Background
Cancer treatment is among the most expensive medical care worldwide and a major cause of catastrophic health expenditure (CHE), often leading to financial health distress for patients and their families.
Objective
Our study aims to analyze the risk factors influencing distress health financing for gastric and pancreatic cancer patients, focusing on its prevalence and timing of onset of distress health financing from their registration to cancer hospitals.
Methodology
The was a prospective study of patients with gastric and pancreatic cancer patients treated at Tata memorial hospital, Mumbai. Kaplan-Meier (KM) estimator and Cox proportional hazards regression were used to examine the time-dependent probability of remaining free from distress health financing among cancer patients.
Results
Poor patients fall sooner in distress health financing (median: 1.83 months) than non-poor patients (4.40 months). Surgical patients (2.87 months) and rural patients (2.13 months) faced distress finance earlier than non-surgical (3.93 months) and urban (4.70 months) and rural patients had a significantly higher hazard (HR: 1.98, p = 0.01). The lower age group (18-45 years) have a higher hazard than patients aged 46–60 (HR: 0.60, p = 0.05) and >60 (HR: 0.57, p = 0.07). Employed patients (HR: 0.42 p-value: 0.01) have a lower hazard of falling into distress health financing than unemployed patients. patients under deferred institutional reimbursement system (?6.3 lacks or $7,600) and patients with employer health insurance (?2.6 lacks or $3,153) received the highest reimbursements. The highest OOPE was seen in patients receiving all three treatments (chemotherapy, surgery and radiotherapy) (?6,45,045 or $7,750), followed by chemotherapy and radiotherapy (?5,50,858 or $6,618) and radiotherapy alone (?5,33,188 or $6,404).
Conclusions
This study highlights the urgent need for tailored financial protection policies based on risk stratification. Policymakers should prioritize vulnerable sections of the populations, such as younger patients, rural residents, and unemployed individuals by enhancing reimbursement limits under government health insurance/policy based on treatment categories.
Trial Registration
The study was registered on the Clinical Trial Registry of India with CTRI No. CTRI/2023/04/051523 on date 12/04/2023.