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IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01
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引用次数: 0
Disparities in Out-of-Pocket Expenditures Among Hospitalized Patients With COVID-19 in Iran: A Decomposition Analysis of Inequality 伊朗新冠肺炎住院患者自费支出差异：不平等的分解分析
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01 DOI: 10.1016/j.vhri.2025.101093
Ahmad Dehghani_Ahmadabad PhD, Sayyed Morteza Hosseini Shokouh PhD, Parisa Mehdizadeh PhD, Mohammad Meskarpour Amiri_Ara PhD

Objectives

Limited information is available on the extent of inequality in out-of-pocket (OOP) expenditures among patients with COVID-19 in Iran and the factors contributing to this disparity. This study aimed to examine the inequality in OOP expenditures among hospitalized patients with COVID-19 and identify the associated factors.

Methods

This study used the Gini coefficient as the primary measure of inequality in OOP expenditures among hospitalized patients with COVID-19. The analysis was conducted using Stata 16 software, supplemented by the Distributive Analysis Stata Package extension. The Gini coefficient was calculated to quantify the degree of inequality and was visualized using graphs. To examine the Gini coefficient across population subgroups, a Distributive Analysis Stata Package extension, the diginig module, was used.

Results

Analysis of the Lorenz curve and the calculated Gini coefficient (0.69) confirmed the presence of inequality in OOP expenditures among hospitalized patients with COVID-19. Additionally, examination of inequality across population subgroups revealed that insurance status and type, clinical characteristics, and temporal patterns of hospitalization significantly contributed to the observed disparities in OOP expenditures among patients with COVID-19.

Conclusions

This study highlights the enduring impact of insurance status, clinical characteristics, and temporal patterns of hospitalization on the financial burden. The findings emphasize the need for targeted interventions to reduce financial barriers and promote equitable access to care, thus offering important insights for managing future public health crises.
目标：关于伊朗COVID-19患者自费支出不平等的程度以及造成这种差异的因素，现有信息有限。本研究旨在探讨COVID-19住院患者OOP支出的不平等，并确定相关因素。方法：本研究采用基尼系数作为衡量COVID-19住院患者OOP支出不平等的主要指标。分析使用Stata 16软件进行，并辅以分布式分析Stata包扩展。基尼系数的计算是为了量化不平等的程度，并使用图形可视化。为了检验人口亚群之间的基尼系数，使用了分布分析软件包扩展，即数字模块。结果：Lorenz曲线分析和计算的基尼系数（0.69）证实了COVID-19住院患者的OOP支出存在不平等。此外，对人口亚组之间不平等的检查显示，保险状况和类型、临床特征和住院时间模式显著导致了观察到的COVID-19患者OOP支出差异。结论：本研究强调了保险状况、临床特征和住院时间模式对经济负担的持久影响。研究结果强调需要采取有针对性的干预措施，以减少财政障碍和促进公平获得医疗服务，从而为管理未来的公共卫生危机提供重要见解。
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引用次数: 0
Public Preferences for Reducing Health Inequality in Japan: A National Survey 日本公众对减少健康不平等的偏好：一项全国性调查。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES
Value in health regional issues
Pub Date : 2026-01-01 DOI: 10.1016/j.vhri.2025.101111
Kyoko Shimamoto PhD , Tim Doran PhD , Richard Cookson PhD

Objectives

Making health programs more equitable sometimes reduces their health benefit per unit of cost. Policy makers therefore need to understand public preferences for reducing health inequalities; however, this evidence has been restricted to Europe, with no estimates available in Asia. Thus, this study aimed to gauge health inequality aversion in Japan in comparison with the UK populations.

Methods

National online survey of Japanese adults (aged 18-69), using a Japanese version of a UK benefit trade-off questionnaire, involving pairwise policy choices with different levels of health benefit and inequality. Attitudes toward reducing health inequality were classified using the same approach as the original UK study. Regression analyses were conducted to explore heterogeneity by age, gender, income, education, and geographic region.

Results

On average, respondents in the analytic sample (n = 473) weighed health gains to the poorest fifth of people approximately 6 times more highly than health gains to the richest fifth; 76.9% had positive health inequality aversion. Health inequality aversion was higher in the poorest fifth of respondents and in the northern region of Japan, but otherwise was not closely correlated with other characteristics. There was a higher proportion of invalid responses in Japan (67.9%) than the United Kingdom (47.0%).

Conclusions

Most people in Japan appear willing to forgo gains in total population health to reduce health inequality, such as in the United Kingdom. However, more research is needed to understand the high rate of inconsistent responses to the online version of this questionnaire, which was even higher in Japan than in the United Kingdom.
目标：使卫生项目更加公平有时会降低单位成本的卫生效益。因此，决策者需要了解公众对减少卫生不平等的偏好；然而，这一证据仅限于欧洲，在亚洲尚无估计数据。因此，本研究旨在衡量日本人对健康不平等的厌恶程度，并将其与英国人进行比较。方法：对日本成年人（18-69岁）进行全国在线调查，使用日本版的英国福利权衡问卷，涉及不同健康福利和不平等水平的两两政策选择。对减少健康不平等的态度采用与最初英国研究相同的方法进行分类。进行回归分析，探讨年龄、性别、收入、教育程度和地理区域的异质性。结果：平均而言，分析样本中的答复者（n = 473）认为最贫穷的五分之一人口的健康收益比最富有的五分之一人口的健康收益高约6倍；76.9%的人厌恶健康不平等。在最贫穷的五分之一受访者和日本北部地区，对健康不平等的厌恶程度更高，但除此之外，与其他特征的关系并不密切。无效应答的比例在日本（67.9%）高于英国（47.0%）。结论：大多数日本人似乎愿意放弃在总人口健康方面的收益，以减少健康不平等，例如在英国。然而，需要更多的研究来理解对该在线问卷的不一致回答的高比率，这在日本甚至比在英国更高。
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