Incidence of Catastrophic Health Expenditure and Its Determinants in Cancer Patients: A Systematic Review and Meta-analysis

Doshmangir, Leila; Hasanpoor, Edris; Jaoude, Gerard Joseph Abou; Eshtiagh, Behzad; Haghparast‐Bidgoli, Hassan

doi:10.1007/s40258-021-00672-2

Cited by 27 publications

(21 citation statements)

References 61 publications

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“…The total out-of-pocket payment expenses accounted for approximately 30% of the total health expenditure, increasing by 120.6% between 2010 and 2019 [ 33 ]. The average incidence of CHE in recent decades was 23.3% (95% CI 21.1%-25.6%) [ 34 ], whereas it was 60.1% in cancer patients [ 27 , 35 ]. The overall incidence of CHE in EC patients was 69.2%, followed by colon cancer, breast cancer, and liver cancer [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Disease and Economic Burdens of Esophageal Cancer in China from 2013 to 2030: Dynamic Cohort Modeling Study

Li¹,

Xu²,

Gu³

et al. 2022

JMIR Public Health Surveill

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Background Esophageal cancer (EC) is the sixth leading cause of tumor-related deaths worldwide. Estimates of the EC burden are necessary and could offer evidence-based suggestions for local cancer control. Objective The aim of this study was to predict the disease burden of EC in China through the estimation of disability-adjusted life years (DALYs) and direct medical expenditure by sex from 2013 to 2030. Methods A dynamic cohort Markov model was developed to simulate EC prevalence, DALYs, and direct medical expenditure by sex. Input data were collected from the China Statistical Yearbooks, Statistical Report of China Children’s Development, World Population Prospects 2019, and published papers. The JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of DALY rates, whereas the average annual growth rate (AAGR) was applied to analyze the changing direct medical expenditure trend over time. Results From 2013 to 2030, the predicted EC prevalence is projected to increase from 61.0 to 64.5 per 100,000 people, with annual EC cases increasing by 11.5% (from 835,600 to 931,800). The DALYs will increase by 21.3% (from 30,034,000 to 36,444,000), and the years of life lost (YLL) will account for over 90% of the DALYs. The DALY rates per 100,000 people will increase from 219.2 to 252.3; however, there was a difference between sexes, with an increase from 302.9 to 384.3 in males and a decline from 131.2 to 115.9 in females. The AAPC was 0.8% (95% CI 0.8% to 0.9%), 1.4% (95% CI 1.3% to 1.5%), and –0.7% (95% CI –0.8% to –0.7%) for both sexes, males, and females, respectively. The direct medical expenditure will increase by 128.7% (from US $33.4 to US $76.4 billion), with an AAGR of 5.0%. The direct medical expenditure is 2-3 times higher in males than in females. Conclusions EC still causes severe disease and economic burdens. YLL are responsible for the majority of DALYs, which highlights an urgent need to establish a beneficial policy to reduce the EC burden.

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Section: Discussionmentioning

confidence: 99%

The Disease and Economic Burdens of Esophageal Cancer in China from 2013 to 2030: Dynamic Cohort Modeling Study

Li¹,

Xu²,

Gu³

et al. 2022

JMIR Public Health Surveill

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“…A systematic review of 38 studies discovered that the economic status of the household, the frequency of hospitalisation, and the presence of an elderly, disabled, or chronically ill family member were all significant factors associated with household CHE [10]. Other factors include age, marital status, education, and a higher level of dependence [11], geographic location, household size [12], the absence of local basic medical insurance coverage [13], the types of family structure [14], living arrangements [15], health facility types [16], physical multimorbidity [17], gender of the household head and the quality of life of sick household member [18]. Despite the numerous CHE determinants mentioned in the literature, none have previously been investigated in Malaysia, owing to the low prevalence of CHE and a general lack of interest in the subject.…”

