Catastrophic health expenditure and its determinant factors among patients with cancer attending Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia

BACKGROUND: Cancer patients often face catastrophic health expenditures (CHE), leading to significant financial burdens for households. When cancer treatment depends mainly on out-of-pocket payments, the risk of incurring CHE increases; thus, this study assessed the incidence and key factors contributing to CHE among cancer patients. METHODS: A cross-sectional study was conducted at Wolaita Sodo University Comprehensive Specialized Hospital, including 294 cancer patients selected systematically. Data were analyzed using SPSS version 27, with bivariable and multivariable logistic regression models used to assess associations between CHE and independent variables. RESULTS: Among cancer patients, the incidence of catastrophic health expenditure (CHE) at a 40% threshold was 83.7% (95% CI: 78.9-87.4). Medication cost constituted the largest treatment expense, accounting for 66.7% of total costs. Multivariable analysis identified three independent factors significantly associated with CHE: lack of formal education (AOR = 3.6; 95% CI: 1.1-12.0), absence of health insurance (AOR = 3.2; 95% CI: 1.5-7.0), and cancer diagnosis in private facilities (AOR = 4.2; 95% CI: 3.5-13.7). CONCLUSION: The incidence of catastrophic health expenditure (CHE) was higher than reported in published studies. Key contributing factors included lack of insurance, educational status, and diagnosis at private healthcare facilities, all of which exacerbated financial hardship. Expanding community-based health insurance (CBHI) is essential, especially for low-income households. Furthermore, hospitals should enhance access to cancer diagnostic services to help alleviate the financial burden of diagnosis.