Costs incurred by patients with oral potentially malignant disorders: is there a public health need for financial protection in India?

Abstract

Objectives Financial protection mechanisms are in place to overcome the costs of a few diseases in India. Our objective was to estimate the costs incurred due to Oral Potentially Malignant Disorders (OPMD) and to determine predictors of such costs. Results We found that the median (Interquartile range IQR) total costs of OPMD was Indian Rupees (INR) 500 (350–750), direct medical costs was INR 0 (0–50), direct non-medical costs was INR 150 (40–200) and indirect costs was INR 350 (250–500). The travel cost to attend the health facilities [INR 100 (40–150)] and the patient’s loss of wages [INR 200 (150–400)] mainly accounted for the direct non-medical and indirect costs respectively. The median expenditure on smokeless and smoking forms of tobacco was INR 6000 (5400–7200) and INR 2400 (1800–3600) respectively. On multiple linear regression analysis, rural residence, belonging to below poverty line family, being a sole earner in the family, number of months since diagnosis and first visit at a private provider were found to be the significant predictors of total costs of OPMD. Financial protection mechanisms are needed for covering the direct non-medical and indirect costs. Early management of OPMD might mitigate the costs of OPMD.

Is It The Right Time for India to Move From Targeted Cash Transfers to Universal Cash Transfers for Patients with Tuberculosis?

“…Many of these costs are common for the care of other diseases as well. 13 A study, using economic models, favored the targeted approach in reducing the TB catastrophic costs among poor families, at the same time favoring the 'universal' approach to alleviate poverty. 14 Targeted cash transfers are found to include a smaller population and most commonly exclude the poor, whereas universal transfers are reported to achieve poverty reduction with a larger inclusion.…”