Socioeconomic health and impact of sickle cell disease and vaso-occlusive crises in India: results from B-VOCAL study.

IF 7.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

BMJ Global Health Pub Date : 2025-05-22 DOI:10.1136/bmjgh-2024-017887

Dipty Jain, Tulika Seth, Shashank Udupi, Suman Jain, Seema Bhatwadekar, Nandakumar Menon, Rabindra Jena, Ravindra Kumar, Bharat Parmar, Anil Goel, Ashvin Vasava, Anupam Dutta, Priyanka Samal, Riya Ballikar, Deepa Bhat, Tuphan Kanti Dolai, Jina Bhattacharyya, Disha Shetty, Manish Mistry, Shomik Ray

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引用次数: 0

Abstract

Background: Sickle cell disease (SCD) with vaso-occlusive pain crisis (VOC) has a major impact on healthcare resource utilisation and poses a significant financial burden for the patients. This study examines the economic implications of managing VOC in individuals with SCD in India, from the perspectives of patients, healthcare system and society.

Methods: This cross-sectional, observational study included 1000 patients with SCD across 14 centres enrolled from November 2021 to June 2022. Data were collected systematically using a structured electronic case record form. Employing a cost-of-illness approach, the study assessed the economic impact of SCD and VOC management, including assessing patient/caregiver costs, healthcare provider costs and societal burdens extrapolated to the larger SCD population in India.

Findings: Patients incurred substantial out-of-pocket expenses, with a median (IQR) annual expenditure of INR 22 080/US$267 (IQR: INR 36 990/US$447.7), representing 14.65% (26.53) of their annual household income. Overall, catastrophic healthcare expenditure (CHE) for total annual average SCD care with VOC management was experienced by 624 patients (62.40%). Moreover, 334 patients (33.4%) experienced CHE of >25% of the annual household income. Patients with SCD with VOC had significantly higher median annual healthcare expenditures and used a higher median percentage of their yearly household income on healthcare compared with those without VOC (19.82% vs 6.08%; p<0.001). Cost incurred by healthcare providers for VOC management in different healthcare facilities (outpatient department/emergency department/intensive care unit) was similar across different reimbursed facilities (government tertiary care hospitals, non-governmental organisation-operated healthcare centres and government-subsidised healthcare setups). The estimated societal burden for VOC management in 1 year for 1000 patients visiting different healthcare facilities was around INR 35 119 074 (~US$0.42 million).

Interpretation: These findings highlight the considerable economic strain on both patients and healthcare providers in SCD and VOC management, which is similar to the other non-communicable diseases emphasising the urgent need for targeted interventions to improve financial hardships among patients.

Funding: The study was funded by Novartis Healthcare Private Limited.

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印度镰状细胞病和血管闭塞危机的社会经济健康和影响：B-VOCAL研究的结果

背景：镰状细胞病（SCD）合并血管闭塞性疼痛危机（VOC）对医疗资源的利用有重大影响，并给患者带来了重大的经济负担。本研究从患者、医疗保健系统和社会的角度考察了印度SCD患者VOC管理的经济影响。方法：这项横断面观察性研究包括从2021年11月到2022年6月在14个中心招募的1000名SCD患者。使用结构化的电子病例记录表格系统地收集数据。采用疾病成本方法，该研究评估了SCD和VOC管理的经济影响，包括评估患者/护理人员成本、医疗保健提供者成本和推断出印度较大SCD人群的社会负担。研究结果：患者产生了大量的自付费用，年支出中位数（IQR）为22080印度卢比/ 267美元（IQR: 36990印度卢比/ 447.7美元），占其家庭年收入的14.65%（26.53）。总体而言，624名患者（62.40%）经历了具有VOC管理的SCD年平均护理的灾难性医疗支出（CHE）。此外，334例患者（33.4%）的CHE占家庭年收入的25%。与无VOC的SCD患者相比，有VOC的SCD患者的年度医疗保健支出中位数明显更高，其家庭年收入中位数百分比用于医疗保健的比例也更高(19.82% vs 6.08%；解释：这些发现突出了SCD和VOC管理对患者和医疗保健提供者造成的相当大的经济压力，这与其他非传染性疾病类似，强调迫切需要有针对性的干预措施来改善患者的经济困难。资助：本研究由Novartis Healthcare Private Limited资助。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Global Health Medicine-Health Policy

CiteScore

11.40

自引率

4.90%

发文量

429

审稿时长

18 weeks

期刊介绍： BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.