1
|
Arora R, Rahman R, Joe W, Bakhshi S, Radhakrishnan V, Mahajan A, Chinnaswamy G, Bhattacharya A, Swami A, Manglani M, Seth R, Singh A, De S, MS L, Raj R, Borker A, Martiniuk A, Tsimicalis A. Families of Children Newly Diagnosed With Cancer Incur Significant Out-of-Pocket Expenditure for Treatment: Report of a Multi-Site Prospective Longitudinal Study From India (INPOG-ACC-16-01). J Glob Oncol 2018. [DOI: 10.1200/jgo.18.42400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Diagnosis of cancer in a child places considerable economic burden on families. The health expenditures are more catastrophic in resource limited countries like India where GDP spend on health is just over 1% and financing of treatment is usually out-of-pocket (OOP). Consequently parents may abandon their child's cancer treatment to ensure financial sustainability of the family. Research in this area is mostly from resource rich countries and OOP expenditure burden remains unknown in India. Aim: The objective of this study is to describe the OOP expenditure incurred by families of children (< 18 years age) with cancer being treated in India prior to and during cancer directed treatment. Methods: A prospective cost of illness study from a family household perspective was conducted in 14 centers (5 public, 5 private and 4 charitable trust sector) in 4 cities in India from 2016-2018. Baseline family demographic and socioeconomic data were collected followed by OOP expenditure incurred prior to start of treatment. For the duration of the child's treatment, a social worker contacted parents at regular intervals to record their expenditure on cancer directed treatment. Data collection was stopped when one of these happened - completion of treatment or death or progression/relapse or abandonment or transfer. Data were described descriptively and a univariate/multivariate analysis using logistic regression was done to detect factors associated with OOP expenditure. Results: 394 children (63% male, median age 5 years) with cancer (64% leukemia/lymphoma, 33% solid tumors, 3% CNS tumors) were enrolled from public (45%), charitable trust (28%) and private (27%) sector hospitals. They were symptomatic for a median duration of 6 weeks (range 0 to 104 weeks). 88% had no insurance and 73% were from families with monthly income of ≤ 10,000 rupees (≤ 159 US$). Mean OOP expenditure was Rs 209,500 (3325 US$) which is 195% of per capita income (1706 US$) of India. OOP expenditure from onset of symptoms to start of treatment was Rs 53,104 (843 US$) of which 77% was medical (15% laboratory tests, 11% medicines, 9% hospital bed costs) and 23% nonmedical (12% travel, 6% food, 3% lodging). OOP expenditure on cancer directed treatment was Rs 156,396 (2482 US$) of which 64% was medical (9% hospital bed costs, 9% supportive care drugs, 8% laboratory tests) and 36% nonmedical (19% food, 9% travel, 6% lodging). On univariate analysis age, gender, city, type of treatment facility, insurance, type of cancer, driving time and distance were significantly associated with OOP expenditure but only insurance and type of treatment facility were found significant on multivariate analysis. Conclusion: Families of children with cancer incur significant OOP expenditure prior to and during cancer directed treatment, which includes a significant portion on nonmedical expenses. Expenditure varied significantly by insurance and type of treatment facility.
