Risk of Catastrophic Health Expenditures Among Thai Elderly

  • Somporn Pettakon นักศึกษา หลักสูตรวิทยาศาสตรมหาบัณฑิต สาขาปัญญาและการวิเคราะห์ธุรกิจ คณะสถิติประยุกต์ สถาบันบัณฑิตพัฒนบริหารศาสตร์
  • Duanpen Teerawanviwat รองศาสตราจารย์ คณะสถิติประยุกต์ สถาบันบัณฑิตพัฒนบริหารศาสตร์
Keywords: Catastrophic health expenditures, Out of pocket payment, Thai elderly


The objectives of this research are to study the prevalence and intensity of catastrophic health expenditures and to investigate the influence of health care and health factors on the risk of catastrophic health expenditures in the Thai elderly. This study used the data from a survey on the well-being of the elderly in Thailand conducted by the National Institute of Development Administration in 2017 with a sample size of 1,613 persons aged 60 years or over. The study found that the prevalence of catastrophic health expenditure is higher in younger elderly while the intensity of the risk of catastrophic health expenditure is higher in the older elderly. The study on the influence of health care and health factors also found that health factors are the only significant predictor of catastrophic health expenditures with statistically significant variables such as the number of chronic diseases, mental health assessment, and physical fitness assessment.


1. Office of The National Economic and Social Development Board, Population Projections for Thailand 2010- 2040. Bangkok: Office of The National Economic and Social Development Board; 2013.Thai.

2. Othaganont P. The Complete Life of Thai Elderly Research Methodology and Lessons Learned .2nd ed. Bangkok: Chulalongkorn University Press; 2011.Thai.

3. Keawsaead P. Problems and Needs of Health Promotion and Social Support of the Elderly in Sriracha Municipality, Chonburi province. Chonburi: Burapha University;2550. Thai.

4. Thongthai W. Age of the Elderly Thai. ln: National Demographic Conference 2006; Thai Population Association.Thai.

5. National Statistical Office Thailand. Health and Welfare Survey 2015. Bangkok: National Statistical Office Thailand; 2016.Thai.

6. Foundation of Thai Gerontology Research and Development institute. Report on the Situation of the Thai elderly population in 2016. Nakhon Pathom: printterry 2017.Thai.

7. Pender NJ. Health Promotion in nursing practice. 2nd ed. California: Appleton & Large; 1987.

8. Berki S. A look at catastrophic medical expenses and the poor. Health Affairs (Millwood). 1986; 5: 138-145.

9. Wagstaff A, van Doorslaer E. Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ. 2003; 12(11): 921-934.

10. World Bank Group. Closing the Health Gaps for the Elderly in Thailand: World bank group; 2016.Thai.

11. Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJL. Household catastrophic health expenditure:
a multicountry analysis. The Lancet. 2003;362(9378): 111-117.

12. Wang Z, Li X, Chen M. Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in china. International journal for equity in health. 2015; 14(8): 1-11.

13. Buigut S, Ettarh R, Amendah DD. Catastrophic health expenditure and its determinants in Kenya slum communities. Int J Equity Health. 2015; 14: 46.

14. Rezapour A, Vahedi S, Khiavi FF, Esmaeilzadeh F, Javan-Noughabi J, Rajabi A. Catastrophic Health Expenditure of Chronic Diseases: Evidence from Hamadan, Iran. International Journal of Preventive Medicine 2017.

15. Xu K. Distribution of health payments and catastrophic expenditures Methodology: WORLD HEALTH ORGANIZATION; 2005.

16. Mahsttwat Y. The Factors Influencing Health Status of the Thai elderly [thesis] .Bangkok: Chulalongkorn University; 1991.Thai.

17. Promprakarn I. The relationship between health perception,social support and self-are behavior among elderly with diabetes mellitus in district hospital,Angthong Province [MSc thesis]. Bangkok: Mahidol University; 1998. Thai.

18. Kritsadtan R. Health status and health care of the Thai elderly [thesis] .Bangkok: Chulalongkorn University; 1992. Thai.

19. Namchaidee R.Choice of Benefits Use at Point-of-services by Patients with Thai Health Insurance. Academic Services Journal.2014; 25(2): 74-82.Thai.

20. Yamchanchai W.Relationship between perceived self-efficacy,Perception of health status and health promoting behaviors of the elderly [thesis]. Bangkok: Mahidol University; 1995. Thai.

21. Choi JW, Choi JW, Kim JH, Yoo KB, Park EC. Association between chronic disease and catastrophic health expenditure in Korea. BMC Health Serv Res. 2015; 15: 26.

22. Arsenijevic J, Pavlova M, Rechel B, Groot W. Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries. PLoS One. 2016; 11(7): e0157765.