Association between multimorbidity patterns and catastrophic health expenditure among Chinese older adults living alone

•This study investigated the association between multimorbidity patterns and catastrophic health expenditure among Chinese older adults living alone in 2018.•Older adults living alone had high risks of CHE, especially for those with multisystem and cardiovascular diseases.•Integrated care should be adopted in the treatment of multimorbidity. Medical assistance should be provided to solitary older adults with certain patterns of multimorbidity. Multimorbidity is prevalent among older adults and may result in catastrophic health expenditures (CHEs) on older adults’ households. However, whether older adults living alone suffer such a financial burden is unknown. We aimed to investigate the association between multimorbidity patterns and CHE in Chinese older adults living alone. We included 884 participants aged 60 years and over and living alone from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). Latent class analysis was performed to identify multimorbidity patterns based on 14 self-reported chronic diseases. The logit model and Tobit model were adopted to analyze the association of multimorbidity patterns with the incidence and intensity of CHE, respectively. Approximately 20.2% of the older adults living alone experienced CHE. Among the four multimorbidity groups (minimal disease, cardiovascular, lung and asthma, and multisystem), the multisystem group and cardiovascular group had significantly higher incidence and intensity of CHE than the minimal disease group. Older adults living alone had high risks of CHE, especially those belonging to the multisystem pattern and cardiovascular pattern. Integrated care should be adopted in the treatment of multimorbidity to reduce health costs. More elder services and social assistance should be provided to solitary older adults with certain patterns of multimorbidity.