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Research article
Catastrophic Healthcare Expenditure and Coping Strategies among Patients Attending Cancer Treatment Services in Addis Ababa, Ethiopia
Gebremicheal Gebreslassie Kasahun
Aksum University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8981-1832
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: With the rapid increase in magnitude and mortality of cancer, which is costly disease to manage, several patients particularly in developing countries are facing a huge financial burden. The aim of the study was to examine the incidence of catastrophic health expenditure (CHE), identify associated factors and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia.
Methods: A hospital based cross-sectional survey of patients with cancer was conducted in public and private hospitals between January and March 2018. Data was collected using a structured questionnaire. All direct medical and nonmedical expenditures were measured and reported as expenditure (US$) per patient (1US$ equivalent to 23.41 Ethiopian Birr). The CHE was estimated using a threshold of 10% of annual household income.
Results: A total of 352 (response rate of 87.1%) participants were interviewed. Majority (73.3%) of the respondents were females; most (94%) from public hospitals and their mean (±SD) age was 48±13.2 years. Breast (36.9%) and Cervical (16.5%) cancers accounted the largest proportion. Vast majority (74.4%) of patients experienced CHE with mean overall expenditure of $2366 per patient (median: $1708). Medical expenditure sharedthe highest overall expenditure (83.6%) with mean medical and nonmedical costs of $1978 (median: $1394) and $388 (median: $222), respectively. Patients who took greater than six cycles of chemotherapy (AOR: 3.64; 95% CI: 1.11-11.92), and age (AOR: 1.03; 95% CI: 1.01-1.06) were significantly associated with CHE. Household saving (85.5%) followed by financial support (43.0%) were the main coping strategies.
Conclusion: A substantial number of patients with cancer are exposed to CHE with considerable medical expenditure. Hence, while efficient mobilization of the over introduced health insurance scheme other better prepayment or insurance mechanisms should also be considered to ensure financial risk protection and realize universal health coverage for patients with cancer.
Keywords
Catastrophic health expenditure, coping strategy, out-of-pocket expenditure, cancer
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CURRENT STATUS: Published
Version 3
Posted 28 May, 2020
Published
On 22 Jun, 2020
Published
On 22 Jun, 2020
No community comments so far
Editorial decision: Major revision
On 03 Jun, 2020
Review #1 received
Received 02 Jun, 2020
Reviewers invited
Invitations sent on 20 May, 2020
Reviewer #1 agreed
On 20 May, 2020
Editor assigned
On 18 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
No comments provided
Review #2 received
Received 21 Apr, 2020
Editorial decision: Major revision
On 21 Apr, 2020
Reviewer #2 agreed
On 13 Apr, 2020
Review #1 received
Received 17 Mar, 2020
Reviewer #1 agreed
On 29 Feb, 2020
Reviewers invited
Invitations sent on 24 Feb, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
No comments provided
Editorial decision: Major revision
On 23 Jan, 2020
Review #4 received
Received 27 Dec, 2019
Review #3 received
Received 27 Dec, 2019
Reviewer #4 agreed
On 06 Dec, 2019
Reviewer #3 agreed
On 05 Dec, 2019
Review #1 received
Received 05 Nov, 2019
Review #2 received
Received 05 Nov, 2019
Reviewer #2 agreed
On 23 Oct, 2019
Reviewer #1 agreed
On 11 Oct, 2019
Reviewers invited
Invitations sent on 08 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 22 Sep, 2019
Editor invited
On 21 Sep, 2019
First submitted
On 19 Sep, 2019
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Catastrophic Healthcare Expenditure and Coping Strategies among Patients Attending Cancer Treatment Services in Addis Ababa, Ethiopia
Gebremicheal Gebreslassie Kasahun
Aksum University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8981-1832
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 28 May, 2020
Published
On 22 Jun, 2020
Published
On 22 Jun, 2020
No community comments so far
Editorial decision: Major revision
On 03 Jun, 2020
Review #1 received
Received 02 Jun, 2020
Reviewers invited
Invitations sent on 20 May, 2020
Reviewer #1 agreed
On 20 May, 2020
Editor assigned
On 18 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
No comments provided
Review #2 received
Received 21 Apr, 2020
Editorial decision: Major revision
On 21 Apr, 2020
Reviewer #2 agreed
On 13 Apr, 2020
Review #1 received
Received 17 Mar, 2020
Reviewer #1 agreed
On 29 Feb, 2020
Reviewers invited
Invitations sent on 24 Feb, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
No comments provided
Editorial decision: Major revision
On 23 Jan, 2020
Review #4 received
Received 27 Dec, 2019
Review #3 received
Received 27 Dec, 2019
Reviewer #4 agreed
On 06 Dec, 2019
Reviewer #3 agreed
On 05 Dec, 2019
Review #1 received
Received 05 Nov, 2019
Review #2 received
Received 05 Nov, 2019
Reviewer #2 agreed
On 23 Oct, 2019
Reviewer #1 agreed
On 11 Oct, 2019
Reviewers invited
Invitations sent on 08 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 22 Sep, 2019
Editor invited
On 21 Sep, 2019
First submitted
On 19 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: With the rapid increase in magnitude and mortality of cancer, which is costly disease to manage, several patients particularly in developing countries are facing a huge financial burden. The aim of the study was to examine the incidence of catastrophic health expenditure (CHE), identify associated factors and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia.
Methods: A hospital based cross-sectional survey of patients with cancer was conducted in public and private hospitals between January and March 2018. Data was collected using a structured questionnaire. All direct medical and nonmedical expenditures were measured and reported as expenditure (US$) per patient (1US$ equivalent to 23.41 Ethiopian Birr). The CHE was estimated using a threshold of 10% of annual household income.
Results: A total of 352 (response rate of 87.1%) participants were interviewed. Majority (73.3%) of the respondents were females; most (94%) from public hospitals and their mean (±SD) age was 48±13.2 years. Breast (36.9%) and Cervical (16.5%) cancers accounted the largest proportion. Vast majority (74.4%) of patients experienced CHE with mean overall expenditure of $2366 per patient (median: $1708). Medical expenditure sharedthe highest overall expenditure (83.6%) with mean medical and nonmedical costs of $1978 (median: $1394) and $388 (median: $222), respectively. Patients who took greater than six cycles of chemotherapy (AOR: 3.64; 95% CI: 1.11-11.92), and age (AOR: 1.03; 95% CI: 1.01-1.06) were significantly associated with CHE. Household saving (85.5%) followed by financial support (43.0%) were the main coping strategies.
Conclusion: A substantial number of patients with cancer are exposed to CHE with considerable medical expenditure. Hence, while efficient mobilization of the over introduced health insurance scheme other better prepayment or insurance mechanisms should also be considered to ensure financial risk protection and realize universal health coverage for patients with cancer.