RESUMO
INTRODUCTION: Catastrophic health expenditure (CHE) incurs when out-of-pocket health expenditure (OOPHE) exceeds a certain threshold, therefore exposing households to financial hardship, with the low-income population being most vulnerable. Data related to the incidence and determinants of CHE among the low-income population in Malaysia are lacking. This study aims to determine the incidence and determinants of CHE among Malaysian lowincome households. METHODOLOGY: This is a cross-sectional study using data from 6,720 low-income households from the national Household Expenditure Survey (HES) 2016 conducted from May 2016 till February 2017. The data were analysed using IBM SPSS software 25.0. OOPHE in this study included all spending on healthcare products and services by the household. CHE was identified in households with OOPHE of at least 10% of total monthly income. RESULTS: The incidence of CHE at the threshold of 10% household income was 1.7% (n=112). The determinants of CHE were households with any accident or medical insurance (p<0.001), having less than five members in a household (p<0.001), presence of elderly (p=0.024), and hospitalisation (p=0.021). In contrast, employment of the head of household (p=0.003) and having a child aged ≤5 years old (p=0.033) protect households from CHE. CONCLUSION: In the context of this study, the incidence of CHE among the low-income Malaysian population was low, indicating that a majority of the low-income population is protected from financial catastrophe. Regardless, the determinants of CHE among low-income population should be considered in future health policies.
