Analyzing and Predicting Catastrophic Healthcare Expenditure in Bauchi State, Nigeria: A Socioeconomic and Policy Perspective

Abstract

Catastrophic health expenditure (CHE) remains a significant barrier to equitable healthcare in Nigeria, particularly in Bauchi State, where out-of-pocket (OOP) payments dominate and insurance coverage is limited. This study aimed to identify and explain the predictors of CHE among households in Bauchi State using a mixed-methods approach. A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 986 households using multistage sampling and analyzed with descriptive and inferential statistics in SPSS. CHE was defined as healthcare spending exceeding 10% of household income. Qualitative data were obtained through purposive sampling and analyzed thematically using NVivo to contextualize quantitative findings. The prevalence of CHE was 41.5%, with a mean overshoot of ₦80,291.13. Significant predictors of CHE included age, education level, urban residence, household size, number of children under five, income class, and method of healthcare payment. Qualitative analysis revealed socioeconomic barriers, healthcare payment burdens, and sociocultural dynamics as key influences. Integration of both data strands enhanced understanding of CHE determinants.CHE is alarmingly prevalent in Bauchi State, disproportionately affecting vulnerable populations. Expanding health insurance coverage and implementing targeted subsidies are essential to alleviate financial hardship and promote universal health coverage.