Presentation (CTI)

OBJECTIVES: While out-of-pocket health expenses continue to rise, households' coping strategies remain largely unexplored. When individuals and families resort to unsustainable coping mechanisms, there exists a risk of exacerbating impoverishment, which may be more pronounced in certain socio-economic groups than others. This study examined the determinants of medical borrowing and the associated inequalities in Saudi Arabia.
METHODS: The study used data from the 2021 World Bank’s Global Financial Inclusion (Global Findex) database and applied descriptive statistics, bivariate analysis using chi-square tests, and multivariate logistic regression to estimate the factors associated with medical borrowing. Concentration curves and indices were employed to assess socio-economic inequalities in medical borrowing at the national level and across income and education groups.
RESULTS: The results indicated that approximately 16.3% of respondents reported borrowing money for medical purposes within the preceding 12 months. There was a slight tendency for medical borrowing to be less prevalent among higher-income groups and respondents with higher educational attainment (Model 3 OR = 0.561; 95% CI: 0.391-0.807; p < 0.01). Borrowing rates are somewhat lower for males than for females. At the same time, across all models, government employees consistently exhibit higher odds of borrowing for medical expenses (Model 3 OR = 1.953; 95% CI: 1.388-2.850; p < 0.01). The inequality analysis showed a negative education-based concentration index (-0.117, p ˂ 0.01), indicating that borrowing was disproportionately concentrated among individuals with lower educational attainment.
CONCLUSIONS: Socio-economic inequalities in borrowing for medical purposes exist in Saudi Arabia, highlighting the need to curb distress financing, particularly among lower-income groups, less-educated individuals, and public sector employees. This is essential to prevent cycles of indebtedness that may exacerbate vulnerability and poverty.