IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0193320.html
   My bibliography  Save this article

Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014

Author

Listed:
  • Sunil Rajpal
  • Abhishek Kumar
  • William Joe

Abstract

With the ongoing demographic and epidemiological transition, cancer is emerging as a major public health concern in India. This paper uses nationally representative household survey to examine the overall prevalence and economic burden of cancer in India. The age-standardized prevalence of cancer is estimated to be 97 per 100,000 persons with greater prevalence in urban areas. The evidence suggests that cancer prevalence is highest among the elderly and also among females in the reproductive age groups. Cancer displays a significant socioeconomic gradient even after adjusting for age-sex specifics and clustering in a multilevel regression framework. We find that out of pocket expenditure on cancer treatment is among the highest for any ailment. The average out of pocket spending on inpatient care in private facilities is about three-times that of public facilities. Furthermore, treatment for about 40 percent of cancer hospitalization cases is financed mainly through borrowings, sale of assets and contributions from friends and relatives. Also, over 60 percent of the households who seek care from the private sector incur out of pocket expenditure in excess of 20 percent of their annual per capita household expenditure. Given the catastrophic implications, this study calls for a disease-based approach towards financing such high-cost ailment. It is suggested that universal cancer care insurance should be envisaged and combined with existing accident and life insurance policies for the poorer sections in India. In concluding, we call for policies to improve cancer survivorship through effective prevention and early detection. In particular, greater public health investments in infrastructure, human resources and quality of care deserve priority attention.

Suggested Citation

  • Sunil Rajpal & Abhishek Kumar & William Joe, 2018. "Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
  • Handle: RePEc:plo:pone00:0193320
    DOI: 10.1371/journal.pone.0193320
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193320
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0193320&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0193320?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
    2. Md Mizanur Rahman & Stuart Gilmour & Eiko Saito & Papia Sultana & Kenji Shibuya, 2013. "Health-Related Financial Catastrophe, Inequality and Chronic Illness in Bangladesh," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-9, February.
    3. Madison, T. & Schottenfeld, D. & James, S.A. & Schwartz, A.G. & Gruber, S.B., 2004. "Endometrial cancer: Socioeconomic status and racial/ethnic differences in stage at diagnosis, treatment, and survival," American Journal of Public Health, American Public Health Association, vol. 94(12), pages 2104-2111.
    4. O'Donnell, Owen & van Doorslaer, Eddy & Rannan-Eliya, Ravi P. & Somanathan, Aparnaa & Adhikari, Shiva Raj & Akkazieva, Baktygul & Harbianto, Deni & Garg, Charu C. & Hanvoravongchai, Piya & Herrin, Ale, 2008. "Who pays for health care in Asia?," Journal of Health Economics, Elsevier, vol. 27(2), pages 460-475, March.
    5. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    6. Leckie, George & Charlton, Chris, 2013. "runmlwin: A Program to Run the MLwiN Multilevel Modeling Software from within Stata," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 52(i11).
    7. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    8. Ajay Mahal & Anup Karan & Victoria Y Fan & Michael Engelgau, 2013. "The Economic Burden of Cancers on Indian Households," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-10, August.
    9. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kane, Sumit & Joshi, Madhura & Desai, Sapna & Mahal, Ajay & McPake, Barbara, 2022. "People's care seeking journey for a chronic illness in rural India: Implications for policy and practice," Social Science & Medicine, Elsevier, vol. 312(C).
    2. Mohammad FaisalUddin & Azadeh Khayat & Azeem Husain Arastu & Javidulla Khan & Pulwasha Maria Iftikhar & Roopam Bansal & Jain Akriti, 2019. "A Bibliometric Analysis of the Top 100 Most-Cited Articles in Chemotherapy (1910- 2019)," Cancer Therapy & Oncology International Journal, Juniper Publishers Inc., vol. 15(2), pages 72-82, December.
    3. Jeetendra Yadav & Geetha R. Menon & Denny John, 2021. "Disease-Specific Out-of-Pocket Payments, Catastrophic Health Expenditure and Impoverishment Effects in India: An Analysis of National Health Survey Data," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 769-782, September.
    4. Sobin George, 2023. "Being sick to a cancer patient: pathways of delay in help seeking and diagnosis of cancer in India," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 25(1), pages 52-69, June.
    5. Divya Chaudhry, 2024. "Pesticide Use in Indian Agriculture: Policy Alternatives for Environmental Health," Journal of Development Policy and Practice, , vol. 9(1), pages 133-161, January.
    6. Li, ChangZheng & Umair, Muhammad, 2023. "Does green finance development goals affects renewable energy in China," Renewable Energy, Elsevier, vol. 203(C), pages 898-905.
    7. Hasan, Mohammad Maruf & Du, Fang, 2023. "Nexus between green financial development, green technological innovation and environmental regulation in China," Renewable Energy, Elsevier, vol. 204(C), pages 218-228.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    2. Ebaidalla Mahjoub Ebaidalla & Mohammed Elhaj Mustafa Ali, 2017. "Determinants and Impact of Households’s Out-of-Pocket Health Care Expenditure in Sudan: Evidence From Urban and Rural Population," Working Papers 1170, Economic Research Forum, revised 12 2017.
    3. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2013. "Measuring the catastrophic and impoverishing effect of household health care spending in Serbia," Social Science & Medicine, Elsevier, vol. 78(C), pages 17-25.
    4. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    5. Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    6. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    7. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.
    8. Rama Pal, 2010. "Analysing Catastrophic OOP Health Expenditure in India: Concepts, Determinants and Policy Implications," Working Papers id:2420, eSocialSciences.
    9. Sanjay K. Mohanty & Anshul Kastor, 2017. "Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period," Health Economics Review, Springer, vol. 7(1), pages 1-15, December.
    10. Anupa Rijal & Tara Ballav Adhikari & Jahangir A M Khan & Gabriele Berg-Beckhoff, 2018. "The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-23, November.
    11. Panos Kanavos & Olivier Wouters & Anna Zawada & Katarzyna Kolasa & Christian Kronborg & Daniel Rabczenko & Tomasz Rybnik & Jørgen T. Lauridsen & Urszula Ceglowska & Tomasz Hermanowski, 2017. "A Comparison of the Burden of Out-of-Pocket Health Payments in Denmark, Germany and Poland," Global Policy, London School of Economics and Political Science, vol. 8, pages 123-130, March.
    12. repec:bla:glopol:v:8:y:2017:i:s2:p:123-130 is not listed on IDEAS
    13. Victoria Fan, Anup Karan, and Anjay Mahal, 2012. "State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India - Working Paper 298," Working Papers 298, Center for Global Development.
    14. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    15. Cavagnero, Eleonora & Bilger, Marcel, 2010. "Equity during an economic crisis: Financing of the Argentine health system," Journal of Health Economics, Elsevier, vol. 29(4), pages 479-488, July.
    16. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    17. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
    18. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2018. "Macroeconomic and financing determinants of out of pocket payments in health care: Evidence from selected OECD countries," Journal of Policy Modeling, Elsevier, vol. 40(6), pages 1290-1312.
    19. Yira Natalia Alfonso & Olakunle Alonge & Dewan Md Emdadul Hoque & Md Kamran Ul Baset & Adnan A. Hyder & David Bishai, 2017. "Care-Seeking Patterns and Direct Economic Burden of Injuries in Bangladesh," IJERPH, MDPI, vol. 14(5), pages 1-9, April.
    20. Kim, Sujin & Kwon, Soonman, 2015. "Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea," Social Science & Medicine, Elsevier, vol. 138(C), pages 241-247.
    21. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0193320. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.