ORIGINAL RESEARCH
Catastrophic Health Expenditure among Chronic
Patients Attending Dessie Referral Hospital,
Northeast Ethiopia
This article was published in the following Dove Press journal:
ClinicoEconomics and Outcomes Research
Yohannes Shumet
1
Solomon Ahmed Mohammed
2
Mesfn Haile Kahissay
2
Birhanu Demeke
2
1
Department of Pharmacy, College of
Medicine and Health Science, Debre
Tabor University, Debre Tabor, Ethiopia;
2
Department of Pharmacy, College of
Medicine and Health Science, Wollo
University, Dessie, Ethiopia
Background: Catastrophic health expenditure is health spending that is not covered by a
health-care plan. These costs tend to escalate over time, due to chronic illnesses. Catastrophic
health expenditure leads to decreased use of health services and poorer treatment outcomes.
This study measured the extent of and factors associated with catastrophic health expenditure
among chronically ill patients attending Dessie Referral Hospital in northeast Ethiopia.
Methods: An institution-based cross-sectional study design was used to quantify cata-
strophic health expenditure among 302 chronically ill patients from May 25, 2018 to June
30, 2018. A stratifed sampling technique was used to select the study participants.
Descriptive and inferential statistics were computed using SPSS 20.
Results: Catastrophic health expenditure was found in 194 (64.2%, 95% CI 58.8%–70.5%)
of chronic patients. Costly service (151, 50%), transport (104, 34.4%), and pharmaceuticals
(189, 62.6%) were the reasons for catastrophic health expenditure among chronic patients.
Factors associated with catastrophic health expenditure were age <30 years (AOR 7.74, CI
0.94–63.62; P=0.01), patient monthly income <Br1,068 (AOR 203.47, CI 34.72–41.70;
P=0), being single (, AOR 0.2, CI 0.02–1.4; P=0.04), familymonthly income <Br1,068
(AOR 0.02, CI 0–0.47; P=0), laboratory examinations (, AOR 1.54, CI 0.23–10.41;
P=0.04), and transport, food, and lodging (AOR 0.05, CI 0.00–0.52; P=0.01).
Conclusion: Two-thirds of chronic patients had catastrophic health expenditure. Starting
and strengthening various health-insurance schemes will make chronic-care services more
accessible and affordable.
Keywords: chronic illness, out-of-pocket, health expenditure
Background
Catastrophic health expenditure is health spending that is not covered by a health-
care plan, neither private health insurance nor a public health scheme.
1
If the
fnancing of health care becomes more dependent on out-of-pocket payments, the
burden imposed on those who use the services regularly is higher.
2
The proportion of households facing catastrophic health expenditure varies
widely among countries.
3
One in six American families with disabled or elderly
members experience high out-of-pocket health-care spending. These costs tend to
escalate over time, due to chronic illnesses. For low-income families, 25% ospend
>5% of their total household income on medical care services.
2
The proportion of
Turkish households with catastrophic health expenditure was 0.6%, and average
out-of-pocket health payments were US$7.36.
4
Correspondence: Solomon Ahmed
Mohammed
Tel +251-91-050-4378
Email ahmedsolomon21@gmail.com
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ClinicoEconomics and Outcomes Research 2021:13 99–107
99
http://doi.org/10.2147/CEOR.S291463
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