Catastrophic health expenditure
Health Economics
Definition. Catastrophic health expenditure occurs when a household’s out-of-pocket health spending exceeds a defined share of its income or capacity to pay.
Explanation
Xu and colleagues showed across many countries that catastrophic spending is driven by reliance on out-of-pocket payment, poverty and limited prepayment (Xu et al., 2003). Analyses of impoverishing health costs, as in Georgia, use related thresholds to track financial protection (Gorgodze et al., 2025).
It is one of the two official indicators of financial protection under the Sustainable Development Goals.
Related concepts
Out-of-pocket expenditure Universal health coverage (UHC) Health financing Health equity
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References
Gorgodze, T., Zoidze, A., Catalan, J. M., & Gotsadze, G. (2025). Financial protection and universal health coverage in Georgia: An analysis of impoverishing healthcare costs using household income and expenditure surveys. BMJ Global Health, 10 (e019150). https://doi.org/10.1136/bmjgh-2025-019150
Xu, K., Evans, D. B., Kawabata, K., Zeramdini, R., Klavus, J., & Murray, C. J. L. (2003). Household catastrophic health expenditure: A multicountry analysis. The Lancet, 362(9378), 111–117. https://doi.org/10.1016/S0140-6736(03)13861-5
Cite this entry: Kurutkan, M. N. (2026). Catastrophic health expenditure. In The Health Topics glossary. https://healthtopic.org/glossary/catastrophic-health-expenditure/