Estimation of Out-of-Pocket and Catastrophic Expenditures among Patients with Cardiovascular Diseases in Khuzestan

Abstract

Background and Aim: The World Health Organization (WHO) has placed special emphasis on the protection of families against the costs of health services. Patients suffer not only from the burden of a disease, but also from the burden of their health costs. The aim of this study was to estimate out-of-pocket costs and to identify the factors that affect catastrophic expenditures among patients with cardiovascular diseases in Khuzestan Province. Materials and Methods: In this descriptive-analytic study, 100 cardiovascular patients having referred to educational hospitals in Ahwaz, Khuzestan Province, were considered. Out-of-pocket costs were estimated and using Econometrics Logit model, factors affecting catastrophic expenditures among households were identified. All analyses were performed using SPSS and Stata. Results: The average out-of-pocket cost was 16,008,936 rials per patient during one year. Also, 55% of patients faced with catastrophic expenditures. Income level and family size had a significant negative impact; however, patients’ employment status had a positive but insignificant effect on catastrophic expenditures. Conclusion: Hospital inpatient expenses and drug costs cover most of out-of-pocket expenditures and should be considered by policymakers. By increasing the income level and family size, families will encounter catastrophic expenditures less. The out-of-pocket costs among patients with cardiovascular diseases can be reduced by boosting the insurance coverage and government help.

Keywords

• out of pocket
• catastrophic expenditures
• logit model
• cardiovascular disease