Analyzing the Socioeconomic Factors Influencing Household Expenditures on Medical Equipment and Supplies in Iran

Abstract

Background: The World Health Organization emphasizes the critical role of medical equipment in patient care, noting an increasing demand due to population growth and aging. This study explores the factors influencing out-of-pocket (OOP) payments for medical equipment, examining both households that have made payments and those unable to do so due to financial or geographical limitations. Objectives: The present study aims to explore the factors influencing OOP payments among households that have made payments for medical equipment and supplies, as well as those that could not due to financial and geographic constraints. Methods: This cross-sectional study was conducted in two stages, utilizing household budget data from 2023. In the first stage, the Delphi method was employed to reach a consensus among experts on the influencing factors. In the second stage, a double hurdle model was used to assess the impact of these factors on household expenditures. Analyses were conducted using Excel 2019 and Stata 14 software, with a significance level set at 0.05 for all tests. Results: In the third round of the Delphi method, a panel identified 13 factors affecting household OOP expenditures based on a study of 37,883 predominantly urban, male-headed households. Gamma regression indicated that income and health insurance costs slightly increased health expenditures. The double hurdle model revealed that the gender of the household head significantly influenced participation in medical equipment payments, with female-headed households experiencing a negative impact (B = -0.117, P < 0.05). Conclusions: This study demonstrated that socioeconomic factors such as income, health insurance, gender of the household head, and rural residence significantly affect both the decision to participate in the healthcare market and the level of expenditures on medical equipment and supplies. These findings highlight the need for targeted policies to enhance equity in health financing.