Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Azzani, Meram; Roslani, April Camilla; Su, Tin Tin

doi:10.21315/mjms2019.26.1.3

Cited by 83 publications

(96 citation statements)

References 48 publications

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“…Households with members suffering from chronic diseases have a greater possibility of experiencing catastrophic health expenditure than their counterparts, which is consistent in both developed countries and developing countries [23][24] . Under a rapid increasing trend in prevalence of hypertension, to identify the incidence and determinants of CHE for hypertension patients in rural areas, and evaluate the effect of hypertension complications on the incidence, intensity of CHE are of high priority for protecting households with hypertension from financial catastrophe in rural China.…”

Section: Introductionmentioning

confidence: 55%

Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China

Zhang

Guo

et al. 2020

Preprint

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Background: Some previous studies have assessed catastrophic health expenditure (CHE) in households with hypertensive patients, but few have examined the difference of CHE in hypertensive patients with and without complications. The purpose of this study is to compare the incidence and determinants of CHE between hypertensive patients with and without complications. Methods: Data of this study were from a cross-sectional study in Shandong Province in China in 2016. Of the recruited 3,457 hypertensive patients registered in the NCDs management system in the sampling villages, 3,113 completed the survey, with a response rate of 90.05%.CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay (non-food expenditure). Hypertension complications (e.g., stroke, coronary heart disease, hypertensive kidney disease, etc.) were collected in this study, which was categorized into 0 (no), 1(single), and 2 and more according to the types of hypertensive complications. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE. Results: The incidence of CHE and impoverishment is 13.6% and 10.8% among hypertensive patients. The incidence of CHE with one complication is 25.3% ( R =0.000, OR=2.29 ) and 47.3% ( P =0.000, OR=3.60 ) in patients with two or more complications, which are both statistically higher than that in patients without complication (6.1%). Across all types of patients, income levels are inversely related to the incidence of CHE. Patients who use outpatient or inpatient service are more likely to experience CHE ( R =0.000 ). Factors including living arrangements, family size, educational attainment are found to be significantly associated with CHE in some subgroups ( P ＜ 0.05 ). Conclusions: CHE and impoverishment incidence among hypertensive patients are both high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication.More attention needs to be paid to households with hypertension patients, especially for those with hypertension complications.

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Section: Introductionmentioning

confidence: 55%

Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China

Zhang

Guo

et al. 2020

Preprint

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“…This demonstrates the potential effect that the presence of this condition has on the welfare of families. Azzani et al [34] in their study showed that socioeconomic status, incidence of hospitalization, and presence of a family member with a chronic illness were signi cant factors associated with household CHE. In the presence of CHE, families may have to cut down on basic needs like education, feeding, clothing and compromise living standards to cope with the long term cost of healthcare [35,36].…”

Section: Discussionmentioning

confidence: 97%

Caring For Children With Congenital Heart Diseases: Economic Burden Of Pre-Surgical Treatment On Nigerian Families

Duru

Okpokowuruk

Adesina³

et al. 2020

Preprint

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Background Congenital Heart Disease (CHD) places an enormous economic burden on families of affected children in Nigeria. This study sought to determine the healthcare costs of pre-surgical management of CHD and describe its effects on the family’s income.Methods Using a semi-structured interviewer-administered questionnaire, family income, type of CHD, co-morbidity, healthcare payment mechanism and healthcare cost were investigated among 121 families with CHD children. Indicators of Catastrophic Health Expenditure (CHE); healthcare spending in excess of 10% family income were calculated. Factors associated with increased healthcare spending in CHD management were explored using the Kruskal Wallis test of significance.Results Of the 121 parents interviewed, about 80% paid for healthcare using out-of-pocket payment mechanism. Mean annual total cost of healthcare was ₦87,951± ₦120,213 ($244.31± $333.92) with direct medical care accounting for 81.0% of this total annual cost. Mean annual consultation, medication, investigation and admission cost were ₦5,515 ($15.32), ₦57,882 ($160.78), ₦30,462 ($84.62) and ₦87,789 ($243.86) respectively. Mean estimated annual indirect cost was ₦19,233 ± ₦31,722 ($53.42 ± $88.12). Incidence of CHE was 35.5% while catastrophic overshoot and mean positive overshoot attributable to CHD healthcare cost were 6.5% and 32.9% of family income respectively. Healthcare cost was significantly higher in families of children with co-morbidities (p = 0.016) and those who suffered financial catastrophe (p = 0.001). Health insurance did not significantly reduce healthcare spending among the insured.Conclusion The economic burden of pre-surgical management of children with CHD is high in Nigeria. There is the need to scale up the inclusion of CHD under the National health insurance scheme.

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“…A study using a national representative data by Li et al found that the incidence of CHE among the general population in China was 13.0%, which was higher than that in some other low-income countries [23]. Households with members suffering from chronic diseases have a greater possibility of experiencing catastrophic health expenditure than their counterparts, which is consistent in both developed countries and developing countries [23,24]. Under a rapid increasing trend in prevalence of hypertension, to identify the incidence and determinants of CHE for hypertension patients in rural areas, and evaluate the effect of hypertension complications on the incidence, intensity of CHE are of high priority for protecting households with hypertension from financial catastrophe in rural China.…”

Section: Introductionmentioning

confidence: 94%

Catastrophic health expenditure: a comparative study between hypertensive patients with and without complication in rural Shandong, China

Zhang

Guo

et al. 2020

BMC Public Health

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Background: Some previous studies have assessed catastrophic health expenditure (CHE) in households with hypertensive patients, but few have examined the difference of CHE in hypertensive patients with and without complications. The purpose of this study is to compare the incidence and determinants of CHE between hypertensive patients with and without complications. Methods: Data of this study were from a cross-sectional study in Shandong Province in China in 2016. Of the recruited 3457 hypertensive patients registered in the NCDs management system in the sampling villages, 3113 completed the survey, with a response rate of 90.05%.CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay (non-food expenditure). Hypertension complications (e.g., stroke, coronary heart disease, hypertensive kidney disease, etc.) were collected in this study, which was categorized into 0 (no), 1(single), and 2 and more according to the types of hypertensive complications. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE. Results: The incidence of CHE and impoverishment is 13.6 and 10.8% among hypertensive patients. The incidence of CHE with one complication is 25.3% (Ρ = 0.000, OR = 2.29) and 47.3% (P = 0.000, OR = 3.60) in patients with two or more complications, which are both statistically higher than that in patients without complication (6.1%). Across all types of patients, income levels are inversely related to the incidence of CHE. Patients who use outpatient or inpatient service are more likely to experience CHE (Ρ = 0.000). Factors including living arrangements, family size, educational attainment are found to be significantly associated with CHE in some subgroups (Ρ <0.05). Conclusions: CHE and impoverishment incidence among hypertensive patients are both high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication. More attention needs to be paid to households with hypertension patients, especially for those with hypertension complications.

show abstract

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Cited by 83 publications

References 48 publications

Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China

Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China

Caring For Children With Congenital Heart Diseases: Economic Burden Of Pre-Surgical Treatment On Nigerian Families

Catastrophic health expenditure: a comparative study between hypertensive patients with and without complication in rural Shandong, China

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