Shumet Yohannes, Mohammed Solomon Ahmed, Kahissay Mesfin Haile, Demeke Birhanu
Department of Pharmacy, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
Clinicoecon Outcomes Res. 2021 Feb 3;13:99-107. doi: 10.2147/CEOR.S291463. eCollection 2021.
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.
An institution-based cross-sectional study design was used to quantify catastrophic health expenditure among 302 chronically ill patients from May 25, 2018 to June 30, 2018. A stratified sampling technique was used to select the study participants. Descriptive and inferential statistics were computed using SPSS 20.
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; =0.01), patient monthly income <Br1,068 (AOR 203.47, CI 34.72-41.70; =0), being single (, AOR 0.2, CI 0.02-1.4; =0.04), familymonthly income <Br1,068 (AOR 0.02, CI 0-0.47; =0), laboratory examinations (, AOR 1.54, CI 0.23-10.41; =0.04), and transport, food, and lodging (AOR 0.05, CI 0.00-0.52; =0.01).
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.
灾难性卫生支出是指医疗保健计划未涵盖的卫生支出。由于慢性病，这些费用往往会随着时间的推移而增加。灾难性卫生支出导致卫生服务利用减少和治疗效果变差。本研究测量了埃塞俄比亚东北部德西转诊医院慢性病患者中灾难性卫生支出的程度及其相关因素。
采用基于机构的横断面研究设计，对2018年5月25日至2018年6月30日期间的302例慢性病患者的灾难性卫生支出进行量化。采用分层抽样技术选择研究参与者。使用SPSS 20进行描述性和推断性统计分析。
194例（64.2%，95%CI 58.8%-70.5%）慢性病患者存在灾难性卫生支出。昂贵的服务（151例，50%）、交通费用（104例，34.4%）和药品费用（189例，62.6%）是慢性病患者灾难性卫生支出的原因。与灾难性卫生支出相关的因素包括年龄<30岁（调整后比值比[AOR]7.74，可信区间[CI]0.94-63.62；P=0.01）、患者月收入
1,068（AOR 203.47，CI 34.72-41.70；P=0）、单身（AOR 0.2，CI 0.02-1.4；P=0.04）、家庭月收入
1,068（AOR 0.02，CI 0-0.47；P=0）、实验室检查（AOR 1.54，CI 0.23-10.41；P=0.04）以及交通、食品和住宿费用（AOR 0.05，CI 0.00-0.52；P=0.01）。
三分之二的慢性病患者存在灾难性卫生支出。启动并加强各种医疗保险计划将使慢性病护理服务更容易获得且更负担得起。
