Catastrophic Health Expenditure among Chronic Patients Attending Dessie Referral Hospital, Northeast Ethiopia

BACKGROUND: 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. METHODS: 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. RESULTS: 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; P=0.01), patient monthly income <Br1,068 (AOR 203.47, CI 34.72–41.70; P=0), being single (, AOR 0.2, CI 0.02–1.4; P=0.04), familymonthly income <Br1,068 (AOR 0.02, CI 0–0.47; P=0), laboratory examinations (, AOR 1.54, CI 0.23–10.41; P=0.04), and transport, food, and lodging (AOR 0.05, CI 0.00–0.52; P=0.01). CONCLUSION: 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.