ArticleCureus2025
Level and Predictors of Catastrophic Health Expenditure Among Recipients of Ambulatory Surgical Care Services at Kyabirwa Surgical Center, Uganda.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundStandalone ambulatory surgical centers are gradually being established globally to minimize the cost barrier to surgery access as, for every dollar spent on surgery in non-ambulatory facilities, standalone ambulatory surgical centers spend less. However, even at ambulatory surgical facilities, patients still have to pay for surgery, which may potentially put them at risk of catastrophic health expenditure (CHE), albeit with varying risk factors. Notwithstanding this, assessments of the prevalence of devastating health expenditure among recipients of ambulatory surgery from standalone facilities have been scarce, not only in Uganda but also globally.
objectiveTo assess the level and predictors of CHE among recipients of ambulatory surgical care services at Kyabirwa Surgical Center (KSC), Jinja, Uganda.
methodAn analytical cross-sectional design was used, with patients sampled using systematic random sampling. Data were collected through structured interviews, medical record abstraction, and document reviews and analyzed in Statistical Product and Service Solutions (SPSS, version 26; IBM SPSS Statistics for Windows, Armonk, NY) using frequency, cross-tabulations, distributions, and a binomial logit model.
resultsThe prevalence of CHE among recipients of ambulatory surgery at KSC was 1.1%. The odds of experiencing CHE were 94.5% less among patients who had received open surgery (aOR = 0.055 (95% CI = 0.004-0.726); p = 0.028). The odds of experiencing CHE were 93.7% less among patients who had had elective surgeries (aOR = 0.063 (95% CI = 0.004 - 0.886); p = 0.040) compared to those who received emergency surgery.
conclusionThe prevalence of CHE among patients who received surgical care at KSC was negligible. Thus, only a small proportion of patients who undergo ambulatory surgery done at KSC experience CHE, implying that the center significantly contributes to the target VI of the Lancet Commission of Global Surgery. However, the prevalence of surgery-related CHE is not yet at the target set by the commission. CHE among patients at the center is predicted by the type of surgery (laparoscopic) and its nature (emergency).
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