Drivers and Predictors of Catastrophic Health Expenditure Associated with Long-Term Medical Conditions for Outpatient Visits at Public Health Facilities in Bayelsa State

Background: Long-term medical conditions (LTMCs) now dominate global disease burden, requiring lifelong care and frequent hospital visits, which impose significant financial strain on households. This study quantified direct costs, measured the prevalence of catastrophic health expenditure (CHE) and identified the biggest cost drivers among patients with LTMCs using public health facilities in Yenagoa, Bayelsa State. Methods: A cross-sectional survey of 339 adult patients with LTMCs, namely Hypertension (HTN), Diabetes mellitus (DM), Tuberculosis (TB), and Human Immunodeficiency Virus (HIV). Healthcare costs were calculated to reflect the average monthly costs. Patients whose monthly direct cost as a proportion of monthly household income was more than 10% were classified as having incurred Catastrophic Health Expenditure (CHE). Results: The median age was 50 years (IQR=40-60). Per clinic visit, the total direct and direct medical costs were ₦3700 and ₦3000 respectively. Patients with non-communicable diseases, multi-morbidity, health insurance coverage, and the elderly incurred higher direct costs. The costs of prescribed drugs were the drivers of direct medical costs. About 33% of respondents experienced CHE. The predictors of CHE were Age (>65 years) and whether the patient received a drug prescription during a clinic visit. Conclusion: This study highlights the substantial economic burden faced by patients with LTMCs accessing care in a public hospital.Overall, findings underscore critical areas for policy interventions such as age-sensitive financial protection policies, enhanced drug affordability policies and government funding support for NCDs to mitigate financial hardship for the elderly and those with complex conditions.