Table 1 List of operational definitions used for the study

Catastrophic expenditure

A patient is said to have sustained CE when the amount of money paid for the service amounts to more than 10% of the patient’s annual expenditure or more than 40% of non-food household expenditure [9]

Direct medical expense

Any payment related directly to the health care is direct medical expense. These include payments for imaging, laboratory tests, procedures, hospital services [9]

Direct nonmedical expenses

These are payments by patients or attendants to receive the health care like transportation cost, food or similar expenses [9]

Emergency laparotomy

Any procedure done for a patient with an acute abdomen that involves incision of the abdomen to treat or diagnose the condition. This includes, but is not limited to, exploratory laparotomy for trauma, perforated peptic ulcer disease, peritonitis due to complicated appendicitis, intestinal obstructions and other causes of peritonitis. Patients who are operated for appendicitis, through the right lower quadrant incision were separately labeled as Appendectomy

Procedure fee

The amount of money paid for the procedure itself, not including payment to buy anesthesia medications or other materials like normal saline