Trends and determinants of catastrophic health expenditure in China 2010–2018: a national panel data analysis

Abstract Background Catastrophic health expenditures (CHE) are out-of-pocket payments (OOP) that exceed a predefined percentage or threshold of household’s resources, usually 40 %, can push households into poverty in China. We analyzed the trends incidence and intensity, explored determinants, CHE, proposed policy recommendation to address CHE. Methods A unique 5-year national urban-rural panel database was constructed from China Family Panel Studies (CFPS) surveys. CHE measured by calculating headcount (percentage incurring total household sample) intensity overshoot (degree which an average out pocket expenditure exceeds sample). linear probability model employed assess trend net effect determinants random logit used analyse role characteristics head, utilization on incidence. Results vary across time geographical location. From 2010 2018, total, urban rural all showed decreasing tend, falling 14.7 8.7 % for households, 12.5–6.6 16.8–10.9 areas. decreased (24.50–20.51 %) (22.31–19.57 areas (23.61–20.15 %). Inpatient services were most important determinant For identified head (age, education, self-rated health); (members 65 + years, chronic diseases, family size income status); healthcare (inpatient outpatient usage) as areas, same variables significant with addition head’s sex insurance. Conclusions The displayed downward trend, but higher than Costs inpatient service usage should be key intervention strategy implications include improving economic level poor reforming insurance reinforcing pre-payment hospital methods.