TY - JOUR ID - 89502 TI - Out-of-Pocket, Catastrophic Health Expenditure and Distress Financing on Non-Communicable Diseases in India: A Systematic Review with Meta-Analysis JO - Asian Pacific Journal of Cancer Prevention JA - APJCP LA - en SN - 1513-7368 AU - Dhankhar, Anushikha AU - Kumari, Ranjeeta AU - Bahurupi, Yogesh A AD - Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India. Y1 - 2021 PY - 2021 VL - 22 IS - 3 SP - 671 EP - 680 KW - out-of-pocket expenditure KW - catastrophic health expenditure KW - distress financing KW - cancer KW - India DO - 10.31557/APJCP.2021.22.3.671 N2 - Objective: The aim of this systematic review is to determine pooled estimates of out-of-pocket (OOPE) and catastrophic health expenditure (CHE), correlates of CHE, and most common modes of distress financing on the treatment of selected non-communicable disease (cancer) among adults in India. Methods: PubMed, Scopus and Embase were searched for eligible studies using strict inclusion and exclusion criteria. Data was extracted and pooled estimates using random effects model of meta-analysis were determined for different types of costs. Forest plots were created and heterogeneity among studies was checked. Results: The pooled estimate of direct OOPE on inpatient and outpatient cancer care were 83396.07 INR (4405.96 USD) (95% CI = 44591.05-122202.0) and 2653.12 (140.17 USD) INR (95% CI = -251.28-5557.53), respectively, total direct OOPE was 47138.95 INR (2490.43 USD) (95% CI = 37589.43-56690.74), indirect OOPE was 11908.50 INR (629.15 USD) (95% CI=-5909.33-29726.31) and proportion of individuals facing CHE was 62.7%. However, high heterogeneity was observed among the studies. Savings, income, borrowing money and sale of assets were the most common modes of distress financing for cancer treatment. Conclusion: Income- and treatment-related cancer policies are needed to address the evidently high and unaffordable cancer treatment cost. Economic studies are needed for estimating all types of costs using standardised definitions and tools for precise estimates. Robust cancer database/registries and programs focusing on affordable cancer care can reduce the economic burden and prevent impoverishment. UR - https://journal.waocp.org/article_89502.html L1 - https://journal.waocp.org/article_89502_db93646b8977dcf0315cdee79c72941b.pdf ER -