Biomaterial Database

Catastrophic Health Expenditure (CHE) among Cancer Population in a Middle Income Country with Universal Healthcare Financing. 2023

Sharifa Ezat Wan Puteh, and Yang Rashidi Abdullah, and Azimatun Noor Aizuddin

Department of Public Health, Universiti Kebangsaan Malaysia, Malaysia.

BACKGROUND The study investigated healthcare expenditure from the perspective of cancer patients, to determine the level of Catastrophic Health Expenditure (CHE) and its associated factors. METHODS This cross-sectional study was conducted in three Malaysian public hospitals namely Hospital Kuala Lumpur, Hospital Canselor Tuanku Muhriz and the National Cancer Institute using a multi-level sampling technique to recruit 630 respondents from February 2020 to February 2021. CHE was defined as incurring a monthly health expenditure of more than 10% of the total monthly household expenditure. A validated questionnaire was used to collect the relevant data. RESULTS The CHE level was 54.4%. CHE was higher among patients of Indian ethnicity (P = 0.015), lower level education (P = 0.001), those unemployed (P < 0.001), lower income (P < 0.001), those in poverty (P < 0.001), those staying far from the hospital (P < 0.001), living in rural areas (P = 0.003), small household size (P = 0.029), moderate cancer duration (P = 0.030), received radiotherapy treatment (P < 0.001), had very frequent treatment (P < 0.001), and without a Guarantee Letter (GL) (P < 0.001). The regression analysis identified significant predictors of CHE as lower income aOR 18.63 (CI 5.71-60.78), middle income aOR 4.67 (CI 1.52-14.41), poverty income aOR 4.66 (CI 2.60-8.33), staying far from hospital aOR 2.62 (CI 1.58-4.34), chemotherapy aOR 3.70 (CI 2.01-6.82), radiotherapy aOR 2.99 (CI 1.37-6.57), combination chemo-radiotherapy aOR 4.99 (CI 1.48-16.87), health insurance aOR 3.99 (CI 2.31-6.90), without GL aOR 3.38 (CI 2.06-5.40), and without health financial aids aOR 2.94 (CI 1.24-6.96). CONCLUSIONS CHE is related to various sociodemographic, economic, disease, treatment and presence of health insurance, GL and health financial aids variables in Malaysia.

UI	MeSH Term	Description	Entries
D009369	Neoplasms	New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.	Benign Neoplasm,Cancer,Malignant Neoplasm,Tumor,Tumors,Benign Neoplasms,Malignancy,Malignant Neoplasms,Neoplasia,Neoplasm,Neoplasms, Benign,Cancers,Malignancies,Neoplasias,Neoplasm, Benign,Neoplasm, Malignant,Neoplasms, Malignant
D002388	Catastrophic Illness	An acute or prolonged illness usually considered to be life-threatening or with the threat of serious residual disability. Treatment may be radical and is frequently costly.	Catastrophic Illnesses,Illness, Catastrophic,Illnesses, Catastrophic
D003430	Cross-Sectional Studies	Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.	Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D003906	Developing Countries	Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures.	LMICs,Less-Developed Countries,Low Income Countries,Low and Middle Income Countries,Lower-Middle-Income Country,Middle Income Countries,Third-World Countries,Under-Developed Countries,Developing Nations,Least Developed Countries,Less-Developed Nations,Third-World Nations,Under-Developed Nations,Countries, Middle Income,Countries, Third-World,Country, Least Developed,Country, Less-Developed,Country, Low Income,Country, Lower-Middle-Income,Country, Middle Income,Country, Third-World,Country, Under-Developed,Developed Country, Least,Developing Country,Developing Nation,Least Developed Country,Less Developed Countries,Less Developed Nations,Less-Developed Country,Less-Developed Nation,Low Income Country,Lower Middle Income Country,Lower-Middle-Income Countries,Middle Income Country,Nation, Less-Developed,Nation, Third-World,Nation, Under-Developed,Third World Countries,Third World Nations,Third-World Country,Third-World Nation,Under Developed Countries,Under Developed Nations,Under-Developed Country,Under-Developed Nation
D005102	Health Expenditures	The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.	Expenditure,Expenditures, Health,Health Expenditure,Out Of Pocket Expenditure,Out-of-Pocket Cost,Out-of-Pocket Expense,Out-of-Pocket Payment,Expenditures,Expenditures, Direct,Expenditures, Indirect,Expenditures, Out-of-Pocket,Out-of Pocket Expenditures,Out-of-Pocket Costs,Out-of-Pocket Expenses,Out-of-Pocket Payments,Out-of-Pocket Spending,Cost, Out-of-Pocket,Costs, Out-of-Pocket,Direct Expenditure,Direct Expenditures,Expenditure, Direct,Expenditure, Health,Expenditure, Indirect,Expenditure, Out-of Pocket,Expenditure, Out-of-Pocket,Expenditures, Out of Pocket,Expenditures, Out-of Pocket,Expense, Out-of-Pocket,Expenses, Out-of-Pocket,Indirect Expenditure,Indirect Expenditures,Out of Pocket Cost,Out of Pocket Costs,Out of Pocket Expenditures,Out of Pocket Expense,Out of Pocket Expenses,Out of Pocket Payment,Out of Pocket Payments,Out of Pocket Spending,Out-of Pocket Expenditure,Out-of-Pocket Expenditure,Out-of-Pocket Expenditures,Payment, Out-of-Pocket,Payments, Out-of-Pocket,Spending, Out-of-Pocket
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D061889	Healthcare Financing	Methods of generating, allocating, and using financial resources in healthcare systems.	Health Financing,Financing, Health,Financing, Healthcare,Financings, Health,Financings, Healthcare,Health Financings,Healthcare Financings