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印度家庭癌症的医疗保健利用情况及经济负担。

Healthcare utilisation and economic burden of cancer on Indian households.

作者信息

Akhtar Md Azharuddin, Chowdhury Indrani Roy, Taneja Bhawna

机构信息

Institute for Human Development, Delhi, NCR, India.

Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India.

出版信息

Sci Rep. 2025 May 14;15(1):16780. doi: 10.1038/s41598-025-01279-6.

Abstract

India is experiencing a rising incidence of cancer with a high mortality rate at a younger age. With high catastrophic healthcare expenditures and inadequate social security, it is imperative to investigate the health-seeking behaviour and corresponding economic burden on cancer-affected households. Using a nationally representative database, we use the matching methods to analyse healthcare utilization, healthcare expenditure, and financial distress of cancer-affected households. We find that the cancer-affected households report a longer hospital stay, more surgery, medicine uptake, and diagnostic tests per member compared to non-cancer households. The out-of-pocket healthcare expenditure borne by the affected households are significantly higher and mostly inflated through inpatient care. Further, we find some adverse spill-over effect in terms of lower per-member inpatient and outpatient visits and lower healthcare expenditure for non-cancer members of affected households when they are afflicted with any diseases. The catastrophic expenditures inflict income loss and distress financing to the cancer affected households. Further, we find per-member work force participation and non-medical consumption expenditures significantly low. We also observe heterogeneous effect in terms of lower inpatient visits, lower medicine uptake, lower capability to pay for treatment, and significantly higher borrowing and selling off assets among various cancer affected socioeconomically disadvantaged groups.

摘要

印度癌症发病率不断上升,且在较年轻年龄段的死亡率很高。由于灾难性医疗支出高昂且社会保障不足,调查癌症患者家庭的就医行为及其相应的经济负担势在必行。我们利用一个具有全国代表性的数据库,采用匹配方法来分析癌症患者家庭的医疗利用情况、医疗支出和经济困境。我们发现,与非癌症家庭相比,癌症患者家庭每个成员的住院时间更长,接受的手术、药物治疗和诊断检查更多。受影响家庭自掏腰包的医疗支出显著更高,且大部分因住院治疗而虚增。此外,我们发现,当受影响家庭的非癌症成员患病时,他们每人的住院和门诊就诊次数减少,医疗支出降低,存在一些不利的溢出效应。灾难性支出给癌症患者家庭带来了收入损失和应急融资问题。此外,我们发现每个成员的劳动力参与率和非医疗消费支出显著较低。我们还观察到,在不同社会经济地位不利的癌症患者群体中,存在住院就诊次数减少、药物治疗减少、支付治疗费用能力降低以及借贷和变卖资产显著增加等异质性影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b3/12078705/a08226df3ee0/41598_2025_1279_Fig1_HTML.jpg

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