Need-Based Mental Health Aid Allocation to Disadvantaged Patients Toward Universal Health Coverage in Bangladesh

Out-of-pocket (OOP) healthcare costs remain prohibitive in low-resource settings, often pushing families into poverty. Universal health coverage (UHC) goals emphasise protecting households from financial hardship due to medical expenses.

This study examines which socioeconomic and demographic factors predict the amount of free mental healthcare support received by applicants.

We conducted a cross-sectional analysis. Descriptive statistics summarised 286 applicant profiles (e.g., 66.8% female and 49% aged 28-48). Spearman and Pearson correlations assessed the relationship between applicants' monthly treatment-related OOP costs and aid received (log-transformed values). A multiple linear regression was then fitted with log (free care amount) as the outcome and predictors including age group, sex, occupation, marital status, income source, reason for support and log (monthly treatment-related OOP cost).

The applicant profile was predominantly young, unmarried, female students relying on parental support, seeking aid mainly for financial hardship. Spearman's ρ showed a small but significant positive correlation between treatment cost and aid amount, confirmed by Pearson's r after log transformation (r ≈ 0.17, p < 0.01). In regression analysis, higher treatment cost strongly predicted more free aid (β ≈ 0.18, p = 0.003), indicating that donors allocate more resources to costlier cases. Households supported by a spouse's income received significantly less aid (β ≈ -0.93, p = 0.038), suggesting that more stable households needed less assistance. Parental income support was marginally associated with reduced aid (p ≈ 0.07), whereas student status showed a borderline positive effect (p ≈ 0.08).

This study highlights that free mental healthcare support in a resource-poor setting is driven primarily by treatment cost and applicants' perceived need. Those with higher medical expenses receive more aid, aligning with the principle of need-based assistance.