catastrophic health expenditures in kermanshah, west of iran: magnitude and distribution

background : health policy makers are concerned about protecting people from catastrophic health expenditures and subsequent impoverishment. this study aimed to describe the magnitude and distribution of catastrophic health expenditures in kermanshah western iran. methods : in this descriptive study, during may 2008, 189 households were chosen by “systematic random sampling” among the community of maskan in maskan center for population. after getting the informed consent forms signed, data ere collected using a questionnaire by interviewing the head of the families. the cut-off point for catastrophic expenditure was defined as health expenditures over 40% of household’s capacity to pay. results : from a total of 189 households, 22.2% (42) households (95% ci 16.3%- 28.1%) incurred catastrophic health expenditures. out of 42 households, for 11.9%, the head of family was female. 40.5 % had one member younger than 12 years old, 26.2% had one member older than sixty years old, and 9.5% were households with at least one member with chronic condition. in addition, 19% were uninsured. in addition, because of financial burden of health expenditures 21.4% of the households sold their jewels, 16.7% used up their savings and 47.6% were in debt. conclusion : compared to 2% of general population facing catastrophic health expenditure, 22.2% was a high proportion. our study revealed the importance of protecting households against the cost of ill-health.