Catastrophic Health Expenditure and Its Determinants in Patients With Ischemic Heart Disease and Their Households: A Cross-Sectional Study From Iran in 2024

Background

Ischemic heart diseases can lead to significant healthcare costs for patients due to their chronic and debilitating nature.

Objective

The objective of this study was to examine the occurrence and causes of exorbitant healthcare expenses faced by individuals with ischemic heart disease and their households in Semnan in 2024.

Methods

This cross-sectional study included a cohort of 400 individuals diagnosed with angina and myocardial infarction who had received medical treatment for a minimum of 1 year. The data were collected using a researcher-made questionnaire with content validity scores of 0.87 and 0.92 for the CVR (Content Validity Ratio) and CVI (Content Validity Index), respectively. The catastrophic healthcare costs were determined by evaluating the expenses incurred by patients and their households, and their annual income. This was done using a model that allocates 40% of nonfood household expenses to healthcare. Logistic regression analysis was used to assess the statistical associations between demographic and contextual characteristics and the occurrence of catastrophic healthcare costs.

Results

The study reveals that patients and their households spend an average of 106,210,000 IRR (286.45 USD) annually on healthcare. Out of this amount, 80% is devoted to medical services, 16% to diagnostic services, and 4% to visits to different healthcare providers. Their mean yearly earnings amount to 1,061,430,000 IRR (2,862.72 USD), of which 297,580,000 IRR (802.58 USD) are allocated to nonfood expenditures. The mean proportion of direct medical expenses from nonfood household spending is 0.87 ( ± 1.50), and 46% of patients experience catastrophic healthcare costs. Significant statistical connections were observed between age, marital status, education, occupation, type of cardiac discomfort, duration of symptoms, initial diagnosis, and patient monitoring with catastrophic healthcare costs.

Conclusions

Numerous demographic and contextual factors contribute to the incredibly high frequency of catastrophic healthcare costs among the patients and their households that were evaluated. Consequently, it is crucial to address this condition by conducting focused measures.