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

Autor: Doshmangir L; Department of Health Policy & Management, Tabriz Health Services Management Research Center, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.; Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran., Hasanpoor E; Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran. edihasanpoor@gmail.com., Abou Jaoude GJ; Institute for Global Health, Center for Global Health Economics, University College London, London, UK., Eshtiagh B; Institute for Global Health, Center for Global Health Economics, University College London, London, UK., Haghparast-Bidgoli H; Department of Health Policy & Management, Tabriz Health Services Management Research Center, School of Management & Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Jazyk: angličtina
Zdroj: Applied health economics and health policy [Appl Health Econ Health Policy] 2021 Nov; Vol. 19 (6), pp. 839-855. Date of Electronic Publication: 2021 Jul 28.
DOI: 10.1007/s40258-021-00672-2
Abstrakt: Background: Cancer is the third leading cause of mortality in the world, and cancer patients are more exposed to financial hardship than other diseases. This paper aimed to review studies of catastrophic healthcare expenditure (CHE) in cancer patients, measure their level of exposure to CHE, and identify factors associated with incidence of CHE.
Methods: This study is a systematic review and meta-analysis. Several databases were searched until February 2020, including MEDLINE, Web of Science, Scopus, ProQuest, ScienceDirect and EMBASE. The results of selected studies were extracted and analyzed using a random effects model. In addition, determinants of CHE were identified.
Results: Among the 19 studies included, an average of 43.3% (95% CI 36.7-50.1) of cancer patients incurred CHE. CHE varied substantially depending on the Human Development Index (HDI) of the country in which a study was conducted. In countries with the highest HDI, 23.4% of cancer patients incurred CHE compared with 67.9% in countries with the lowest HDI. Key factors associated with incidence of CHE at the household level included household income, gender of the household head, and at the patient level included the type of health insurance, education level of the patient, type of cancer and treatment, quality of life, age and sex.
Conclusion: The proportion of cancer patients that incur CHE is very high, especially in countries with lower HDI. The results from this review can help inform policy makers to develop fairer and more sustainable health financing mechanisms, addressing the factors associated with CHE in cancer patients.
(© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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