The economic burden of cancers on Indian households.
We assessed the burden of cancer on households' out-of-pocket health spending, non-medical consumption, workforce participation, and debt and asset sales using data from a nationally representative health and morbidity survey in India for 2004 of nearly 74 thousand households. Propensity scores were used to match households containing a member diagnosed with cancer (i.e. cancer-affected households) to households with similar socioeconomic and demographic characteristics (controls). Our estimates are based on data from 1,645 households chosen through matching. Cancer-affected households experienced higher levels of outpatient visits and hospital admissions and increased out-of-pocket health expenditures per member, relative to controls. Cancer-affected households spent between Indian Rupees (INR) 66 and INR 85 more per member on healthcare over a 15-day reference period, than controls and additional expenditures (per member) incurred on inpatient care by cancer-affected households annually is equivalent to 36% to 44% of annual household expenditures of matched controls. Members without cancer in cancer-affected households used less health-care and spent less on healthcare. Overall, adult workforce participation rates were lower by between 2.4 and 3.2 percentage points compared to controls; whereas workforce participation rates among adult members without cancer were higher than in control households. Cancer-affected households also had significantly higher rates of borrowing and asset sales for financing outpatient care that were 3.3% to 4.0% higher compared to control households; and even higher for inpatient care.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Ajay
A
Mahal
Anup
A
Karan
Victoria Y
VY
Fan
Michael
M
Engelgau
D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005102:Health Expenditures; D006801:Humans; D007194:India; D009369:Neoplasms / Q000191:economics*; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors