Catastrophic health expenditures for children with disabilities in Iran: A national survey.

Objective: The aim of this study was to investigate the percentage of households with disabled children aged 0-8 years who had faced catastrophic health expenditures (CHEs) due to the health costs of these children in Iran.

Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0-8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Determinants of CHE were identified using logistic regression.

Results: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR = 18.89, 95%CI: 10.88-29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR = 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR = 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR = 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR = 2.71, 95%CI, 1.60-4.69), and type of basic health insurance (having Iranian Health Insurance: Adjusted OR = 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR = 1.66, 95%CI, 1.06-2.61) significantly increased the chances of facing CHE.

Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.