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孟加拉国癌症幸存者的医疗保健服务经济负担。

Economic Burden of Healthcare Services on Cancer Survivors in Bangladesh.

机构信息

Department of Public Health, North South University, Dhaka, Bangladesh.

Research Rats, Dhaka, Bangladesh.

出版信息

Cancer Rep (Hoboken). 2024 Aug;7(8):e2144. doi: 10.1002/cnr2.2144.

Abstract

BACKGROUND

Cancer is a critical public health issue that imposes a considerable economic burden, especially in low-resource countries. In Bangladesh, there has been a noticeable lack of research focusing on the economic burden associated with cancer.

AIMS

This study aimed to examine the economic burden of cancer care and the contributing factors.

METHODS

This cross-sectional study included 623 cancer patients. Data were collected between January and May 2022. The magnitude of the economic burden (no burden to extreme burden) was the outcome variable. A logistic regression model was performed to determine the associated factors of the economic burden of cancer.

RESULTS

Overall, 34% of cancer survivors experienced extreme economic burden due to treatment costs. Patients with prostate (relative risk ratio, RRR = 23.24; 95% confidence interval, CI: 1.97, 273.70), bone (RRR = 5.85; 95% CI: 1.10, 31.04), and liver cancer (RRR = 4.94; 95% CI: 1.29, 18.9) reported significantly higher extreme economic burden compared to patients with other cancers. The economic burden was significantly higher for patients diagnosed with Stage III (RRR = 38.69; 95% CI: 6.17, 242.72) and Stage IV (RRR = 24.74; 95% CI: 3.22, 190.11) compared to Stage 0. Patients from low-income households suffered from nine times more extreme burden (RRR = 8.85; 95% CI: 4.05, 19.36) compared with those from high-income households.

CONCLUSION

Our study found a disproportionately high economic burden among patients with cancer, across disease sites, stages, and income quintiles. The burden was significantly higher among patients with prostate, bone, and liver cancer, and those diagnosed with advanced stage. The findings underscore the importance of early cancer detection before metastasis which may lead to more efficient treatment, avoid disease progression, lower disease management costs, and better health outcomes. Patients from low-income households experience an extreme economic burden due to cancer, highlighting the need for affordable healthcare services, financial support, and healthcare subsidies.

摘要

背景

癌症是一个严重的公共卫生问题,尤其是在资源匮乏的国家,它带来了巨大的经济负担。在孟加拉国,鲜有研究关注癌症相关的经济负担。

目的

本研究旨在调查癌症治疗的经济负担及其影响因素。

方法

这是一项横断面研究,纳入了 623 名癌症患者。数据收集于 2022 年 1 月至 5 月。无负担至极端负担是经济负担的结局变量。采用逻辑回归模型确定癌症经济负担的相关因素。

结果

总体而言,34%的癌症幸存者因治疗费用而承受极端经济负担。与其他癌症患者相比,前列腺癌(相对风险比,RRR=23.24;95%置信区间,CI:1.97,273.70)、骨癌(RRR=5.85;95%CI:1.10,31.04)和肝癌(RRR=4.94;95%CI:1.29,18.9)患者的极端经济负担更高。与 0 期患者相比,III 期(RRR=38.69;95%CI:6.17,242.72)和 IV 期(RRR=24.74;95%CI:3.22,190.11)患者的经济负担显著更高。来自低收入家庭的患者比高收入家庭的患者极端负担高 9 倍(RRR=8.85;95%CI:4.05,19.36)。

结论

本研究发现,癌症患者在疾病部位、分期和收入五分位水平上的经济负担不成比例地高。前列腺癌、骨癌和肝癌患者以及晚期诊断患者的负担明显更高。这些发现强调了在转移前进行早期癌症检测的重要性,这可能会导致更有效的治疗、避免疾病进展、降低疾病管理成本和改善健康结局。低收入家庭的癌症患者面临极端的经济负担,这突显了提供负担得起的医疗服务、经济支持和医疗补贴的必要性。

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