Joshi Saurabh, Damani Anuja, Garg Anant, Malik Sunny, Dewan Ajay Kumar, Sharma Rakesh, Joshi Upkar
Hospice Education India LLP, New Delhi 110088, India.
Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India.
Ecancermedicalscience. 2024 Dec 12;18:1820. doi: 10.3332/ecancer.2024.1820. eCollection 2024.
Financial toxicity (FT) places a significant burden on individuals undergoing cancer care, leading to emotional distress, social isolation and financial burnout. In India, the growing number of cancer cases and the ever-expanding population, combined with insufficient government investment in public healthcare, inadequate insurance coverage, poor financial literacy among medical and non-medical communities and the lack of comprehensive financial planning exacerbate the financial difficulties faced by patients. This article aims to address FT as a source of suffering and explores potential frameworks and solutions for preventing and managing FT in patients undergoing cancer treatment and seeking palliative and hospice care in India. We conducted a literature search to review the burden of FT, across diverse healthcare settings for cancer patients. The prevalence of FT in cancer care ranges from 30% to 90.1% and is influenced by various socio-demographic, disease and healthcare-related factors. The sources of distress financing include consumption of savings, asset sales and borrowing, which add to the financial suffering. This interdisciplinary collaborative research paper highlights the dearth of financial literacy in our population and emphasises the pressing need to enhance financial awareness for healthcare professionals, cancer patients and their families. More than 30% of the Indian population lacks any form of insurance coverage, and many of those who do have it mostly lack 'adequate' coverage. We explore essential financial strategies, such as budgeting, expense analysis, asset consolidation, liquidity management, understanding estate planning tools and banking operations, streamlining paperwork, ensuring smooth transactions, adopting methods like low-interest loans and crowdfunding platforms, advance care planning, early palliative care ntegration and timely transition to hospice care. We also highlight the importance of available community resources, non-profit organisations, cancer foundations, health insurance and government support. Overall, integrating financial planning into cancer palliative care seems essential for reducing FT and enhancing the quality of cancer care in India. Further research on the topic is needed.
经济毒性（FT）给接受癌症治疗的个人带来了沉重负担，导致情绪困扰、社会孤立和财务倦怠。在印度，癌症病例数量不断增加，人口不断膨胀，再加上政府对公共医疗保健的投资不足、保险覆盖范围不够、医疗和非医疗群体的金融知识匮乏以及缺乏全面的财务规划，加剧了患者面临的经济困难。本文旨在将经济毒性作为痛苦的一个来源加以探讨，并探索在印度接受癌症治疗以及寻求姑息治疗和临终关怀的患者中预防和管理经济毒性的潜在框架及解决方案。我们进行了文献检索，以审视不同医疗环境下癌症患者的经济毒性负担。癌症治疗中经济毒性的发生率在30%至90.1%之间，且受到各种社会人口统计学、疾病和医疗保健相关因素的影响。痛苦融资的来源包括动用储蓄、出售资产和借贷，这增加了经济痛苦。这篇跨学科合作研究论文凸显了我国人口金融知识的匮乏，并强调迫切需要提高医疗保健专业人员、癌症患者及其家属的金融意识。超过30%的印度人口没有任何形式的保险覆盖，而许多有保险的人大多也缺乏“足够的”保险范围。我们探讨了一些基本的财务策略，如预算编制、费用分析、资产整合、流动性管理、了解遗产规划工具和银行运作、简化文书工作、确保交易顺利、采用低息贷款和众筹平台等方法、提前护理规划、早期姑息治疗整合以及及时过渡到临终关怀。我们还强调了现有社区资源、非营利组织、癌症基金会、健康保险和政府支持的重要性。总体而言，将财务规划纳入癌症姑息治疗对于减轻印度的经济毒性和提高癌症护理质量似乎至关重要。需要对该主题进行进一步研究。
