Tracking of Financial Burden: A Longitudinal Study of Out-of-Pocket Expenditure (OOPE) among Rural Households with Hypertension (HTN)

Abstract Objectives The study aimed to determine the monthly expenditure pattern and out-of-pocket expenditure (OOPE) associated with managing hypertension in households with patients with hypertension in a rural community in Karnataka, India. Materials and Methods A longitudinal study was conducted over a period 6 months in a rural community under a rural primary health center in Karnataka. One hundred and one households were included in the study with at least one member diagnosed with hypertension. Household income and other sociodemographic variables were also recorded to assess the economic impact relative to household resources. Monthly spending on nonhealth essentials and hypertension-related OOPEs revealed significant financial strain on households. Statistical Analysis Descriptive statistics were used to summarize the study of population's demographic characteristics, monthly expenditure in nonhealth essentials, and OOPE. Inferential statistics of Friedman and chi-square tests (Fischer's exact) were used to determine factors associated with OOPE. Results The population's median age was 59.1 ± 12 years, with a median of 5 (3–10) years since diagnosis with hypertension. Micro to macro vascular complications related to hypertension were present in 17 (22.66%), and 13 (24.52%) were admitted to the hospital in the past 1 year/for 6 months’ follow-up. Seventy-two (71.30%) had a monthly OOPE on health (INR) of ≥ 500. Higher socioeconomic status and visits to private health facilities for hypertension treatment were associated with higher OOPE. Conclusion Monthly expenditure among households with patients with hypertension in the rural community shows no significant variation for nonhealth essential items. Higher OOPE was associated with households having higher socioeconomic status and visits to private health facilities for treatment of hypertension.