Catastrophic Healthcare Expenditures of Hospitalized Patients in the Hospitals of Shiraz in 2013

Abstract

Background: Disease often occurs unpredictably and, in the absence of adequate coverage, its expenditures can have significant economic impacts on a family. Objectives: This study aimed to identify the determinants of exposure to catastrophic healthcare expenditures in the hospitalized patients, in the selected hospitals of Shiraz University of Medical Sciences, Shiraz, Iran. Patients and Methods: This study was conducted on 376 patients hospitalized in similar wards of a public and a semi-private hospital in Shiraz, Iran. The study data were collected using World Health Organization questionnaire, the Persian version of which it was validated in a previous study. Catastrophic health expenditures payments were calculated based on the households’ capacity. Data were analyzed using chi-square test, T-test, Mann-Whitney, and logistic regression by SPSS. Results: Based on the findings of the present study, 175 (47.3%) of the hospitalized patients were exposed to catastrophic healthcare expenditures in 2013. Additionally, the results of regression analysis indicated that the type of hospital, ward, supplemental insurance status of the head of household, duration of diagnosis, duration of hospitalization, and ability to pay, and not the household's economic status, were effective in reducing the exposure to catastrophic healthcare expenditures. Conclusions: The high percentage of households, facing catastrophic expenditure in hospitalized patients, revealed an expenditure bottleneck in the health system. Therefore, when planning to reduce excessive expenditures in the health system, a crucial point is to consider hospitalizations.