Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain

Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use health systems has been extensively studied in the literature, especially emerging or developing countries. However, it subject little research European countries, is almost nonexistent after crisis 2008. aim work to analyze incidence intensity catastrophism derived from Spanish associated with care during period 2008–2015. Methods. Household Budget Survey was used catastrophic measures were estimated, classifying households into those above threshold catastrophe versus below. Three ordered logistic regression models margins effects estimated. Results. results reveal that, 2008, 4.42% dedicated more than 40% their income financing health, an average annual gap EUR 259.84 (DE: 2431.55), which overall terms amounts 3939.44 million (0.36% GDP). Conclusion. findings this study existence resulting OOP Spain need design protection policies against risk facing these types costs.