Variation Of Catastrophic Health Expenditure By Chronic Disease In Kenya

Abstract

Background: Protection of households from financial risk as a result of seeking healthcare is one of the fundamental goals of universal health coverage (UHC). Out-of-pocket health expenses create barriers to healthcare utilization and exposes households to financial catastrophe. Households with chronically ill members face higher financial risks because of the long-term need for healthcare. Objective: The aim of this study was to determine the effect of chronic illness on catastrophic health expenditure in Kenyan households. Methods: Using data from Kenya Household Healthcare Expenditure and Utilization Survey (KHHEUS) 2018, the study estimated the incidence of catastrophic health expenditure across the different types of chronic illnesses. Catastrophic health expenditures was estimated using the WHO methodology where a household whose out-of-pocket expenses for health were more than 40 percent of total expenditure on non-food items was deemed catastrophic. The effect of each chronic disease on catastrophic health expenditure was assessed using logistic regression. Results: The overall CHE incidence was estimated to be 7.96%. The incidence was higher amongst households with chronic diseases members (10.12%) as compared to those without (5.89%). The incidence of CHE was highest for households with cancer at 22.72%, followed by TB 15.19%, diabetes 14.86%, hypertension 12.21%, other cardiac diseases 11.03%, mental disorders 9.68%, asthma 9.12%, other respiratory diseases 9%, and HIV/AIDS 8.26%. Cancer increased the likelihood of a household incurring CHE by 7.6%, diabetes 3.5%, TB 3.4%, hypertension 1.9%, and other cardiac diseases by 0.9%. Overall, having a chronic disease member increases the likelihood of household incurring CHE by 2.2%. Conclusion: Chronic illnesses expose households to the negative effects of out-of-pocket health spending such catastrophic expenditure which limit spending on other basic necessities. There is a need for greater financial protection of households with chronically ill members to not only cushion them from out-of-pocket expenditures but also help them access the much needed healthcare without forgoing other needs.