating what is, explaining and explaining the reasons for its existence and why the problem's situation and its dimensions have been addressed. To explain and justify the reasons, it has been used as the basis of reasoning in the literature and theoretical discussions of the research.The data collection method used in this study is library and documentary method. The data and the Ministry of Cooperatives, Social Welfare and theMinistry of Health and Medical Education, the search for books, journals and articles and researchare used. Findings: Based on the results, there is a significant and negative relationship between absolute poverty, health extremely high expenditures, poverty caused by health extremely high expenditures, inflation, Gini coefficient, urbanization, unemployment as independent variables and equity in health as a dependent variable. In other words, by increasing one indicator, another index value is reduced. There is also a positive and significant relationship between education and economic participation rates. The findings indicate that the socioeconomic status of individuals and macroeconomic components of health of individuals is overshadowed by them. As well as Our findings indicate an acceptable improvement in many of the health indicators in rural areas of Iran during the recent 1-2 decades. On the other hand, despite the inequality decrease in some of the indicators in recent years, still inequality remains as the chronic and main problem of rural health system in Iran. Discussion: Regarding the results achieved in the field of health, the increase in cost of health systems due to the expansion of new and expensive health technologies, the increase in community expectations regarding the health systems and the growth of chronic diseases cause significant growth in health expenditure of the households. Some of the problems of the health filed are structural and some others are caused by sectors outside the health filedand health macro policies. There is no doubt that none of the payment and reimbursement policies is perfect and each of them has the potential to put caregivers or health care providers financially at risk. Therefore, policy-makers should select a combination of the best approaches, considering socioeconomic factors, in order to provide a maximum coverage of health services and ensure fairness in the health system. Efficient payment and reimbursement approaches should undoubtedly preserve the rights of all parties in a fair and logical manner. Current national policy shows that a high percent of health care expenditures are financed through out-of-pocket payments, and therefore appropriate policies should be adopted to lighten this burden. Herefore, promotion of health in deprived and vulnerable people through appropriate programs for these groups of the population, reducing the gap between poor and rich communities in the community and creating a positive health slope for all social and economic strata should be considered by the government. The actual commitment of the authorities Health as a social goal and considering it as an important component of development can be a cause of success in the health of individuals and society. |