Catastrophic and impoverishing health expenditures and it's affecting factors among health staffs in Iran: A case study in Tehran

Despite a lot of studies carried out on catastrophic and impoverishing health expenditures, exposure to these expenditures have not been studied among health staffs and their families yet. So that our study has analyzed exposure to CHE (Catastrophic Health Expenditures) and factors affecting them among the health staffs affiliated to army medical universities in Tehran.

This study was a descriptive-analytical and cross-sectional study implemented in 2016. Among all health staffs of a university of medical sciences, the full details of 240 households (838 individuals) were collected by using a stratified random sampling method. The data gathering and analyzing process have been done based on WHO standard guideline. Finally, the odds ratio of CHE determinants is reported using logistic regression by backward elimination method and chi-square test.

The results of this study showed that 7.5% (CI: 7.3-7.7) of health staff households (54 individuals) are faced with CHE. The odds of exposure to CHE for households with 3 members and less, households with lower education level and households with two or more outpatient visits were significantly more than others (p<0.05). Households who have used dental services during the past year were 8.77 times (p<0.001) more at risk of CHE. Also, households with 3 members and less, households with lower education level and households with two or more outpatient visits were 8.59, 7.96, and 3.39 times more at risk of such payments, respectively.

CHE is a common financing dilemma even among health staffs.  Families who have more referring to health centers and less education level and also dental service users are more at risk of exposure. Health policy-makers should pay more attention to such vulnerable and high-risk groups. Finally, our study results recommended the increase of dental insurance coverage as an effective strategy to reduce exposure to CHE.