Table 4. Results of studies quantifying out-of-pocket spending, debt.
| Study | Scope | Summary statistics | Key conclusions |
|---|---|---|---|
| Emanuel (2010) | Total OOP spending on health care last two months, total debt among people receiving palliative care | Mean total spending: INR 15,000 (USD 325) Mean debt: INR 50,000 (USD 1,082) | •High prevalence of debt, out-of-pocket spending |
| Ladusingh (2013) | Total OOP spending among hospital inpatients | Mean costs Decedents (2004/5): INR 10,036 Survivors (2004/5): INR 7,126 | •OOP spending was significantly higher for those dying in hospital than those discharged alive |
| Atieno (2018) | Total direct medical costs of palliative care in people with cancer | Average cost of palliative care: KES 98,931 (USD 977) Sub-group in public hospital: KES 94,867 (USD 937) Sub-group in private hospital: KES 118,708 (USD 1172) |
•Wide variation in cancer costs by diagnosis and treatment choices •Palliative care accounted for 12% of cancer costs •Other cost categories, e.g. surgery, chemotherapy, were not reported specifically for end-of-life population |
| Das (2018) | Total OOP spending among hospital inpatients | Mean costs Decedents (2004/5): INR 22,649 Survivors (2004/5): INR 15,485 Decedents (2014/5): INR 43,897 Survivors (2014/5): INR 19,438 |
•OOP spending was significantly higher for those dying in hospital than those discharged alive •Mean decedent OOP spending nearly doubled during the ten-year observation period |
| Prinja (2018) | Total OOP spending among hospital inpatients with liver disease | Mean costs All (ICU): INR 2,465 Decedents (ICU): INR 2,128 Survivors (ICU): INR 2,465 All (ICU): INR 1,752 Decedents (ICU): INR 3,553 Survivors (ICU): INR 1,484 |
•OOP costs are higher in intensive care unit among survivors, and higher in high dependency unit among decedents •Wide variation in costs by locality, education, occupation, but these difference are not statistically significant |
| Kongpakwattana (2019) | Total OOP spending among people diagnosed with dementia | Mean OOP spending Mild: USD 509 Moderate: USD 951 Severe: USD 1003 |
•Mean OOP spending was highest among the severe disease group, but this difference was not statistically significant |
| Leng (2019) | Total end-of-life (EOL) health care costs among cancer decedents | Mean total spending OOP: USD 11,288 | •OOP spending was 36% of total cancer costs •OOP spending was significantly higher in urban areas than rural, geographic variation was also identified |