Catastrophic health expenditures for children with disabilities in Iran: A national survey

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Abstract
Objective: The aim of this study was to investigate the percentage of households with disabled children aged 0–8 years who had faced catastrophic health expenditures (CHEs) due to the health costs of these children in Iran.Methods: This cross‐sectional study was carried out on 2000 households with disabled children aged 0–8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face‐to‐face interview. Determinants of CHE were identified using logistic regression.Results: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR = 18.89, 95%CI: 10.88–29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42–35.94; Q2: Adjusted OR = 8.27, 95%CI, 4.45–15.36; Q3: Adjusted OR = 13.88, 95%CI, 7.89–24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR = 6.13, 95%CI, 3.39–11.26), having a child with mental disability (Adjusted OR = 2.71, 95%CI, 1.60–4.69), and type of basic health insurance (having Iranian Health Insurance: Adjusted OR = 2.20, 95%CI, 1.38–3.49; having Social security insurance: Adjusted OR = 1.66, 95%CI, 1.06–2.61) significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy‐makers in order to more financial protection of these households.

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