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Background: Health care spending by households can be a great indicator of a society's commitment to good health stewardship and the efficiency of institutions responsible for managing health costs. Equitable and appropriate distribution of dental services is a challenging issue for realising universal health coverage. This study aimed to evaluate Iranian households’ per capita dental expenditure (DE) according to their socioeconomic status (SES). Methods: In this cross-sectional study, the income and expenditure of 18,701 urban and 19,261 rural households in Iran were scrutinised according to the data provided by the Statistics Center of Iran (2017-2018). After model creation, the SES index was determined using principal component analysis and weighting based on the analytical hierarchy process. The dependent variable was the share of per capita household's expenditure spent on dental health. The zero-inflated gamma regression model was applied to confirm the presumed association between per capita DE and SES. Analyses were performed using PROC NLMIXED in SAS software (version 4.9). Results: The results revealed that approximately 9% of urban and 4% of rural households paid for dental treatments in the past month. The DE to total health expenditure (HE) ratios were 8.5% and 14.8% for rural and urban households, respectively. Also, with each level increase in SES, the average per capita DE increased by 23% and 16% in rural and urban households, respectively. Conclusions: The study confirms association between per capita DE and SES in Iran. This implies targeted strategies to facilitate the utilisation of dental care especially for lower SES groups according to their needs.

Background: Socioeconomic status (SES) is a criterion consisting of several components that encompass socioeconomic and cultural dimensions. This study aimed to design and develop a methodological guideline for calculating a single summary index (SSI) using the contributing variables of SES in a family unit.Methods: The data consisted of 18 700 urban and 19 200 rural households. Effective components of SES were extracted using two-step factor analysis and the structural equational modeling (SEM) method for both populations separately with AMOS software. Then, in order to customize and validate the weight of each component, the analytic hierarchy process (AHP) method was performed by a panel of experts. Finally, the SES index computational tool was developed as an SSI using all effective components by Excel software. Statistical analysis was done with SPSS software version 21.Results: In rural areas, the four wealth components of education, job, income, and family size were recognized as effective socioeconomic factors. Yet, in urban areas, family size was disregarded as an effective factor. In both rural and urban communities the three welfare components of appropriate nutrition, appropriate home appliance, and appropriate housing were similarly effective. The SES of rural population had a homogeneous distribution, while urban population did not follow a particular trend.Conclusion: The SES index impacts all aspects of life, especially health status. The introduced method is comprehensive and applicable to both rural and urban populations. Due to ever-changing lifestyles, constant technological advances, and socio-political changes in each society, the tool requires modification in a specific time intervals.

Abstract Objective The socioeconomic status (SES) is as a symbol of social determinants of health which has a dominant influence on population health. The purpose of this study was collecting, weighing, and determining the most relevant SES measurement items in Iran. Results The SES health studies conducted in Iran was searched from 2007 to 2017. First, the SES items were categorized. Then, each item was weighed based on its reliability and generalizability. Finally, the necessity of items was determined, weighed, and ranked. This is the two-round Delphi technique. After weighing 57 SES items, 37 items were selected with ≥ 1 weight and classified in 7 categories. According to the Delphi evaluation, 15 items were identified ≥ 3.5 for measuring SES of Iranian households: household size, head of household education, head of household job, household monthly income, type of school that children attend, house ownership, local value of residence, number of rooms in the house, house area, personal computer/laptop, smart cell phone, 3D TV, dishwasher, microwave, and car ownership. The SES items for the present society are categorized in 7 domains. The items collected in this study have the most comprehension of all studies related to income, life facilities, and assets.