Catastrophic Health Expenditure of Chronic Diseases: Evidence from Hamadan, Iran

Aziz Rezapour, Sajad Vahedi, Farzad Faraji Khiavi, Firooz Esmaeilzadeh, Javad Javan-Noughabi, Abdolhalim Rajabi


Background: Chronic noncommunicable diseases (NCDs) could increase the risk of catastrophic health expenditure (CHE). The present study aims to analyze CHE among households with and without chronic NCDs in Hamedan.

Methods: In this cross‑sectional study, 780 households’ patients, who were being discharged from hospitals in Hamedan, were selected using a proportional stratifed random sampling method. Required data were collected through interview and observation using World Health Organization standard questionnaire. A household with chronic NCDs is defned as the one with ≥1 chronic disease patient. Both descriptive and analytical statistics, as well as different approaches and thresholds, were used to study CHE among households.

Results: The households with chronic disease had higher incidence and intensity of CHE in all approaches and threshold. This result was shown through distributive‑sensitive measures. The Regression analysis revealed that lower economic status, lower household size, and high utilization of health care were associated with the CHE incidence and intensity in the households with chronic NCDs in Hamedan.

Conclusions: There is a high degree of CHE were caused by chronic NCDs. By thoughtful reconsideration in health‑care fnancing, along with addressing relevant socioeconomic factors, the health system of Iran could cope with fnancial adversities caused by chronic NCDs.

Keywords: Catastrophic health expenditure, chronic diseases, Hamedan, Iran

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