Catastrophic out-of-pocket payments for households of people with severe mental disorder: a comparative study in rural Ethiopia

Hailemichael, Yohannes; Hailemariam, Damen; Tirfessa, Kebede; Docrat, Sumaiyah; Alem, Atalay; Medhin, Girmay; Lund, Crick; Chisholm, Dan; Fekadu, Abebaw; Hanlon, Charlotte

doi:10.1186/s13033-019-0294-7

International Journal of Mental Health Systems

Table 4 Factors associated with catastrophic health payments at the 40%+ threshold capacity to pay among households with a person with SMD and comparison households

From: Catastrophic out-of-pocket payments for households of people with severe mental disorder: a comparative study in rural Ethiopia

Factors	Monthly OOP payment in Birr, mean (SD)	Share of health payment as % of non-food consumption	OOPCHE (40%+)	Unadjusted model	Adjusted model
Factors	Monthly OOP payment in Birr, mean (SD)	Share of health payment as % of non-food consumption	OOPCHE (40%+)	Odds ratio (95% CI)	Odds ratio (95% CI)
Households of person with SMD	50.6 (82.1)	30.6	32.2	2.1 (1.2, 3.6)**	1.5 (1.0, 2.7)*
Households without person with SMD	51.7 (61.0)	22.7	18.2	1.00^a	1.00^a
Household size				0.5 (0.4, 0.7)***	0.6 (0.4, 0.9)**
Age ≥ 60 years in HH
Yes	50.0 (78.8)	29.1	33.0	1.4 (0.9, 2.3)	1.2 (1.1, 2.2)*
No	50.5 (64.3)	27.2	25.1	1.00^a	1.00^a
Area of residence
Urban	58.1 (74.2)	26.6	27.1	0.9 (0.5, 1.7)	1.3 (0.6, 2.5)
Rural	49.2 (76.3)	28.4	27.8	1.00^a	1.00^a
Gender of the head of the HH
Male	49.9 (75.5)	26.7	25.4	0.6 (0.3, 1.1)	0.9 (0.5, 1.7)
Female	50.9 (71.3)	31.0	34.0	1.00^a	1.00^a
Household head education
No formal education	44.2 (54.3)	27.1	24.3	0.8 (0.3, 1.8)	0.7 (0.3, 1.9)
Primary education	63.0 (106.0)	29.8	35.3	1.4 (0.6, 3.2)	1.5 (0.6, 3.9)
More than primary education	59.8 (88.4)	28.6	27.7	1.00^a	1.00^a
Children in the household
0	54.8 (72.0)	36.0	40.5	2.6 (1.4, 4.7)**	1.2 (0.5, 3.0)
1–2	56.9 (73.3)	29.0	27.8	1.4 (0.8, 2.5)	0.8 (0.4, 1.7)
3 and more	43.5 (80.0)	22.8	20.6	1.00^a	1.00^a
Consumption quintile
Quintile 1 (lowest)	21.2 (14.3)	38.0	45.7	9.5 (3.7, 24.0)***	10.8 (3.8, 30.5)***
Quintile 2	34.5 (32.4)	34.8	38.0	6.9 (2.7, 17.5)***	8.2 (2.9, 22.9)***
Quintile 3	59.7 (79.4)	29.6	29.3	4.6 (1.8, 11.7)**	5.7 (2.0, 15.8)**
Quintile 4	60.1 (70.0)	26.7	25.6	3.8 (1.5, 9.9)**	4.9 (1.7, 13.5)**
Quintile 5 (highest)	67.7 (110.5)	16.0	8.1	1.00^a	1.00^a

OOPCHE: out-of-pocket catastrophic health expenditure; HH: household
* p < 0.05; ** p < 0.01; *** p < 0.001; US$1 = Birr 20.69 (2015)
^aReference group

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ISSN: 1752-4458

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