Coping strategies for financial burden among families of patients with cardiovascular disease attending public and private hospitals in Sana’a City 2023

Cardiovascular diseases are a leading cause of morbidity and mortality worldwide and impose a substantial financial burden on patients and their families, particularly in low-income and conflict-affected settings. In Yemen, heavy reliance on out-of-pocket health expenditures and limited insurance coverage forces many CVD-affected households to adopt coping strategies to manage the costs of care. The purpose of this study is to evaluate the financial burden and coping mechanisms experienced by relatives of CVD patients admitted to specific Yemeni public and private hospitals. This cross- sectional descriptive study was conducted on 400 patients, admitted cardiovascular patients and selective outpatients came to treat in outpatient clinics at cardiovascular admission rooms and outpatient clinics in selected public and private hospitals. The patient’s socio-demographic information, medical history, lifestyle choices, comorbidities, surgical background, and ability to pay for medical treatment were all part of the data collected through questionnaires. Only 7% of participants reported having health insurance. A total of 59.3% of patients delayed necessary health procedures, with 93.2% attributing delays to financial constraints. Borrowing money (60.0%), using personal income (51.5%), and drawing on savings (36.5%) were the most common coping strategies, often used in combination. There was a strong correlation (P < 0.05) between parameters such age, place of residence, educational level, socioeconomic status, and the type of hospital and the ability to afford medical expenses. Furthermore, there was a significant correlation between open-heart surgery and delays in care, and a significant correlation between residency, employment level, and health insurance coverage and the number of coping mechanisms utilized (P < 0.05). Complications from CVD can be prevented through early detection, better screening, and raising awareness of risk factors. Important steps toward better results and less financial strain were public education, healthcare system strengthening (particularly in rural regions), and comprehensive health insurance.