Table 2.
Socio-economic differentials in the cost of treatment at TMC (in ₹), out-of-pocket payment (in ₹) and out-of-pocket payment as a share of total cost at TMC for breast cancer at TMC, Mumbai.
| SES variables | N | Cost of treatment at TMC (in ₹) |
OOP (in ₹) |
OOP as a share of TC |
||||
|---|---|---|---|---|---|---|---|---|
| Mean | 95% CI | p-value | Mean | 95% CI | p-value | % | ||
| Age of patients | 0.026 | 0.177 | ||||||
| Up to 45 years | 202 | 266,258 | (237,607, 294,909) | 188,367 | (161,950, 214,784) | 70.7 | ||
| Over 45 years | 227 | 250,831 | (223,170, 278,492) | 184,765 | (157,948, 211,582) | 73.7 | ||
| Marital status | 0.009 | 0.046 | ||||||
| Other | 63 | 192,676 | (156,627, 228,725) | 124,540 | (96,088, 152,993) | 64.6 | ||
| Currently married | 366 | 269,355 | (247,094, 291,617) | 197,120 | (175,791, 218,449) | 73.2 | ||
| Location of residence | <0.001 | <0.001 | ||||||
| Urban | 196 | 206,389 | (182,637, 230,142) | 131,193 | (110,802, 151,584) | 63.6 | ||
| Rural | 233 | 301,590 | (271,993, 331,187) | 232,953 | (204,088, 261,818) | 77.2 | ||
| Education level | <0.001 | 0.002 | ||||||
| Never attended | 99 | 236,252 | (201,359, 271,145) | 166,617 | (136,225, 197,009) | 70.5 | ||
| Primary | 36 | 235,438 | (163,538, 307,339) | 176,455 | (106,896, 246,014) | 74.9 | ||
| Secondary | 167 | 209,950 | (188,041, 231,860) | 141,081 | (120,760, 161,401) | 67.2 | ||
| Higher secondary | 50 | 275,740 | (214,278, 337,202) | 214,277 | (156,430, 272,124) | 77.7 | ||
| Above HS | 77 | 389,730 | (322,750, 456,711) | 297,013 | (229,610, 364,417) | 76.2 | ||
| Religion | 0.239 | 0.082 | ||||||
| Hindu | 332 | 263,135 | (239,598, 286,673) | 189,326 | (167,232, 211,421) | 72.0 | ||
| Muslim | 80 | 252,210 | (212,125, 292,296) | 193,549 | (153,028, 234,070) | 76.7 | ||
| Others | 17 | 187,350 | (115,262, 259,439) | 97,149 | (44,797, 149,501) | 51.9 | ||
| Caste | 0.007 | 0.007 | ||||||
| General | 226 | 287,088 | (256,362, 317,814) | 214,131 | (184,973, 243,289) | 74.6 | ||
| OBC | 145 | 239,628 | (209,348, 269,908) | 168,999 | (140,702, 197,297) | 70.5 | ||
| SC/ST/Other | 58 | 191,289 | (157,426, 225,152) | 122,299 | (88,868, 155,730) | 63.9 | ||
| Distance to Mumbai | <0.001 | <0.001 | ||||||
| <500 kms | 185 | 164,606 | (144,749, 184,463) | 95,887 | (80,337, 111,437) | 58.3 | ||
| 501–1500 kms | 60 | 348,865 | (292,630, 405,100) | 290,706 | (230,106, 351,306) | 83.3 | ||
| >1500 kms | 184 | 322,493 | (289,199, 355,787) | 243,534 | (211,893, 275,176) | 75.5 | ||
| Income source | 0.055 | 0.028 | ||||||
| Agriculture | 54 | 280,074 | (234,368, 325,780) | 214,717 | (171,665, 257,770) | 76.7 | ||
| Labour | 103 | 216,336 | (186,723, 245,950) | 150,144 | (123,667, 176,620) | 69.4 | ||
| Self-employed | 66 | 300,722 | (232,620, 368,824) | 230,801 | (168,221, 293,382) | 76.7 | ||
| Service | 206 | 259,556 | (229,884, 289,227) | 183,007 | (154,103, 211,911) | 70.5 | ||
| MPCE | <0.001 | <0.001 | ||||||
| Poorest | 83 | 147,955 | (126,233, 169,677) | 90,430 | (72,868, 107,993) | 61.1 | ||
| Poorer | 78 | 175,336 | (148,825, 201,846) | 115,596 | (89,997, 141,196) | 65.9 | ||
| Middle | 89 | 218,674 | (191,974, 245,374) | 152,673 | (125,935, 179,412) | 69.8 | ||
| Richer | 89 | 293,421 | (244,702, 342,140) | 215,062 | (166,951, 263,173) | 73.3 | ||
| Richest | 90 | 435,442 | (380,660, 490,225) | 341,569 | (288,275, 394,863) | 78.4 | ||
| Type of patient | <0.001 | <0.001 | ||||||
| General/Non-chargeable | 369 | 210,246 | (195,308, 225,183) | 149,315 | (135,179, 163,451) | 71.0 | ||
| Private | 60 | 552,368 | (478,449, 626,287) | 414,910 | (331,623, 498,197) | 75.1 | ||
| Stage of cancer | 0.017 | 0.044 | ||||||
| Early stage (I/II) | 155 | 231,335 | (200,106, 262,564) | 164,721 | (136,915, 192,527) | 71.2 | ||
| Advance stage (III/IV) | 274 | 273,233 | (247,714, 298,751) | 195,395 | (173,880, 223,639) | 72.0 | ||
| Comorbidities | 0.735 | 0.435 | ||||||
| No comorbidity | 296 | 251,805 | (230,358, 273,252) | 182,909 | (162,108, 203,710) | 72.6 | ||
| At least 1 comorbidity | 133 | 272,093 | (229,086, 315,101) | 194,367 | (154,802, 233,931) | 71.4 | ||
| Place of treatment | <0.001 | <0.001 | ||||||
| TMC | 243 | 217,448 | (193,008, 241,888) | 148,239 | (125,711, 170,767) | 68.2 | ||
| At least one outside TMC | 186 | 311,198 | (279,777, 342,619) | 236,397 | (205,794, 267,000) | 76.0 | ||
| Duration of treatment | <0.001 | <0.001 | ||||||
| <9 M | 214 | 232,674 | (207,563, 257,786) | 156,228 | (134,364, 178,092) | 67.1 | ||
| 9 M−12 M | 174 | 262,883 | (232,652, 293,115) | 196,180 | (166,389, 225,971) | 74.6 | ||
| 12 M | 41 | 370,456 | (275,925, 464,987) | 303,018 | (208,908, 397,128) | 81.8 | ||
| Total | 429 | 258,095 | (238,255, 277,934) | 186,461 | (167,666, 205,257) | 72.2 | ||
Note: 1 US$ = ₹73.1 at 2020 prices.