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Hospitalization Costs of Breast Cancer Before and After the Implementation of the Health Sector Evolution Plan (Hsep), Iran, 2017: A Retrospective Single-Centre Study Publisher



Afkar A1 ; Heydari S2 ; Jalilian H3, 4 ; Pourreza A5 ; Emami Sigaroudi A6
Authors
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Authors Affiliations
  1. 1. Social Determinants of Health Research Center, School of Health, Guilan University of Medical Sciences, Rasht, Iran
  2. 2. School of Public Health, Guilan University of Medical Sciences, PO Box: 3391, Rasht, Iran
  3. 3. Iranian Center of Excellence in Health Management, School Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
  4. 4. Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  5. 5. School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Source: Journal of Cancer Policy Published:2020


Abstract

Background: An important objective of health systems is financial protection against out-of-pocket health expenditure. In Iran, the Health Sector Evolution Plan (HSEP) has been implemented so as to achieve universal health coverage and decrease out-of-pocket health expenditure as a percentage of total health expenditure. Objectives: This study aimed to compare the hospitalization costs of breast cancer before and after the implementation of the HSEP and its impact on patient co-payment in Iran (2017). Methods: This study was a prevalence-based cost-of-illness study. A total of 151 patients (75 patients 3 years before and 76 patients 3 years after HSEP implementation) were included from a public hospital by the census method. Data were extracted from patients’ records and analyzed using SPSS software (Version 22). Results: The total mean hospitalization costs increased significantly after the implementation of HSEP. Before and after the implementation of HSEP the total means (SDs) of hospitalization costs were estimated at 1489.44 (1609.33) PPP (purchasing power parity) and 4343.69 (5389.51) PPP, respectively. The percentage of patient co-payment decreased from 19.61% before the implementation of HSEP to 6.47% after its implementation, whereas the mean (SD) of patient contributions increased from 272.26 (334.50) PPP before the implementation of HSEP to 281.13 (307.22) PPP after its implementation. Conclusion: The cost of breast cancer is substantial. After the implementation of HSEP, the percentage of patient co-payment decreased, but due to the increase in tariffs, hospitalization costs of breast cancer and the amount paid by a patient rose substantially. HSEP certainly requires more attention from health policy-makers. © 2020
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