Catastrophic Health Expenditure and Its Determinants in Households with Pediatric Cancer and Oncology Disorders

Families are willing to spend their entire lives improving their children due to emotional attachments, which, in turn, increases their exposure to catastrophic health expenditures (CHEs). The present study aimed to estimate the level of exposure to CHEs and its determinants among households with pediatric cancer and oncology disorders.

This cross-sectional study was performed on 101 households with pediatric cancer and oncology patients who referred to Shahid Sadoughi Hospital of Yazd in 2021. The CHE in this regard was defined as the out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay. The data on each household were collected with reference to the patient's electronic file and through a questionnaire completed during an interview with the head of the household. The data were also analyzed with descriptive statistics and logistic regression in Excel (2019) and STATA ver.15.

Out of 101 households in the study, 43 (42.6%) incurred CHEs (based on a threshold of 40% of disposable income). Regarding the job of the heads of households, manual workers were vulnerable to CHEs up to 11.7 times more than employees and self-employed individuals (OR=11.7, p<0.05). Also, the lower the education level of the head of the household, the higher the risk of facing CHEs (OR=10.45, p<0.05). Similarly, the lower his or her income, the higher the CHE.

The results showed that households with pediatric cancer and oncology disorders were significantly exposed to CHEs. Due to the limited resources of the health system in the treatment of cancer patients and the need for expenditure control programs, it seems better to focus on cost control strategies for this group of patients.