ESTRO 2024 - Abstract Book

S2779

Interdisciplinary - Health economics & health services research

ESTRO 2024

10. Calaguas MJ, Gubat JA. South East Asia, Differing Socioeconomic Factors, Differing Access to Radiotherapy: The Philippines, a Microcosm. Semin Radiat Oncol. 2017 Apr;27(2):176-183. doi: 10.1016/j.semradonc.2016.11.010. Epub 2016 Nov 16. PMID: 28325245.

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Digital Poster

Catastrophic health expenditure (CHE): Experience from a tertiary cancer care centre in India

SUSHMITA CHAKRABARTI 1 , Hardik Sharma 1 , Srinivas Y Gowda 1 , Shankar Prinja 2

1 PGIMER, Radiotherapy, CHANDIGARH, India. 2 PGIMER, Community Medicine, CHANDIGARH, India

Purpose/Objective:

To quantify the out of pocket expenditure (OOPE) and assess the scope of financial protection among cancer patients treated in our institute.

Material/Methods:

One hundred consecutive patients registered in our department for radical multimodality treatment of cancer were recruited following definite inclusion/ exclusion criteria. Patients and caregivers were interviewed to note the demographic and socio-economic status of these patients. A semi-structured questionnaire was used to document the details of expenses incurred during diagnosis, treatment and follow up. Total family income was grouped under five categories according to the 20th percentile. Direct OOPE was subdivided into treatment related and unrelated expenses. Indirect OOPE was estimated by wage loss of patient and caregivers. The mean OOPE was calculated in Indian Rupees (INR). When OOPE was 40% or more of the capacity to pay, it was considered as Catastrophic Health Expenditure (CHE). Factors influencing the OOPE were identified using multivariate linear regression. Chi square test was used to compare proportion of CHE between groups.

Results:

The median age of this cohort was 48 years and 57/ 100 were female patients. Approximately half of this population lived in villages and 66% had no health insurance at all. Only 25% of them were covered by the national health insurance scheme (ABPMJAY). Mean OOPE was INR 16508 before coming to this hospital and 102,820 in the hospital. Approximately 70% of the OOPE was directly related to treatment. OOPE was significantly higher in uninsured patients and in all patients who received chemotherapy as part of multimodality treatment. Indirect OOPE (mean) was 70469 for patients and 17984 for accompanying caregivers. CHE was 58.4% in the entire cohort but more in people coming from villages (p=0.009).Prevalence of CHE was twice higher in the poorest income group as compared to the wealthiest (p<0.03). Among the patients covered by ABPMJAY, CHE was 0.16 times lesser.

Conclusion: