Catastrophic health costs in households with and without elderly living alone in Shandong, China

The catastrophic health expenditure (CHE) incidence among elderly households is 44.9%, with empty-nest households showing higher rates.

• Empty-nest singles have a CHE incidence of 59.3%, while empty-nest couples have a rate of 52.9%, both significantly higher than the 31.4% incidence in non-empty-nest households.
• An inverse relationship exists between CHE incidence and income level across all elderly household types.
• Key risk factors for CHE include having one or more elderly members with chronic diseases in the past 6 months, hospitalization of an elderly member in the past year, and lower household income.
• Health insurance status significantly affects CHE incidence, particularly among empty-nest singles and non-empty-nest households.

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