Out of Pocket Expenditure on Hypertension among Patients Attending at Tanta University Hospitals

Abstract

Aims: Determine the level of out-of-pocket expenditure incurred by hypertensive patients at Tanta University Hospitals. Identify different determinants of out-of-pocket health expenditure among hypertensive patients in Tanta University Hospitals. Study Design:  A cross sectional study. Place and Duration of Study: The study was conducted from July 2020 up to July 2022, at Tanta University Hospitals, Cardiovascular medicine department. Methodology: Collection of data was conducted by a questionnaire-based interview. The study included 195 hypertensive patients attending outpatient clinics. Their ages ranged from 36.0 to 75.0 years old. Males represented 57.4% while females’ percentage was 42.6%. Expenditure was estimated over the last three months, then the monthly average was calculated. Results: All included patients incurred out of pocket expenditure on medications. Their cost had a mean of 550.4±325.0 and ranged from 45 L.E up to 1215.0 L.E. As regards outpatient visits’ cost, more two third of the patients (69.2%) incurred cost for physicians’ visits with a mean of 98.1±80.6 and ranged from 50.0 L.E. Concerning investigations’ cost, (61.0%) of the study patients incurred investigations’ cost that ranged from 65.0 to 150.0 with a mean of 115.0±21.8 L.E. Overall direct OOP expenditure had a mean of 682.4±283.8 with a markedly wide range from 60.0 to 1550 L.E. Regarding the factors affecting the incidence of catastrophic health expenditure, those who were unemployed, or housewives represented had the highest level of CHE (70.3%) with a statistically significant differences in CHE regarding the employment status (p=.001). Patients without regular fixed income had higher CHE (58.9%) than patients with regular monthly salary (16.7%) with a statistically significant difference (p=.001). Conclusion: Hypertensive patients incur substantial direct and indirect costs. High rates of catastrophic costs illustrate the urgency of improving financial risk protection of these patients and strengthening primary care to ensure affordability of hypertension care.