MAGNITUDE OF CATASTROPHIC HEALTH EXPENDITURE & ASSOCIATED FACTORS AMONG CHRONIC ILL PATIENTS ATTENDING IN DEBRETABOR REFERRAL HOSPITAL, DEBRE TABOR, NORTHWEST ETHIOPIA, 2024

Abstract

Background: Protection of households from financial risk as a result of seeking healthcare is one of the fundamental goals of universal health coverage. Out of pocket health expenses create barriers to healthcare utilization and exposes households to financial catastrophe. Households with chronically ill members face higher financial risks because of the long-term need for healthcare. Objective: the purpose of this study was to assess magnitude of catastrophic healthcare expenditure and associated factors among chronic patients attending in Debre tabor referral hospital, Debre tabor, Ethiopia. Methods: An institutional cross-sectional study was conducted from March 12 to June 2024, involving 359 chronic follow-up patients who were interviewed using a structured questionnaire. Participants were selected through systematic random sampling, and data quality was ensured through careful design and pre-testing of the questionnaires. Data were collected using Epicollect5 and analyzed with SPSS version 26 and Microsoft Excel for binary logistic regression. The relationship between independent and dependent variables was assessed using bivariable and multivariable logistic regression, with statistical significance set at a p-value of less than 0.05. Results: The study revealed that 37% of chronic disease patients experienced catastrophic healthcare expenditure (CHE). Key findings included: Patients with a family size greater than five were 1.96 times more likely to incur CHE compared to those with five or fewer family members (AOR=1.96; 95% CI: 1.07-3.60). Individuals without health insurance were 2.19 times more likely to experience CHE than those with insurance (AOR=2.19; 95% CI: 1.33-3.60). Participants with comorbid illnesses were 2.31 times more likely to incur CHE compared to those without comorbidities (AOR=2.31; 95% CI: 1.43-3.73). Conclusion: The study found a high prevalence of catastrophic healthcare expenditure (CHE) among chronic disease patients, with significant associations linked to family size, health insurance status, and comorbid illnesses. Health insurance provided crucial financial protection against CHE. The findings suggest that the Ethiopian government should enhance health insurance implementation for chronic patients and develop supportive strategies for those with larger families and comorbid conditions