AB1811-HPR CATASTROPHIC HEALTH EXPENSES IN PREGNANT WOMEN WITH RHEUMATIC DISEASE

Abstract

BackgroundRheumatic diseases (RD) have an impaired quality of life and a high cost of healthcare. Out-of-pocket health expenses are those expenditures that households make to acquire medicines and associated services that come from family income [1]. A disease with catastrophic health expenses is a condition that, due to its high cost and the expenses derived from treatment and medications, exceeds 30% of the family income [1]. Such catastrophic expenses can negatively influence the therapeutic adherence of patients and the prognosis [2]. A policy challenge has been the achievement of universal coverage of health services. A key was the implementation of “Seguro Popular” (SP) in 2003; however, the abolition of the SP in 2020and the foundation of “Instituto de Salud para el Bienestar” (INSABI) by the current government, created uncertainty due to some omissions detected regarding the clarity of its performance [1].ObjectivesTo estimate the frequency of pregnant patients with RD who experienced catastrophic health expenses when using medical services.MethodsAn observational cross-sectional, retrospective study was carried out at the Pregnancy and Reproductive Health Clinic for Rheumatic Diseases (CEER) from the University Hospital “Dr. José Eleuterio González”, in Mexico. The data of all pregnant patients was collected from the clinical record. From the socioeconomic study, sociodemographic data, family nucleus, family’s monthly income, monthly health expenditures, as well as the type of health insurance they had, were obtained. The percentage of out-of-pocket health expenses (medication) of each patient was calculated, and if this exceeded 30%, it was defined as a catastrophic expense. For statistical analysis, the sociodemographic and clinical characteristics of the population are presented as frequencies, percentages, or standard deviations.ResultsA total of 54 patients were included in the period from 2019 to 2022 with a mean age of 28.02 (±6.45) years. The rheumatic diagnoses were rheumatoid arthritis with 24 (44.4%), systemic lupus erythematosus with 13 (24.1%), antiphospholipid syndrome with 5 (9.3%), dermatomyositis with 3 (5.6%),juvenile idiopathic arthritis with 2 (3.7%),Sjögren’s syndrome with1 (1.8) and others with 6 (11.1%).The sociodemographic characteristics are described inTable 1. Most of the patients had health insurance coverage with 43 (79.6%), where SP stood out as the main one with 24 (55.8%). Of the 43 patients who had health insurance coverage, 5 (11.6%) experienced catastrophic health expenses, which we can see inFigure 1. Of the 11 (20.4%) patients who did not have health insurance coverage, 1 (9.1%) experienced catastrophic health expenses.ConclusionThe 11.6% of the patients who had health insurance coverage reported having catastrophic health expenses, in which they spent more than 30% of the family’s monthly income. 9.1% of those who did health insurance coverage presented catastrophic health expenses. It is of vital importance that rheumatic diseases should be recognized as catastrophic illnesses to ensure quality patient-tailored care.