4.5 Article

The Burden of Out-of-Pocket Expenditure Related to Gynaecological Cancer in Malaysia

期刊

HEALTHCARE
卷 10, 期 10, 页码 -

出版社

MDPI
DOI: 10.3390/healthcare10102099

关键词

out-of-pocket expenditure; gynaecological cancer; catastrophic health expenditure; financial burden; impoverished

资金

  1. Ministry of Health of Malaysia

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This study estimated the economic burden on gynaecological cancer patients and their households, showing the out-of-pocket expenditure, catastrophic health expenditure (CHE), and poverty impact. The study found that low-income households and patients receiving chemotherapy were more likely to face catastrophic health expenditure.
This study aimed to estimate the economic burden on gynaecological cancer patients and their households, in terms of out-of-pocket expenditure, catastrophic health expenditure (CHE) and poverty impact. A cross-sectional study was conducted at an academic tertiary-care health centre in an upper-middle-income country. Data were obtained via structured interviews of 120 gynaecological cancer patients alongside review of medical charts. Mean (SD) and median (IQR) annual household out-of-pocket expenditures were USD 2780 (SD = USD 3926) and USD 1396 (IQR = 3013), respectively. Two thirds (n = 77/120, 64%) of households experienced CHE and 17% (n = 20/120) were impoverished due to out-of-pocket expenditure related to gynaecological cancer. Factors associated with CHE, explored using multivariate logistic regression analysis, estimated that the highest income quintile households, Q5, were 90% less likely to incur CHE compared to the lowest income quintile households, Q1 (adjusted odds ratio = 0.100; p-value < 0.05) and that patients who were not receiving chemotherapy were 88% less likely to incur CHE compared to those receiving chemotherapy (adjusted odds ratio = 0.120; p-value < 0.05). These results indicate the necessity to broaden the coverage of existing financial assistance for patients from low- and middle-income households, such as extending coverage to adult patients of all ages and to those treated in all public hospitals, including academic health centres.

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