Out of pocket expenditure on cancer patients at a tertiary care hospital of Lucknow

Abstract

The increasing cost of cancer diagnosis and its management has led to a huge financial burden and noticed to be one of the major contributors to poverty. Out-of-pocket expenses (OOPE) significantly impact patients households work as well as experience to cancer treatment. Understanding its nature of burden will guide us in formulation of plans to avoid financial distress among the cancer patients.A tertiary care hospital based cross-sectional observational and analytical study was conducted on 120 cancer patients attending surgical OPD at King Georges Medical University, Lucknow, from July 2020 to November 2021. Sociodemographic and economic variables, costs incurred under various headings and expenditure details of the subjects were obtained by pre-designed, pre-tested, semi-structured questionnaire. Direct medical and direct non-medical costs were calculated, and its total was used as the OOPE. Appropriate statistical tests were applied wherever applicable.Overall mean out-of-pocket expenditure by study participants was Rs 79925.5 (51776-121651). The expense on direct medical expenditure was Rs 45151(30051, 90051) and indirect non-medical expenditure was Rs 10000(5000,14000). We found significantly higher OOPE in subjects residing more than 100 km away from Lucknow (P = 0.017), with gall bladder cancer (P = 0.001), who were diagnosed with cancer while screening (P =0.034), who were diagnosed at Private clinic/hospital (P = < 0.001) and delayed treatment (P = 0.023). Cancer patients experience significant OOPE following their diagnosis. Its impact on patient wellbeing with their treatment decisions need to be further studied.