Collapse
Affiliation(s)
- R. Arora
- Max Super Speciality Hospital, New Delhi, India
| | - R.U. Rahman
- Max Super Speciality Hospital, New Delhi, India
| | - W. Joe
- Max Super Speciality Hospital, New Delhi, India
| | - S. Bakhshi
- Max Super Speciality Hospital, New Delhi, India
| | | | - A. Mahajan
- Max Super Speciality Hospital, New Delhi, India
| | | | | | - A. Swami
- Max Super Speciality Hospital, New Delhi, India
| | - M. Manglani
- Max Super Speciality Hospital, New Delhi, India
| | - R. Seth
- Max Super Speciality Hospital, New Delhi, India
| | - A. Singh
- Max Super Speciality Hospital, New Delhi, India
| | - S. De
- Max Super Speciality Hospital, New Delhi, India
| | - L. MS
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - R. Raj
- Apollo Speciality Cancer Hospital, Chennai, India
| | - A. Borker
- Asian Institute of Oncology, Mumbai, India
| | - A. Martiniuk
- The George Institute for Global Health, Sydney, Australia
- University of Sydney, Faculty of Medicine, Sydney, Australia
| | - A. Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, Canada
| | | |
Collapse
|
2
|
|
3
|
L. M, Hureaux R. La diagonale carolingienne. Les dynamiques européennes de l'aménagement du territoire. Population (French Edition) 1996. [DOI: 10.2307/1534678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
4
|
L. M, Weil P. Racisme et discrimination dans la politique française de l'immigration, 1938-1945 et 1974-1995. Population (French Edition) 1995. [DOI: 10.2307/1534347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
5
|
L. M, Sullerot E. Quels peres? Quels fils? Population (French Edition) 1993. [DOI: 10.2307/1534148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
6
|
L. M, Schmelz UO, Dellapergola S, Avner U. Ethnic Differences among Israeli Jews: A New Look. Population (French Edition) 1992. [DOI: 10.2307/1533651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
7
|
L. M, Cohen A. La Shoah. Population (French Edition) 1991. [DOI: 10.2307/1533311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
8
|
L. M, Milo DS. Trahir le Temps (Histoire). Population (French Edition) 1991. [DOI: 10.2307/1533315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
9
|
L. M, Kaltenbach JH, Kaltenbach PP, Kaltenbach JH. La France, une chance pour l'Islam. Population (French Edition) 1991. [DOI: 10.2307/1533312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
10
|
L. M, Fossaert R. Le monde au XXIe siècle. Une théorie des systèmes mondiaux. Population (French Edition) 1991. [DOI: 10.2307/1533310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
11
|
L. M. Le veuvage avant soixante ans: ses conséquences financières. Population (French Edition) 1987. [DOI: 10.2307/1533100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
12
|
L. M, Kaltenbach PP. La famille contre les pouvoirs. De Louis XIV à Mitterrand. Population (French Edition) 1987. [DOI: 10.2307/1532771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
13
|
L. M, Dupâquier J, Dupâquier M, Dupaquier J, Dupaquier M. Histoire de la démographie. Population (French Edition) 1985. [DOI: 10.2307/1533146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
14
|
L. M. Rapport sur la situation sociale dans le monde. Population (French Edition) 1983. [DOI: 10.2307/1532536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
15
|
L. M, Mizrahi A, Mizrahi A, Sandier S, Mizrahi A, Mizrahi A. Socio-économie de la santé. Présentation graphique. Population (French Edition) 1983. [DOI: 10.2307/1532156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
16
|
L. M, Halacy D. Census: 190 Years of Counting America. Population (French Edition) 1983. [DOI: 10.2307/1532159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
17
|
L. M, Bouillaguet-Bernard P, Gauvin-Ayel A, Outin JL. Femmes au travail. Prospérité et crises. Population (French Edition) 1983. [DOI: 10.2307/1532672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
18
|
L. M, Marchal B. Gestion démographique et sociale des collectivités 1. Bilan démographique et social de la commune. Population (French Edition) 1982. [DOI: 10.2307/1532075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
19
|
L. M, Blaug M, Alcouffe A, Alcouffe C. La pensée économique, origine et développement. Population (French Edition) 1982. [DOI: 10.2307/1532068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
20
|
L. M, Schelling TC. La tyranie des petites décisions. Population (French Edition) 1982. [DOI: 10.2307/1532072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
21
|
L. M, Peccei A. 100 pages pour l'avenir. Réflexions du Président du Club de Rome. Population (French Edition) 1982. [DOI: 10.2307/1532071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
22
|
L. M, Rosanvallon P. La crise de l'Etat-providence. Population (French Edition) 1982. [DOI: 10.2307/1532475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
23
