Evidence map›Paper›PMID 40474100›Full record

ArticleBMC health services research2025

Catastrophic health expenditure and associated factors among adult diabetes patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Kibret Mesgie, Asmamaw Atnafu, Tesfahun Zemene Tafere, Nigusu Worku, Banchlay Addis, Asebe Hagos

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Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kibret MesgieTefera Hailu Memorial General Hospital, Waghemara Zone, Amhara National Regional Health Bureau, Bahir Dar, Ethiopia.
Asmamaw AtnafuDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Tesfahun Zemene TafereDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Nigusu WorkuDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Banchlay AddisDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
Asebe HagosDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia. asebehagos21@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOut-of-pocket health expenditures pose a substantial financial burden for millions of people worldwide. Diabetes patients without financial protection often face catastrophic out-of-pocket health expenditure. However, the catastrophic out-of-pocket health expenditure at a 40% threshold have not been well investigated in Ethiopia. Therefore, this study aimed to assess the magnitude of catastrophic out-of-pocket health expenditures and identify associated factors among adult diabetes patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

methodsAn institutional-based cross-sectional study was conducted on 395 diabetes patients from March 28 to May 15, 2021. Participants were selected using a systematic random sampling technique. Data were collected using a structured questionnaire, entered into Epi-Data version 4.6, and analyzed using STATA version-16. Catastrophic health expenditure was estimated at a 40% threshold of total household non-food expenditure. A multivariable logistic regression model was used to identify factors associated with catastrophic out-of-pocket health expenditures. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a p-value < 0.05 was used to determine statistical significance.

resultThe incidence of catastrophic out-of-pocket health expenditure at the 40% threshold was 51.4% (47.2, 54.2). Age older than 60 years (AOR = 4.67; 95% CI:1.65, 12.06), 3-4 family size (AOR = 2.01; 95%CI:1.04, 3.91), urban residence (AOR = 0.02; 95%CI:0.002, 0.24), 6-10 years of duration of illness (AOR = 1.74;95%CI:1.02, 2.96), and history of admission (AOR = 2.48;95% CI:1.02, 6.00) were significantly associated factors with catastrophic out-of-pocket health expenditures.

conclusionsOut-of-pocket health expenditures impose a significant financial burden on diabetes patients and their families. Age above 60 years, a family size of 3-4, urban residence, duration of illness 6-10 years, and history of admission were significantly associated with catastrophic out-of-pocket health expenditure. Therefore, the government should strengthen financial protection mechanisms to protect diabetes patients from catastrophic out-of-pocket health expenditures.

Indexed as

Catastrophic IllnessDiabetes MellitusHealth ExpendituresAdultAgedCross-Sectional StudiesEthiopiaFemaleFinancing, PersonalHospitals, SpecialHumansMaleMiddle AgedSocioeconomic FactorsSurveys and QuestionnairesYoung AdultCatastrophic out-of-pocket health expenditureDiabetes mellitusEthiopiaFinancial protectionOut-of- pocket payment

Identifiers

PMID40474100
PMCPMC12143024

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.