Table 6. Results of studies reporting prevalence of objective and subjective financial burden.

Study	Scope	Summary statistics	Key conclusions
Ngalula (2002)	Among people who died, prevalence of health care expenditure and funeral expenses borne by decedent and spouse; received financial assistance outside the family; sold property for care or funeral	Decedent or spouse was primary source of payment: AIDS: 37% Other diseases: 48% Injuries: 14% Received financial assistance outside the family: AIDS: 1% Other diseases: 5% Injuries: 0% Sold property for care or funeral: AIDS: 29% Other diseases: 10% Injuries: 19%	•Widespread prevalence of decedents and families meeting costs, including selling property •Little evidence of financial assistance outside the family
Emanuel (2010)	Prevalence of objective and subjective financial burden among people receiving palliative care	Patient left workforce: 100% Family members working less: 100% Education missed or foregone: 100% Had to sell assets: 100% Married/feeling pressure to marry: 45% Resort to dangerous or illegal work: 64%	•Foregone work, income, education reported by all participants •Widespread prevalence of pressure to replace lost income and meet medical costs
Ratcliff (2017)	Prevalence of household poverty, association between poverty and palliative care receipt	Patient left workforce: 66% Family member left workforce: 26% In debt: 98% Had to sell assets: 59%	•Widespread prevalence of lost income, debt, pressure to sell assets •Palliative care reportedly associated with lower out-of-pocket spending and high income through return to work and awareness of government benefits. No formal statistical evaluation of this.
Kumar (2018)	Prevalence of subjective financial burden among patients with advanced cancer receiving palliative care	Financial insecurity among participants: 26% Concern regarding financial security of family members in future: 33%	•Widespread prevalence of insecurity about current and future finances
Leng (2019)	Prevalence of borrowing among cancer decedents	Borrowing to meet EOL expenses: 33%	•Widespread prevalence of borrowing, with variation by urban/rural, geographic region and spending type
Arisar (2020)	Prevalence of objective and subjective financial burden among patients with severe chronic liver disease	Worsening economic status: 89% Stopped saving: 89% Utilization of previous savings: 93% Need to borrow to meet expenses: 71% Delay in repaying loans: 36% Delay in children’s education: 61% Electricity/gas cut off: 14% Had to leave current house: 14% Had to forego food: 22% Unpaid medical expenses: 47% Skip medicines: 72% Buy fewer medicines than required: 61% Missed surgery: 57% Missed doctor’s appointment: 61%	•Socioeconomic burden of chronic liver disease is considerable •Magnitude of burden is strongly associated with severity of disease–and is therefore greatest in the end-of-life cohort