Table 2. Health insurance, access to care and catastrophic expenditure for adults aged 50 years or older with chronic illness in six middle-income countries, 2007–2010.

Indicator of universal health coverage	OR (95% CI)a for indicator for insuredb versus uninsured participantsc
	China	Ghana	India	Mexico	Russian Federationd	South Africa
Access to basic chronic caree	1.54 (1.02 to 2.33)	1.69 (1.25 to 2.28)	3.03 (1.88 to 4.87)	2.73 (1.40 to 5.33)	N/A	1.01 (0.67 to 1.52)
Catastrophic health spending in last yearf	1.50 (1.13 to 1.99)	1.22 (0.86 to 1.73)	1.96 (1.00 to 3.85)	0.49 (0.22 to 1.07)	N/A	3.39 (2.01 to 5.70)
Catastrophic out-of-pocket expenditureg	0.94 (0.54 to 1.63)	0.38 (0.23 to 0.62)	1.90 (1.14 to 3.17)	0.35 (0.14 to 0.84)	N/A	1.42 (0.38 to 5.25)

CI: confidence interval; N/A: not applicable; OR: odds ratio.

^a ORs and 95% CI were calculated using logistic regression models that controlled for sex, age, urban or rural residence, educational level, household income quintile and comorbidity.

^b Health insurance included voluntary and mandatory insurance.

^c Participants had reported being diagnosed with at least one chronic disease

^d As insurance coverage was almost universal in the Russian Federation no ORs could be calculated.

^e Basic chronic care included: (i) the provision of treatment, such as medications or advice on physical activity or diet, for each of the patient’s conditions; (ii) visiting outpatient services for the chronic condition or conditions one or more times in the last reported year; and (iii) maintenance of a stable health state after outpatient care.

^f Catastrophic health spending in the last year was defined as the household spending more on health in the last reported year than 30% of annual household income, after deduction of food expenditure.

^g Catastrophic out-of-pocket expenditure was defined as spending more on the last outpatient visit than 30% of annual household per capita income, after deduction of food expenditure.