Magnitude and determinants of the catastrophic out-of-pocket healthcare expenditure in rural and urban areas: lessons from Tanzania panel data survey

Out-of-pocket (OOP) healthcare costs can impose a strain, their consequences are regressive, they may result into disaster and bankruptcy. These health expenses that surpass a certain percentage of total households income compelling the household to bear the cost of the illness is considered as catastrophic health expenditure (CHE). Using the national panel data collected in 2008/09, 2010/11 and 2012/13 waves in Tanzania, the study sampled a total of 1476 households with at least one member who had an experience of visiting a healthcare provider 4 weeks before the survey and she or he covered costs for treatment from own pocket. The logistic model was used to analyse the determinants of CHE in both rural and urban areas. The two most commonly thresholds were used, such as 10% and 40% of the overall income and non-food revenue, respectively. OOP healthcare costs are strongly and positively linked to catastrophic costs as well as household poverty. For both thresholds, income, household size, and age of the household's head above 60 years significantly influenced CHE at a 5% level. We support the literature pointed out that OOP healthcare expenses inflict financial catastrophe to the poor households and they even expose them to more hardship.