Out of pocket payments (OOPs) act as a boundary to healthcare access. People fall into financial catastrophe and impoverishment due to large Out Of Pocket Payments incurred during the period of hospitalization and the consequent productivity loss. The aim of this study is to assess the pattern of out of pocket expenditure and to determine the prevalence of catastrophic healthcare in a tertiary care hospital in Chennai. The current study is a descriptive cross-sectional study conducted among the

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... patients of Saveetha Medical College and Hospital. 277 patients were chosen through convenient sampling. A pretested semi-structured questionnaire was used for data collection and the collected data was compiled and analyzed in MS Excel. While various factors such as transportation fee, laboratory fee, consultation fee, etc., have been found to determine OOPs pharmaceutical products make up most of the expenses.The prevalence of catastrophic healthcare expenditure was estimated as 37.9%. Statistically significant association between Catastrophic Healthcare Expenditure and age (p<0.001), marital status (p<0.001), occupation (p=0.001), duration of hospitalization (p<0.001), socioeconomic status (p<0.001) and financial burden due to loss of wages (p<0.001) and hospital visits in a month (p<0.001) was found. The Health financing systems should adopt prepayment mechanisms in order to reduce the out of payments and the subsequent financial catastrophe and impoverishment.