Understanding Household Catastrophic Health Expenditures and Fairness of Financing for Cancer Treatment: A Cross-sectional Case Study in West of Iran

Abstract

Background: Direct out-of-pocket (OOP) and indirect healthcare payments can limit the household budget and cause several financial problems for the household. Objectives: This study aimed to measure the financial protection and determinants of catastrophic health expenditures (CHEs) for cancer treatment in Shahid Rahimi Hospital, Khorramabad, located in western Iran. Methods: This study was conducted on 220 households of cancer patients in Lorestan Province, Iran. The framework of data collection was based on the World Health Organization (WHO) Global Health Survey. Interviews were conducted with individuals who met the inclusion criteria of this study; they were selected using a simple random sampling method. Data were analyzed using Chi-square test in STATA. Results: The present results showed that the incidence of CHEs and the fair financial contribution index (FFCI) were 70% and 86%, respectively. There was a significant relationship between the household CHEs and variables, such as supplementary insurance coverage, household income status, educational level of the household head, household size, age of the household head, type of cancer, and type of cancer treatment. Conclusions: More financial protection should be provided for the families of cancer patients due to the high incidence of CHEs and unfair financing of cancer care services. Moreover, healthcare systems should consider supportive policies for cancer patients and their household members by increasing the insurance coverage and expanding service packages to reduce cancer treatment expenditures.