Publication: Catastrophic health expenditure and its associated factors among adult cancer patients in hospital Universiti Sains Malaysia
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Date
2024-06
Authors
Zaman, Muhammad Abdul Hafiz Kamarul
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Abstract
Introduction:ِ Highِ out-of-pocketِ (OOP)ِ healthِ expendituresِ dueِ toِ costlyِ treatmentsِ andِ
prolongedِ care,ِ posesِ aِ substantialِ riskِ ofِ catastrophicِ healthِ expenditureِ (CHE)ِ forِ
households.ِ Catastrophicِ healthِ expenditureِ amongِ householdsِ affectedِ byِ cancerِ canِ beِ
devastatingِ forِ familiesِ alreadyِ facingِ theِ emotionalِ andِ psychologicalِ challengesِ ofِ cancerِ
diagnosisِ andِ treatment.
Objective: Theِ purposeِ ofِ thisِ studyِ wasِ toِ determineِ theِ proportionِ ofِ CHEِ andِ itsِ
associatedِ factorsِ amongِ adultِ cancerِ patientsِ atِ Hospitalِ Universitِi Sainsِ Malaysia.
Methodology:ِ Aِ cross-sectionalِ studyِ wasِ conductedِ withِ 209ِ adultِ cancerِ patientsِ atِ
Hospitalِ Universitِi Sainsِ Malaysiaِ fromِ Decemberِ 2023ِ toِ Aprilِ 2024.ِ Participantsِ wereِ
selectedِ usingِ systematicِ randomِ samplingِ andِ dataِ wereِ collectedِ throughِ guidedِ face-to-
faceِ interviews.ِ Theِ proformaِ usedِ includedِ sectionsِ onِ sociodemographicِ details,ِ diseaseِ
information,ِ householdِ details,ِ andِ expenditureِ andِ income.ِ Theِ primaryِ outcomeِ wasِ theِ
proportionِ ofِ patientsِ experiencingِ CHE,ِ definedِ asِ out-of-pocketِ (OOP)ِ healthِ expensesِ
exceedingِ 10%ِ ofِ householdِ income.ِ Multipleِ logisticِ regressionِ analysisِ wasِ employedِ toِ
identifyِ factorsِ associatedِ withِ CHE.
Results:ِ Theِ studyِ revealedِ thatِ 15.3%ِ ofِ theِ participantsِ experiencedِ CHE.ِ Significantِ
factorsِ associatedِ withِ CHEِ includedِ ethnicity,ِ educationِ level,ِ GLِ status,ِ andِ theِ
employmentِ statusِ ofِ theِ householdِ head.ِ Non-Malayِ patientsِ hadِ 6.63ِ timesِ theِ oddsِ ofِ experiencingِ CHEِ comparedِ toِ Malayِ patientsِ (p-value=0.013,ِ 95%ِ CI:ِ 1.49,29.57).ِ Patientsِ
withِ primaryِ schoolِ educationِ orِ belowِ hadِ 9.56ِ timesِ theِ oddsِ ofِ experiencingِ CHEِ
comparedِ toِ thoseِ withِ tertiaryِ educationِ (p-value=0.005,ِ 95%ِ CI:ِ 2.01,45.57).ِ Patientsِ
withoutِ GLِ wereِ 4.81ِ timesِ moreِ likelyِ toِ experienceِ CHEِ thanِ thoseِ withِ GLِ (p-
value=0.008,ِ 95%ِ CI:ِ 1.51,15.34).ِ Householdsِ whereِ theِ headِ wasِ unemployedِ hadِ 6.55ِ
timesِ theِ oddsِ ofِ experiencingِ CHEِ comparedِ toِ thoseِ withِ employedِ headsِ (p-
value=0.014,ِ 95%ِ CI:ِ 1.46,29.35).
Conclusion:ِ Theِ studyِ highlightsِ significantِ sociodemographicِ andِ householdِ factorsِ
contributingِ toِ CHEِ amongِ adultِ cancerِ patientsِ inِ Hospitalِ Universitِi Sainsِ Malaysia.ِ Theseِ
findingsِ emphasizeِ theِ needِ forِ targetedِ interventionsِ toِ mitigateِ financialِ burdensِ onِ
cancerِ patients,ِ particularlyِ focusingِ onِ education,ِ employment,ِ andِ financialِ supportِ
mechanisms.