Document Type : Research Articles
Authors
1
Department of Public Health, Universiti Kebangsaan Malaysia, Malaysia.
2
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia.
3
Department of Community Health, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Jalan Yaakob Latif Bandar Tun Razak, Malaysia.
Abstract
Background: The study investigated healthcare expenditure from the perspective of cancer patients, to determine the level of Catastrophic Health Expenditure (CHE) and its associated factors. Methods: This cross-sectional study was conducted in three Malaysian public hospitals namely Hospital Kuala Lumpur, Hospital Canselor Tuanku Muhriz and the National Cancer Institute using a multi-level sampling technique to recruit 630 respondents from February 2020 to February 2021. CHE was defined as incurring a monthly health expenditure of more than 10% of the total monthly household expenditure. A validated questionnaire was used to collect the relevant data. Results: The CHE level was 54.4%. CHE was higher among patients of Indian ethnicity (P = 0.015), lower level education (P = 0.001), those unemployed (P < 0.001), lower income (P < 0.001), those in poverty (P < 0.001), those staying far from the hospital (P < 0.001), living in rural areas (P = 0.003), small household size (P = 0.029), moderate cancer duration (P = 0.030), received radiotherapy treatment (P < 0.001), had very frequent treatment (P < 0.001), and without a Guarantee Letter (GL) (P < 0.001). The regression analysis identified significant predictors of CHE as lower income aOR 18.63 (CI 5.71–60.78), middle income aOR 4.67 (CI 1.52–14.41), poverty income aOR 4.66 (CI 2.60–8.33), staying far from hospital aOR 2.62 (CI 1.58–4.34), chemotherapy aOR 3.70 (CI 2.01–6.82), radiotherapy aOR 2.99 (CI 1.37–6.57), combination chemo-radiotherapy aOR 4.99 (CI 1.48–16.87), health insurance aOR 3.99 (CI 2.31–6.90), without GL aOR 3.38 (CI 2.06–5.40), and without health financial aids aOR 2.94 (CI 1.24–6.96). Conclusions: CHE is related to various sociodemographic, economic, disease, treatment and presence of health insurance, GL and health financial aids variables in Malaysia.
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