Section: Introductionmentioning

confidence: 99%

Assessing progress towards Sustainable Development Goal 3.8.2 and determinants of catastrophic health expenditures in Malaysia

Sayuti

Sukeri

2022

PLoS ONE

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The Sustainable Development Goal 3.8.2 is an indicator to track a country’s progress toward universal health coverage on the financial protection against catastrophic health expenditure (CHE). The purpose of this study is to determine the proportion of households with catastrophic health expenditure, and its associated factors among Malaysian households. A secondary data analysis was performed using the Household Expenditure Survey 2015/2016. The inclusion criterion was Malaysian households with some health spending in the past 12 months before the date of the survey. Catastrophic health expenditure was defined as out-of-pocket health expenditures exceeding 10% of the total household consumption. The study included a total of 13015 households. The proportion of households with CHE in the sample was 2.8%. Female-led households (AdjOR 1.6; CI 1.25, 2.03; p-value <0.001), households in rural areas (AdjOR 1.29; 95% CI 1.04, 1.61; p-value = 0.022), small household size (AdjOR 2.4; 95% CI 1.81, 3.18; p-value <0.001) and heads of household under 60 years old (AdjOR2.34; 95% CI 1.81, 3.18; p-value <0.001) were significantly associated with CHE. Although the proportion of Malaysian households affected by CHE is small, it is increasing in comparison to previous findings. This is concerning because it may jeopardise efforts to achieve universal health coverage by 2030. To ensure financial protection and access to care, a health financing policy that includes safety net measures for households at risk of CHE is required.

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“…A great number of factors can affect the incidence of CHE, the main of which can be divided into health-related and economic factors [ 4 , 5 , 6 ]. Poor health conditions, obviously, can increase the demand and usage of medical care, further leading to high costs in health-care and finally triggering CHE.…”

Section: Introductionmentioning

confidence: 99%

Association of Body Mass Index with Risk of Household Catastrophic Health Expenditure in China: A Population-Based Cohort Study

Wang

Liu

2022

Nutrients

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Catastrophic health expenditure (CHE) is a major obstacle to achieving universal health coverage, and body mass index (BMI) is linked to both health and economy. We aimed to explore the association of BMI with the risk of CHE to provide advice for reducing CHE. We used national cohort data from the China Family Panel Studies, which comprised 33,598 individuals (14,607 households) from 25 provinces between 2010 to 2018. We used multivariate Cox proportional hazard models to estimate adjusted hazard ratios (aHRs) and 95% confident interval (CI) for CHE in participants at underweight, overweight, and obesity, compared with those at normal weight. Restricted cubic splines were employed to model the association of continuous BMI scale with risk of CHE. We found that families with female household heads at underweight had a 42% higher risk of CHE (aHR = 1.42, 95%CI: 1.16–1.75), and those at overweight had a 26% increased risk of CHE (aHR = 1.26, 95%CI: 1.09–1.47), compared with those at normal weight. A weak U-shaped curve for the association of continuous BMI with risk of CHE in female-headed households (p for non-linear = 0.0008) was observed, which was not significant in male-headed households (p for non-linear = 0.8725). In female-headed households, underweight and overweight BMI are connected with a higher risk of CHE. Concerted efforts should be made to keep a normal BMI to prevent CHE.

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Incidence of Catastrophic Health Expenditure and Its Determinants in Cancer Patients: A Systematic Review and Meta-analysis

Cited by 27 publications

References 61 publications

The Disease and Economic Burdens of Esophageal Cancer in China from 2013 to 2030: Dynamic Cohort Modeling Study

The Disease and Economic Burdens of Esophageal Cancer in China from 2013 to 2030: Dynamic Cohort Modeling Study

Assessing progress towards Sustainable Development Goal 3.8.2 and determinants of catastrophic health expenditures in Malaysia

Association of Body Mass Index with Risk of Household Catastrophic Health Expenditure in China: A Population-Based Cohort Study

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