|
L. M, Chaunu P. Un futur sans avenir. Histoire et population. Population (French Edition) 1981. [DOI: 10.2307/1532282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
24
|
L. M, Quarti C. Profession: Parent. Population (French Edition) 1981. [DOI: 10.2307/1532277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
25
|
L. M, Volle M. Le métier de statisticien. Population (French Edition) 1980. [DOI: 10.2307/1532704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
26
|
L. M, Mauco G. Les étrangers en France et le problème du racisme. Population (French Edition) 1980. [DOI: 10.2307/1532702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
27
|
L. M, Dumont GF, Chaunu P, Legrand J, Sauvy A, département des études de l'APRD, Dumont GF, departement des etudes de l'APRD. La France ridée. Echapper à la logique du déclin. Population (French Edition) 1980. [DOI: 10.2307/1532597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
28
|
L. M. Human teratocarcinoma workshop. Nature 1980. [DOI: 10.1038/283621b0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
29
|
L. M, Poursin JM. La population mondiale. Population (French Edition) 1979. [DOI: 10.2307/1531576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
30
|
L. M, Ergan L, Laurent L. Vivre au pays. Population (French Edition) 1978. [DOI: 10.2307/1531708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
31
|
L. M, Courthéoux JP, Courtheoux JP. Mesure et structure de la population inactive. Définition statistique et répartition socio-économique des non-actifs dans la société française. Population (French Edition) 1978. [DOI: 10.2307/1531847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
32
|
L. M, Boulding E, Nuss SA, Carson DL. Handbook of International Data on Women. Population (French Edition) 1978. [DOI: 10.2307/1531735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
33
|
L. M. World Tables 1976. Population (French Edition) 1977. [DOI: 10.2307/1531408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
34
|
L. M, Prou C. Leçons introductives d'économie. Population (French Edition) 1977. [DOI: 10.2307/1532025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
35
|
L. M, Jacquin P. Histoire des Indiens d'Amérique du Nord. Population (French Edition) 1977. [DOI: 10.2307/1532021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
36
|
L. M, Lambert A, Lambert A. Structures et mouvements dans les populations en déclin: la Belgique contemporaine. Population (French Edition) 1977. [DOI: 10.2307/1532010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
37
|
L. M, Orselli J. Transports individuels et collectifs en région parisienne. Population (French Edition) 1977. [DOI: 10.2307/1531610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
38
|
|
39
|
L. M. Situation (la) mondiale de l'alimentation et de l'agriculure 1974. Population (French Edition) 1976. [DOI: 10.2307/1531645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
40
|
L. M. Environnement et cadre de vie: dossier statistique. Population (French Edition) 1976. [DOI: 10.2307/1531654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
41
|
L. M, Kuroda T. Changement de la structure démographique du Japon. Population (French Edition) 1976. [DOI: 10.2307/1531043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
42
|
|
43
|
L. M. Une monographie sur la "clientèle" des centres de planification familiale: les adhérentes au M.F.P.F. Population (French Edition) 1975. [DOI: 10.2307/1531211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
44
|
L. M, Wolton D. Le nouvel ordre sexuel. Population (French Edition) 1975. [DOI: 10.2307/1531247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
45
|
L. M. Les attitudes des cadres envers la sécurité. Population (French Edition) 1975. [DOI: 10.2307/1530491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
46
|
L. M. Noms et prénoms. Aperçu historique sur la dénomination des personnes en divers pays. Population (French Edition) 1975. [DOI: 10.2307/1530514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
47
|
L. M, Uri P. Développement sans dépendance. Population (French Edition) 1975. [DOI: 10.2307/1531377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
48
|
L. M. Les memoires de stage des eleves de l'Ecole nationale d'administration en 1964. Population (French Edition) 1966. [DOI: 10.2307/1527932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
49
|
L. M, Husain I, Afzal M, Rizui SAAB. Social Characteristics of the People of Karachi. Population (French Edition) 1966. [DOI: 10.2307/1528153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
50
|
L. M, Granai G, Idiart P. Aspects sociaux des problemes de l'habitat collectif urbain. Conclusions d'une enquete aupres des habitants de trois grands ensembles marseillais. Population (French Edition) 1966. [DOI: 10.2307/1527758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|