Household Costs of Breast Cancer Morbidity: An Empirical Assessment from Pakistan

Mahmood, Hafiz Zahid; Khaliq, Imran Hameed; Bhatti, Zafar Iqbal; Wilson, Kim; Gondal, Khalid Masood; Malik, Summaira; Zaman, Shakila

doi:10.2139/ssrn.3377176

Cited by 13 publications

(39 citation statements)

References 12 publications

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“…In the absence of a social health insurance system, the majority of direct and indirect costs of cancer treatment depend on out-of-the-pocket financing by the patient household (Carrin and James, 2005). In a study conducted at two public-sector hospitals in Lahore, Pakistan, it was found that each household spends approximately seven times their monthly household income on direct medical, direct non-medical and indirect medical costs on average (Mahmood et al , 2018). This amount is even higher in private-sector facilities in the country.…”

Section: Discussionmentioning

confidence: 99%

The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions

Fayyaz

Ahmed

Abid

et al. 2020

IJHCQA

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PurposeThis study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed.Design/methodology/approachThis is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and p-values.FindingsThe authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (p-value < 0.01 using t-test for two independent samples). The data showed an increasing trend of “satisfied” responses as the household income increased.Research limitations/implicationsA comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care.Practical implicationsAssessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability.Social implicationsAfter being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life.Originality/valueCancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.

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Section: Discussionmentioning

confidence: 99%

The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions

Fayyaz

Ahmed

Abid

et al. 2020

IJHCQA

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Section: Discussionmentioning

confidence: 99%

“…Previous studies addressing the extent of spouse wage losses differed in the types of cancer considered (eg, any type, lung cancer, and colorectal cancer), included mixed stages of disease or focused only on advanced disease, and were conducted in countries with different Cancer March 1, 2020 insurance and health care systems (eg, Canada, the United States, China, and Norway). [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In these studies, wage loss estimates were calculated for different time periods (range, 1 day of work to 8 years after diagnosis) and with various data sources (self-reported data and administrative databases) and methods of valuing time lost from work. In 1 case, caregiver wage losses were determined to assess the incremental loss from metastatic breast cancer versus nonmetastatic breast cancer, although whether the reason for leave was breast cancer was not documented.…”

Section: Discussionmentioning

confidence: 99%

“…3 Recent systematic 9 and scoping reviews 10 have reported that cancer negatively affects the employment of spouses of patients with cancer in terms of decreased productivity and work absences. Although a few studies have estimated how decreased productivity and work absences translate into spouses' wage losses, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] most have focused on cancers other than breast cancer 17,18,[24][25][26] or mixed groups including breast cancer with varying disease stages 11,12,[14][15][16]23 Cancer March 1, 2020 or only advanced disease, 13,[19][20][21][22] and this makes it impossible to isolate specifically the effect of nonmetastatic breast cancer on spouse wage losses. Thus, information is needed to understand the extent to which spouses experience wage losses as a result of nonmetastatic breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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Wage losses among spouses of women with nonmetastatic breast cancer

Humphries

Lauzier

Drolet

et al. 2019

Cancer

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Background The aim of this study was to evaluate the wage losses incurred by spouses of women with nonmetastatic breast cancer in the 6 months after the diagnosis. Methods A prospective cohort study of spouses of women diagnosed with nonmetastatic breast cancer who were recruited in 8 hospitals in the province of Quebec (Canada) was performed. Information for estimating wage losses was collected by telephone interviews conducted 1 and 6 months after the diagnosis. Log‐binomial regressions were used to identify personal, medical, and employment characteristics associated with experiencing wage losses, and generalized linear models were used to identify characteristics associated with the proportion of usual wages lost. Results Overall, 829 women (86% participation) and 406 spouses (75% participation) consented to participate. Among the 279 employed spouses, 78.5% experienced work absences because of breast cancer. Spouses were compensated for 66.3% of their salary on average during their absence. The median wage loss was $0 (mean, $1820) (2003 Canadian dollars). Spouses were more likely to experience losses if they were self‐employed or lived 50 km or farther from the hospital. Among spouses who experienced wage losses, those who were self‐employed or whose partners had invasive breast cancer lost a higher proportion of wages. Conclusions Although spouses took some time off work, for many, the resulting wage losses were modest because of compensation received. Still, the types of compensation used may hide other forms of burden for families facing breast cancer.

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“…Approximately 25% of cases are diagnosed in Asia. 2 The best approach to decrease the burden of breast cancer is its prevention. In Pakistan, Breast Cancer is the most common cancer affecting females and becomes more aggressive as it usually presents in the 3 rd and 4 th stages.…”

Section: Introductionmentioning

confidence: 99%

The knowledge regarding Breast Cancer, its risk factors, and screening practices among women from Islamabad, Pakistan

Khan¹,

Ansari²,

Qureshi³

et al. 2021

JRMC

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Introduction: Breast Cancer is the rising Public health problem of the world. Pakistan is bearing a high disease burden not only in Asian countries but in the whole world. Pakistan ranks highest in Breast cancer and accounts for almost 34.6%of female cancers. The incidence of the disease in Asian countries is quite different from that in Western countries regarding age i.e. (40-50 years.) while (60-70 years) in Western countries. This study was based on assessing the knowledge regarding breast cancer, risk factors, and screening practices to determine the barriers in the path of the community to seek medical care.Materials and Methods: A cross-sectional study was done between October to December 2019 on 310 females participants of ages from 25 to 70 years, residents of Islamabad, the capital of Pakistan, and knowledge was assessed by applying a self-responding questionnaire.Results: Using SPSS version 23 and chi-square tests, the results showed that 87.7% of participants knew about the prevalence of Breast Cancer. Whereas, 90.3% of the females with the disease are not aware of their illness and show a strong association (p-value is less than 0.05) between knowledge regarding breast cancer and screening tests. Conclusion: The study concluded that 90% of socio-cultural barriers are in the path of access to medical facilities and 90% of participants believed that the non-availability of female doctors in health facilities is a big barrier to access to health. Access to medical facilities should be made easy by promoting health education and removing the fear of results, making small health facility units.

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Household Costs of Breast Cancer Morbidity: An Empirical Assessment from Pakistan

Cited by 13 publications

References 12 publications

The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions

The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions

Wage losses among spouses of women with nonmetastatic breast cancer

The knowledge regarding Breast Cancer, its risk factors, and screening practices among women from Islamabad, Pakistan

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