Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China
Abstract 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 prevalence and determinants of CHE between hypertensive patients with and without complications.Methods The data were draw from a cross-sectional study conducted in four rural counties of Shandong Province in China in 2016, including 3,113 hypertensive patients. CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE.Results The prevalence of CHE is 13.6% among hypertensive patients. The prevalence 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 prevalence 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 prevalence among hypertensive patients is high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication.