Table 2.
Odds ratios (95% confidence interval) of catastrophic health expenditure (CHE) and impoverishment by covariates in 40 low and middle income countries
| Factors | CHE | Impoverishment | ||
|---|---|---|---|---|
| COR [95% CI] | AOR [95% CI] | COR [95% CI] | AOR [95% CI] | |
| Fixed effects: Individual Level | ||||
| Paid for dental care in last 4 weeks | ||||
| No | 1.00 | 1.00 | 1.00 | 1.00 |
| Yes | 1.81 [1.72–1.91]*** | 1.88 [1.78–1.99]*** | 1.53 [1.41–1.65]*** | 1.65 [1.52–1.80]*** |
| Insurance status | ||||
| None | 1.00 | 1.00 | 1.00 | 1.00 |
| Some | 1.02 [0.96–1.07] | 0.99 [0.94–1.06] | 0.79 [0.73–0.87]*** | 0.87 [0.78–0.96]** |
| All | 0.80 [0.76–0.85]*** | 0.80 [0.75–0.85]*** | 0.62 [0.56–0.70]*** | 0.71 [0.64–0.78]*** |
| Sex | ||||
| Women | 1.00 | 1.00 | 1.00 | 1.00 |
| Men | 0.96 [0.93–0.99]** | 0.97 [0.94–1.00] | 0.94 [0.89–0.98]* | 0.97 [0.92–1.02] |
| Age | ||||
| 18–29 years | 1.00 | 1.00 | 1.00 | 1.00 |
| 30–39 years | 0.97 [0.93–1.01] | 0.96 [0.91–1.00] | 0.96 [0.91–1.00] | 0.95 [0.89–1.02] |
| 40–49 years | 0.92 [0.87–0.96]* | 0.94 [0.89–0.99]* | 0.92 [0.86–0.99]* | 0.97 [0.89–1.05] |
| 50–59 years | 1.04 [0.99–1.09] | 1.06 [0.99–1.12] | 1.04 [0.99–1.14] | 1.08 [0.99–1.18] |
| 60–69 years | 1.26 [1.19–1.33] | 1.04 [0.96–1.12] | 1.25 [1.15–1.36]*** | 1.08 [0.96–1.21] |
| 70+ years | 1.18 [1.08–1.28]*** | 1.18 [1.08–1.28]*** | 1.35 [1.23–1.48]*** | 1.18 [1.04–1.33]** |
| Marital Status | ||||
| Married | 1.00 | 1.00 | 1.00 | 1.00 |
| Never married | 0.93 [0.88–0.98]** | 0.93 [0.88–0.98]** | 0.87 [0.81–0.92]*** | 0.98 [0.90–1.06] |
| Previously married | 0.97 [0.93–1.02] | 0.97 [0.93–1.02] | 1.06 [0.99–1.13] | 0.99 [0.93–1.07] |
| Education | ||||
| Primary school | 1.00 | 1.00 | 1.00 | 1.00 |
| Secondary school | 0.93 [0.90–0.97] | 1.00 [0.96–1.04] | 0.72 [0.68–0.77]*** | 0.86 [0.80–0.92]*** |
| College and above | 0.75 [0.71–0.80]*** | 0.79 [0.74–0.85]*** | 0.47 [0.43–0.54]*** | 0.62 [0.55–0.70]*** |
| Household wealth | ||||
| First tertile (Poorest) | 1.00 | 1.00 | 1.00 | 1.00 |
| Second tertile (Middle) | 1.11 [1.07–1.15]*** | 1.12 [1.08–1.17]*** | 0.98 [0.92–1.04] | 1.02 [0.96–1.08] |
| Third tertile (Wealthiest) | 1.07 [1.02–1.10]*** | 1.08 [1.04–1.13]*** | 0.81 [0.76–0.86]*** | 0.89 [0.84–0.94]*** |
| Household size | ||||
| 1–2 members | 1.00 | 1.00 | 1.00 | 1.00 |
| 3–5 members | 0.95 [0.91–0.99]* | 0.93 [0.89–0.98]** | 1.01 [0.94–1.07] | 0.99 [0.92–1.08] |
| > 5 members | 1.00 [0.96–1.06] | 0.89 [0.84–0.95]*** | 1.11 [1.03–1.20]** | 0.98 [0.90–1.08] |
| Have child <5 years | ||||
| No | 1.00 | 1.00 | 1.00 | 1.00 |
| Yes | 1.15 [1.11–1.19]*** | 1.25 [1.21–1.30]*** | 1.28 [1.22–1.37]*** | 1.34 [1.26–1.42]*** |
| Have adult >60 years | ||||
| No | 1.00 | 1.00 | 1.00 | 1.00 |
| Yes | 1.38 [1.33–1.42]*** | 1.34 [1.28–1.40]*** | 1.30 [1.24–1.40]*** | 1.26 [1.17–1.34]*** |
| Urban/rural status | ||||
| Urban | 1.00 | 1.00 | 1.00 | 1.00 |
| Rural | 1.06 [1.02–1.09]** | 1.02 [0.99–1.06] | 1.46 [1.39–1.54]*** | 1.31 [1.24–1.38]*** |
| Fixed effects: Country Level | ||||
| GDP per capita (1000-increase) | 0.91 [0.84–0.99]* | 0.92 [0.86–1.00] | 0.85 [0.78–0.93]*** | 0.92 [0.85–0.99]* |
| Gini index (1-percent increase) | 0.99 [0.98–1.01] | 1.00 [0.98–1.02] | 0.99 [0.98–1.01] | 1.00 [0.98–1.02] |
| Out-of-pocket health expenditure | 1.02 [1.01–1.02]*** | 1.02 [1.01–1.03]*** | 1.02 [1.01–1.02]*** | 1.02 [1.01–1.03]*** |
Two-level logistic regression was fitted. COR: Crude odds ratio; AOR: adjusted odds ratio
* < 0.05; ** < 0.01; *** < 0.001