Catastrophic Health Expenditure and Associated Factors Among Hospitalized Cancer Patients in Addis Ababa, Ethiopia.

Ethiopia cancer catastrophic out-of-pocket health expenditure coping mechanisms

Journal

Risk management and healthcare policy
ISSN: 1179-1594
Titre abrégé: Risk Manag Healthc Policy
Pays: England
ID NLM: 101566264

Informations de publication

Date de publication:
2024
Historique:
received: 10 09 2023
accepted: 01 03 2024
medline: 18 3 2024
pubmed: 18 3 2024
entrez: 18 3 2024
Statut: epublish

Résumé

Out-of-pocket (OOP) health expenditures for cancer care expose households to unanticipated economic consequences. When the available health services are mainly dependent on OOP expenditure, the household faces catastrophic health expenditure (CHE). This study aimed to estimate the incidence and intensity of CHE in hospitalized cancer patients and identify coping strategies and associated factors. Hospital-based cross-sectional study design was conducted on 305 cancer inpatients in Addis Ababa between November 2021 and February 2022. All patients with cancer who were hospitalized during the data collection period were included in the study. The incidence of CHE was estimated at the 40% threshold of households' non-food expenditure and the intensity of CHE was captured based on the amount by which household expenditure exceeded the threshold and mean positive overshoot, the mean level by which CHE exceeds the threshold used. Multivariate logistic regression was used to assess the relationship between CHE levels and the independent variables. The incidence of CHE at the 40% threshold of households' non-food expenditure was 77.7%, while the O and MPO were 36.2% and 46.6%, respectively. CHE for cancer care was significantly associated with patient residence, increased number of chemotherapy cycles, increased duration of hospital admission, lack of insurance enrolment, and lower-income quintiles. Saving and selling assets were identified as the primary coping mechanisms. The incidence and intensity of CHE among inpatients with cancer were high and which could lead to impoverishment of households. Improved quality and coverage of health insurance and decentralizing cancer care to regions standards similar to Addis Ababa will save households from incurring CHE.

Sections du résumé

Background UNASSIGNED
Out-of-pocket (OOP) health expenditures for cancer care expose households to unanticipated economic consequences. When the available health services are mainly dependent on OOP expenditure, the household faces catastrophic health expenditure (CHE). This study aimed to estimate the incidence and intensity of CHE in hospitalized cancer patients and identify coping strategies and associated factors.
Method and Material UNASSIGNED
Hospital-based cross-sectional study design was conducted on 305 cancer inpatients in Addis Ababa between November 2021 and February 2022. All patients with cancer who were hospitalized during the data collection period were included in the study. The incidence of CHE was estimated at the 40% threshold of households' non-food expenditure and the intensity of CHE was captured based on the amount by which household expenditure exceeded the threshold and mean positive overshoot, the mean level by which CHE exceeds the threshold used. Multivariate logistic regression was used to assess the relationship between CHE levels and the independent variables.
Results UNASSIGNED
The incidence of CHE at the 40% threshold of households' non-food expenditure was 77.7%, while the O and MPO were 36.2% and 46.6%, respectively. CHE for cancer care was significantly associated with patient residence, increased number of chemotherapy cycles, increased duration of hospital admission, lack of insurance enrolment, and lower-income quintiles. Saving and selling assets were identified as the primary coping mechanisms.
Conclusion UNASSIGNED
The incidence and intensity of CHE among inpatients with cancer were high and which could lead to impoverishment of households. Improved quality and coverage of health insurance and decentralizing cancer care to regions standards similar to Addis Ababa will save households from incurring CHE.

Identifiants

pubmed: 38496370
doi: 10.2147/RMHP.S434075
pii: 434075
pmc: PMC10941663
doi:

Types de publication

Journal Article

Langues

eng

Pagination

537-548

Informations de copyright

© 2024 Matebie et al.

Déclaration de conflit d'intérêts

The authors have declared that they have no conflicts of interest in this work.

Auteurs

Girum Yihun Matebie (GY)

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Global Health Working Group, Medical Faculty Martin-Luther-University Halle-Wittenberg, Wittenberg, Germany.

Anagaw Derseh Mebratie (AD)

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Tamiru Demeke (T)

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Global Health Working Group, Medical Faculty Martin-Luther-University Halle-Wittenberg, Wittenberg, Germany.

Bezawit Afework (B)

Department of Midwifery, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.

Eva J Kantelhardt (EJ)

Global Health Working Group, Medical Faculty Martin-Luther-University Halle-Wittenberg, Wittenberg, Germany.

Adamu Addissie (A)

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Global Health Working Group, Medical Faculty Martin-Luther-University Halle-Wittenberg, Wittenberg, Germany.

Classifications MeSH