印度南部某地区癌症治疗的经济负担：一项横断面分析研究。
Economic Burden of Cancer Treatment in a Region in South India: A Cross Sectional Analytical Study.
机构信息
Department of Preventive and Social Medicine, JIPMER, India.
Department of Radiation Oncology, JIPMER, India.
出版信息
Asian Pac J Cancer Prev. 2021 Dec 1;22(12):3755-3762. doi: 10.31557/APJCP.2021.22.12.3755.
INTRODUCTION
The rising cost of cancer diagnosis and treatment has imposed a huge financial burden on the affected households. Understanding the nature of this burden will help us to formulate plans to avoid financial distress among the same.
OBJECTIVE
The study aims to estimate the Out of Pocket Expenditure (OOPE) for the management of selected solid cancers among the Out-Patient Department (OPD) of Regional Cancer Centre in South India and to determine the proportion of families experiencing Catastrophic Health Expenditure (CHE) due to the same.
METHODS
A hospital based cross sectional analytical study was undertaken in the authors' institute in South India. 474 solid cancer patients were interviewed in OPD of Radiation Oncology by a trained data collector. Sociodemographic variables, costs incurred under various headings and expenditure details of participants were obtained. Direct Medical and Direct Non-Medical costs were calculated, and its total was used as the OOPE. Costs were presented as mean with its standard error. Incidence of CHE was calculated using the 40% threshold on the Capacity to pay and was expressed as proportions with 95% confidence interval. Appropriate statistical tests were used to look for statistically significant differences in the study groups.
RESULTS
The average OOP expenditure incurred by a cancer patient was INR 35,817 (USD 523.6) for male and INR 20,496 (USD 299.6) for female. Males had a significantly higher OOPE than females. The prevalence of catastrophic health expenditure (CHE) was 61.6% at the 40% CTP threshold. Patients who used insurance schemes had higher prevalence of CHE than those who did not use insurance schemes (65.5% vs 60.7%, p value 0.351).
CONCLUSION
Cancer care provided through public institutions had a low direct medical cost, but the indirect cost seemed to be extremely high. Public based financial assistance is the need of the hour to help the cancer affected families.
简介
癌症诊断和治疗费用的上涨给患者家庭带来了巨大的经济负担。了解这种负担的性质将有助于我们制定计划，避免同样的家庭陷入财务困境。
目的
本研究旨在评估印度南部地区癌症中心门诊（OPD）中选定实体癌的自付费用（OOPE），并确定因该疾病而导致灾难性医疗支出（CHE）的家庭比例。
方法
本研究在印度南部的一家医院进行了一项基于医院的横断面分析研究。通过一名经过培训的数据收集员，在该机构的放射肿瘤学 OPD 对 474 名实体癌患者进行了访谈。获得了患者的社会人口统计学变量、各个标题下的费用以及参与者的支出详细信息。计算了直接医疗和直接非医疗费用，并将其总和作为 OOPE。费用以平均值及其标准误差表示。使用支付能力的 40%阈值来计算 CHE 的发生率，并以比例及其 95%置信区间表示。使用适当的统计检验来寻找研究组之间的统计学显著差异。
结果
男性癌症患者的平均 OOPE 支出为 35817 印度卢比（523.6 美元），女性为 20496 印度卢比（299.6 美元）。男性的 OOPE 明显高于女性。在 40%CTP 阈值下，灾难性医疗支出（CHE）的患病率为 61.6%。使用保险计划的患者比未使用保险计划的患者 CHE 的患病率更高（65.5%比 60.7%，p 值为 0.351）。
结论
通过公共机构提供的癌症护理的直接医疗费用较低，但间接费用似乎极高。公共财政援助是当前帮助癌症患者家庭的需要。
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