Catastrophic Health Expenditure in Households with Severe Mental Disorders Patients: Evidence After Iran's Health Transformation Plan

Abstract

Background: The high cost of mental health services can be a great barrier to accessing healthcare for patients with mental disorders. Objectives: The present study aimed to measure the catastrophic health expenditure (CHE) for households with severe mental disorders (SMDs) patients. Methods: A cross-sectional study was conducted among 400 households with SMDs patients who referred to four psychiatric university centers located in Tehran for outpatient services from July 2017 to March 2018. We consecutively selected 100 participants from each hospital. Data were collected using the World Health Survey questionnaire through interviews. The method considered by the WHO was used to measure the CHE and a forced-entry logistic regression technique was applied to assess factors affecting the CHE using STATA version 14.0 software. Results: The results showed that 25.75% of the households with SMDs patients faced CHE. There was also a significant relationship between households facing CHE and variables including the age of the household head (40 - 59 years; OR: 0.283, P value = 0.049), education status of the household head (university; OR: 0.075, P value = 0.002), utilization of dental (OR: 12.38, P value = 0.000), rehabilitation (OR: 6.99, P value = 0.012), and medication (OR: 3.17, P value = 0.049) services, and the household expenditures quintile (the fifth quintile; OR: 0.111 P value = 0.000). Conclusions: It is suggested that the Health Transformation Plan financially covers outpatient healthcare services more sufficiently, especially for mental disorders.