Catastrophic Out-of-Pocket Health Expenditure Among Rural Households in the Semi-Pastoral Community, Western Ethiopia: A Community-Based Cross-Sectional Study.
Ethiopia
catastrophic out-of-pocket health expenditure
semi-pastoral community
Journal
ClinicoEconomics and outcomes research : CEOR
ISSN: 1178-6981
Titre abrégé: Clinicoecon Outcomes Res
Pays: New Zealand
ID NLM: 101560564
Informations de publication
Date de publication:
2020
2020
Historique:
received:
08
10
2020
accepted:
22
12
2020
entrez:
7
1
2021
pubmed:
8
1
2021
medline:
8
1
2021
Statut:
epublish
Résumé
Every year, 808 million people face catastrophic health expenditure (CHE), and 122 million people were pushed into poverty. It aggravates healthcare inequalities, incurs double burden opportunity costs, and pushes households to sit in a deep poverty trap. A few studies have been done so far; however, it is not enough to inform policy decisions. Therefore, this study aimed to assess the catastrophic out-of-pocket health expenditure and associated factors among rural households in Mandura District, Western Ethiopia. We conducted a community-based cross-sectional study among the Mandura district's 488 rural households from April to May 2017. We used a multistage systematic sampling technique to select the participants. We fitted a binary logistic regression model to identify the factors associated with catastrophic out-of-pocket health expenditure. We used the adjusted odds ratio (AOR) with 95% CI and the p-value <0.05 to determine the variables associated with catastrophic out-of-pocket health expenditure. Catastrophic health expenditure (CHE) with a 40% capacity to pay (CTP) households in the study area was 22.5%. Female household head (AOR = 2.92; 95% CI: 1.44, 5.93) and household with chronic illnesses (AOR = 3.93; 95% CI: 1.78, 9.14) were positively associated with CHE and, while households who had adult household members (AOR = 0.32; 95% CI: 0.16, 0.63) were negatively associated. The overall CHE, with a 40% CTP threshold, was high. Prevention of chronic illness might help to reduce the burden of the expenditure. Strengthening financial risk protection mechanisms, such as community-based health insurance, could help bring healthcare services equity.
Sections du résumé
BACKGROUND
BACKGROUND
Every year, 808 million people face catastrophic health expenditure (CHE), and 122 million people were pushed into poverty. It aggravates healthcare inequalities, incurs double burden opportunity costs, and pushes households to sit in a deep poverty trap. A few studies have been done so far; however, it is not enough to inform policy decisions. Therefore, this study aimed to assess the catastrophic out-of-pocket health expenditure and associated factors among rural households in Mandura District, Western Ethiopia.
METHODS
METHODS
We conducted a community-based cross-sectional study among the Mandura district's 488 rural households from April to May 2017. We used a multistage systematic sampling technique to select the participants. We fitted a binary logistic regression model to identify the factors associated with catastrophic out-of-pocket health expenditure. We used the adjusted odds ratio (AOR) with 95% CI and the p-value <0.05 to determine the variables associated with catastrophic out-of-pocket health expenditure.
RESULTS
RESULTS
Catastrophic health expenditure (CHE) with a 40% capacity to pay (CTP) households in the study area was 22.5%. Female household head (AOR = 2.92; 95% CI: 1.44, 5.93) and household with chronic illnesses (AOR = 3.93; 95% CI: 1.78, 9.14) were positively associated with CHE and, while households who had adult household members (AOR = 0.32; 95% CI: 0.16, 0.63) were negatively associated.
CONCLUSION
CONCLUSIONS
The overall CHE, with a 40% CTP threshold, was high. Prevention of chronic illness might help to reduce the burden of the expenditure. Strengthening financial risk protection mechanisms, such as community-based health insurance, could help bring healthcare services equity.
Identifiants
pubmed: 33408491
doi: 10.2147/CEOR.S285715
pii: 285715
pmc: PMC7781027
doi:
Types de publication
Journal Article
Langues
eng
Pagination
761-769Informations de copyright
© 2020 Shikuro et al.
Déclaration de conflit d'intérêts
The authors have declared that they have no conflicts of interest for this work.
Références
Int J Equity Health. 2016 Nov 10;15(1):182
pubmed: 27832821
Lancet Glob Health. 2018 Feb;6(2):e169-e179
pubmed: 29248367
Health Econ. 2003 Nov;12(11):921-34
pubmed: 14601155
Iran J Public Health. 2011;40(1):94-9
pubmed: 23113061
BMC Int Health Hum Rights. 2014 Mar 05;14:5
pubmed: 24597486
BMC Health Serv Res. 2015 Jan 22;15:26
pubmed: 25608983
Bull World Health Organ. 2012 Sep 1;90(9):664-71
pubmed: 22984311
PLoS One. 2012;7(12):e52928
pubmed: 23285229
Int J Equity Health. 2015 May 14;14:46
pubmed: 25971679
Lancet Glob Health. 2018 Feb;6(2):e180-e192
pubmed: 29248366
Bull World Health Organ. 2018 Sep 1;96(9):599-609
pubmed: 30262941
Bull World Health Organ. 2014 Oct 1;92(10):760-7
pubmed: 25378730
Int J Health Policy Manag. 2014 Sep 17;3(5):243-9
pubmed: 25337598
J Korean Med Sci. 2016 Mar;31(3):336-44
pubmed: 26955233
Lancet. 2003 Jul 12;362(9378):111-7
pubmed: 12867110
PLoS One. 2015 Aug 13;10(8):e0135051
pubmed: 26270049
Global Health. 2014 Apr 03;10:21
pubmed: 24708831
Int J Equity Health. 2016 Jul 11;15(1):105
pubmed: 27401464
PLoS One. 2014 Apr 08;9(4):e93253
pubmed: 24714605
J Prev Med Public Health. 2019 Jul;52(4):214-223
pubmed: 31390684
Diabetes Metab Syndr Obes. 2020 Aug 18;13:2865-2876
pubmed: 32922053
BMC Health Serv Res. 2013 Dec 05;13:506
pubmed: 24308317