前往印度公共部门癌症专科医院接受治疗的路程所造成的经济负担：对胃癌和胰腺癌患者的个案研究

IF 2 Q3 HEALTH POLICY & SERVICES

Journal of Cancer Policy Pub Date : 2025-08-15 DOI:10.1016/j.jcpo.2025.100632

Mohit Pandey , T.R. Dilip , Amit Chopade , Shailesh V. Shrikhande , Manish Bhandare

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引用次数: 0

摘要

背景：印度和世界大部分地区提供的癌症治疗是异质性的，很少有地区拥有专门的高容量中心，并建立了转诊模式。由于治疗癌症的专门单位很少，病人常常不得不长途跋涉去看病。我们的研究考察了癌症患者在寻求胃癌和胰腺癌治疗时长途旅行对其家庭的额外经济负担（非医疗费用）的影响。方法数据（n = 244）是在印度孟买塔塔纪念医院（TMH）进行的一项前瞻性、非干预性队列研究的一部分。连续的胃癌和胰腺癌患者。每次就诊的医疗和非医疗费用以及其他癌症特异性和治疗细节都被收集起来。紧急融资被定义为借钱或出售资产以支付与治疗相关的费用。患者平均行走距离为1475 km。63.1 %的患者行程大于1500 公里。旅行超过1500 公里的患者的平均非医疗卫生支出（NMHE）为107,040卢比（1278美元），比旅行少于500 公里的患者的支出高出近两倍，49,112卢比（587美元）。NMHE的42.9% %用于旅行，33.3% %用于住宿，17.2% %用于食品。逻辑回归结果显示，与旅行>； 500 公里的患者相比，旅行>； 500 公里的患者经历灾难性NMHE （CNMHE）的可能性是前者的三倍。因癌症治疗造成的健康窘迫占39.3% %。与CNMHE的10 %（45.8 %）相比，CNMHE的痛苦健康融资更高，为25 %(52.8 %)，并且在旅行>； 500 km的患者中比<； 500 km的患者高出两倍。结论癌症护理的结构化分散化需要一小时来抵消癌症患者及其家属所经历的额外经济负担和CNMHE。如果在非城市地区提供足够的基础设施，训练有素的肿瘤学家可以部署到离病人家更近的医院，在早期治疗癌症。

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Financial burden due to distance traveled to access treatment from specialized cancer hospitals in public sector in India: a case study of patients treated for gastric and pancreatic cancer

Background

Cancer care offered in India and large part of the world is heterogenous with few regions having dedicated high volume centres with established referral patterns. Due to scarcity of the specialized units treating cancer, patients often have to travel for long distances for medical care. Our study examines the impact of additional financial burden (non-medical expenses) on cancer patients’ families due to long distance travelled while seeking treatment for gastric and pancreatic cancer.

Methods

The data (n = 244) were collected as part of a prospective, non-interventional cohort study, conducted at Tata Memorial Hospital (TMH), Mumbai, India. Consecutive patients with gastric and pancreatic cancers. The medical and non-medical expenditures were collected for each visit along with other cancer specific and treatment details. Distress financing defined as borrowing money or selling assets to meet treatment-related expenses.

Findings

The mean distance travelled by patients was 1475 km. 63.1 % of patients travelled greater than 1500 km. The mean Non-Medical Health Expenditure (NMHE) for patients traveling more than 1500 km was ₹107,040 ($1278), nearly two times higher than the expenditure for patients traveling less than 500 km, ₹49,112 ($587). A total of 42.9 % of NMHE was spent on travel, 33.3 % on accommodation, and 17.2 % on food. The logistic regression results depict that patients traveling > 500 km are three times more likely to experience Catastrophic NMHE (CNMHE) compared to < 500 km. The distress health financing due to cancer treatment was 39.3 %. Distress health financing was higher with CNMHE at 25 % (52.8 %) compared to CNMHE at 10 % (45.8 %), and was two times higher in patients travelling > 500 km compared to < 500 km

Conclusion

A structured decentralization of cancer care is the need of the hour to negate the additional financial burden and CNMHE experienced by the cancer patients and their families. If adequate infrastructure is provided at the non-urban areas, well trained oncologists can be deployed in hospitals closer to patients homes to treat cancers at earlier stage.

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来源期刊

Journal of Cancer Policy Medicine-Health Policy

CiteScore

2.40

自引率

7.70%

发文量

审稿时长

65 days