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Abstract

Background: Physiotherapy services are important because they help disabled patients to return to work and other social activities. High out-of-pocket payments of physiotherapy services are one of the major barriers to the utilization of these services. In 2014 a reform was implemented in Iran named as Health Transformation Plan aimed to improve Universal Health Coverage of Iranians. We tried to find the effects of HTP on the financial outcomes of physiotherapy services.

Method: Data of Iranian Household Income and Expenditures Survey (IHIES) before and after HTP was used in this study. Out of Pocket payments and utilization of physiotherapy services and facing catastrophic expenditures were compared using a propensity score matching estimator. Inequity indices were compared using concentration indices and curves.

Results: Out-of-pocket payments did not change significantly after the plan, however, utilization of physiotherapy services decreased significantly (coefficient= -0.00188, P-value=0.032). Inequity in out-of-pocket payments improved significantly after HTP (P-value=0.000), whoever inequity in the utilization of services become worst in favor of the rich (P-value=0.000) and the percentage of households facing catastrophic health expenditures did not change significantly (P-value=0.407).

Conclusion: The health transformation plan, one year after its implementation, did not achieve its goals in terms of utilization and out-of-pocket payments and their inequity in physiotherapy services.

Keywords: Health Equity, Iranian Health Transformation Plan, Out-of-Pocket Payment, Physiotherapy Services

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