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 6 Adjusted odds of coping strategies for financial difficulties by mental health disorder and covariates

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

Characteristics	Total by subgroup	Coping strategies implemented for financial constraint
		Sold assets (n = 238)	Drew up accounts at shops (n = 97)	Cut down food consumption (n = 125)	Withdrew children from school (n = 65)	Relatives/family assistance (n = 118)	Reduce medical visits (n = 75)	Used savings (n = 35)	Took on extra work (n = 118)
		AOR (95% CI)	AOR (95% CI)	AOR (95% CI)	AOR (95% CI)	AOR (95% CI)	AOR (95% CI)	AOR (95% CI)	AOR (95% CI)
HH of person with SMD	241	0.4 (0.2, 0.9)*	1.5 (0.8, 2.7)	3.3 (1.8, 6.0)***	3.1 (1.4, 6.7)**	2.4 (1.4, 4.1)**	5.6 (2.4, 13.0)***	0.8 (0.3, 1.8)	1.8 (1.1, 3.2)*
HH without person with SMD	115	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a
Residence
Urban	70	0.08 (0.04, 0.17)***	3.0 (1.6, 5.4)***	1.1 (0.6, 2.1)	0.9 (0.4, 1.9)	0.9 (0.5, 1.7)	1.0 (0.4, 2.1)	0.7 (0.2, 2.2)	2.4 (1.3, 4.4)**
Rural	286	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a
Gender
Male	262	1.4 (0.8, 2,7)	0.6 (0.3, 1.1)	0.4 (0.2, 0.8)**	1.1 (0.5, 2.1)	1.1 (0.6, 1.9)	0.4 (0.1, 0.7)**	1.3 (0.5, 3.4)	1.3 (0.8, 2.3)
Female	91	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a
Household consumption
Quintile 1 (lowest)	58	0.6 (0.2, 1.5)	1.7 (0.7, 4.0)	4.1 (1.8, 9.2)**	1.9 (0.7,5.0)	1.0 (0.4, 2.2)	10.2 (3.7, 27.9)***	1.8 (0.5, 5.6)	2.6 (1.2, 5.8)*
Quintile 2	63	0.7 (0.2, 1.6)	1.1 (0.5, 2.5)	2.6 (1.1, 5.7)*	1.8 (0.7, 4.6)	0.9 (0.4, 1.9)	4.9 (1.7, 13.6)**	1.0 (0.3, 3.5)	2.9 (1.3, 6.2)**
Quintile 3	75	0.5 (0.2, 1.2)	1.4 (0.6, 3.0)	3.2 (1.5, 7.0)**	1.6 (0.6, 4.0)	1.4 (0.7, 2.8)	6.9 (2.4, 19.2)***	1.3 (0.4, 3.8)	2.3 (1.1, 4.8)*
Quintile 4	74	0.9 (0.4, 2.2)	1.6 (0.7, 3.3)	1.5 (0.6, 3.3)	1.2 (0.4, 3.1)	1.2 (0.6, 2.4)	5.0 (1.7, 14.1)**	1.1 (0.3, 3.6)	1.8 (0.8, 3.7)
Quintile 5 (highest)	86	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a	1.00^a

The model was run separately for each coping strategy using the same set of independent variables
CI: 95% confidence interval; AOR: Adjusted odds ratio; HH: household
* p < 0.05, ** p < 0.01, *** p < 0.001
^aReference group

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