未经评估:尽管印度的结直肠癌正在增加,综合治疗的费用及其对患者和家庭的影响尚不清楚。这项研究旨在描述具有结直肠癌治疗计划的患者的灾难性支出和治疗减员。
未经批准:预期,多中心,队列研究于2020年12月至2022年3月在印度的5家三级医院进行.连续接受新的结直肠癌治疗计划的患者随访6个月。报告了治疗的总费用,包括自付付款(OOPP,由患者在服务时间使用时支付),并由第三方(保险,公共基金)。主要结果是灾难性的支出,定义为OOPPs大于患者家庭年收入的25%,次要结果是治疗减员,定义为临床团队不建议的治疗过程的计划外中断。
未经批准:纳入226名患者,在提供治疗计划后的六个月内,有20人死亡,有4人失去了随访。结直肠癌治疗的总费用中位数为407,508印度卢比(INR/5340USD),其中最大的贡献者是患者的OOPP(中位数为330,277INR/4328美元)。手术和麻醉费用(中位数85,944INR/1126美元)高于放疗(中位数55,525INR/728美元)和化疗(中位数14,780INR/194美元)。总体灾难性支出率为90.1%(182/202),治疗减员率为9.4%(19/202)。与完成治疗的患者相比,治疗减员的OOPP较低(中位数为205,926vs349,398INR,p<0.01),但灾难性支出的风险相似(OR0.23,95CI0.03-2.28,p=0.186)。
UNASSIGNED:大多数结直肠癌的治疗费用由患者自付,灾难性支出很常见。三级中心的治疗流失率很低,这表明在以前的护理阶段有更大的减员。更好的财务保护可以使更多的患者接受全面的癌症治疗,同时避免家庭财务灾难。
UNASSIGNED:这项研究由美国国立卫生研究院(NIHR)(NIHR16.136.79)资助,使用英国政府的英国援助来支持全球卫生研究。由伯明翰大学印度研究所和伯明翰大学的全球挑战计划。本出版物中表达的观点是作者的观点,不一定是NIHR或英国政府的观点。
UNASSIGNED: Although colorectal cancer is increasing in India, the cost of comprehensive treatment and its consequences for patients and households are unknown. This study aimed to describe catastrophic expenditure and treatment attrition in patients with a treatment plan for colorectal cancer.
UNASSIGNED: A prospective, multicentre, cohort study was conducted in five tertiary hospitals in India from December 2020 to March 2022. Consecutive patients with a new treatment plan for colorectal cancer were followed-up for six months. The total cost of treatment was reported, including out-of-pocket payments (OOPP, paid by patients at the time-of-service use) and covered by third parties (insurance, public funds). The primary outcome was catastrophic expenditure, defined as OOPPs greater than 25% of patient\'s annual household income and the secondary outcome was treatment attrition, defined as unplanned interruption of the treatment course not recommended by the clinical team.
UNASSIGNED: Of 226 patients included, 20 died within six months of being offered a treatment plan and four were lost to follow-up. The median total cost of colorectal cancer treatment was 407,508 Indian Rupees (INR/5340 USD), to which the biggest contributor was the patient\'s OOPP (median 330,277 INR/4328 USD). Surgery and anaesthesia costs (median 85,944 INR/1126 USD) were higher than radiotherapy (median 55,525 INR/728 USD) and chemotherapy (median 14,780 INR/194 USD). The overall catastrophic expenditure rate was 90.1% (182/202) and the treatment attrition rate was 9.4% (19/202). Patients with treatment attrition made lower OOPPs than those who completed treatment (median 205,926 vs 349,398 INR, p < 0.01) but had a similar risk of catastrophic expenditure (OR 0.23, 95%CI 0.03-2.28, p = 0.186).
UNASSIGNED: Most treatment costs for colorectal cancer were paid out-of-pocket by patients and catastrophic expenditure was common. Treatment attrition rates at tertiary centres were low, suggesting greater attrition at previous stages of care. Better financial protection may allow more patients to receive comprehensive cancer treatment while avoiding household financial catastrophe.
UNASSIGNED: This research was funded by the National Institute for Health Research (NIHR) (NIHR 16.136.79) using UK aid from the UK Government to support global health research, by the India Institute of the University of Birmingham and by the Global Challenges program of the University of Birmingham. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.