Is financial burden associated with health-related quality of life?: A cross-sectional study among patients undergoing cancer treatment in Nepal
1
Nepal Health Economics Association, Kathmandu, Nepal
Popul. Med. 2026;8(Supplement Supplement 1):A3053
ABSTRACT
INTRODUCTION:
There are limited studies from low-resource settings explaining the role of financial burden on quality of life among patients living with chronic diseases. This study assessed whether financial burden (out-of-pocket expenditure, OOPE) is associated with health-related quality of life (HRQoL) among patients undergoing treatment for selected cancers (breast, cervical, lung, esophagus, and stomach).
METHODS:
A cross-sectional survey was conducted from April to May 2024 among 353 purposively selected adult patients with cancer attending two tertiary cancer hospitals in Nepal. We used European Quality of Life 5 dimensions (EQ-5D-5L) and European Quality of Life Visual Analogue Scale (EQ-VAS) to describe health profile and compute EQ-5D-5L index score which ranged from <0 (worse than dead) to 1 (the value of full health). We estimated annual OOPE (direct medical and direct non-medical costs after deducing any reimbursement) through patient interviews and verification of patient medical bill, where possible. Ordinary least squares regression model with robust standard errors was used to assess the relationship between OOPE and EQ-5D-5L index score, adjusting for potential confounders.
RESULTS:
The mean (SD) EQ-5D-5L index score and EQ-VAS score were 0.39 (0.42) and 56.65 (21.71) out of 100, respectively while the annual mean (SD) OOPE was 2547 (±SD 2687) USD. In the regression analysis, a negative association between the logarithm of OOPE and EQ-5D-5L index score was observed (β =-0.086; 95% CI: -0.132 to -0.040). Among the covariates, currently married status and increasing patient satisfaction score was significantly associated with higher EQ-5D-5L while increasing cancer staging at diagnosis was negatively associated.
CONCLUSIONS:
The findings suggest that OOPE has a negative effect on the HRQoL of patients undergoing cancer treatment in Nepal. Given limited financial risk protection for cancer, we suggest policymakers prioritize cancer interventions in health benefit packages and reduce financial burden on patients to improve their HRQoL.
There are limited studies from low-resource settings explaining the role of financial burden on quality of life among patients living with chronic diseases. This study assessed whether financial burden (out-of-pocket expenditure, OOPE) is associated with health-related quality of life (HRQoL) among patients undergoing treatment for selected cancers (breast, cervical, lung, esophagus, and stomach).
METHODS:
A cross-sectional survey was conducted from April to May 2024 among 353 purposively selected adult patients with cancer attending two tertiary cancer hospitals in Nepal. We used European Quality of Life 5 dimensions (EQ-5D-5L) and European Quality of Life Visual Analogue Scale (EQ-VAS) to describe health profile and compute EQ-5D-5L index score which ranged from <0 (worse than dead) to 1 (the value of full health). We estimated annual OOPE (direct medical and direct non-medical costs after deducing any reimbursement) through patient interviews and verification of patient medical bill, where possible. Ordinary least squares regression model with robust standard errors was used to assess the relationship between OOPE and EQ-5D-5L index score, adjusting for potential confounders.
RESULTS:
The mean (SD) EQ-5D-5L index score and EQ-VAS score were 0.39 (0.42) and 56.65 (21.71) out of 100, respectively while the annual mean (SD) OOPE was 2547 (±SD 2687) USD. In the regression analysis, a negative association between the logarithm of OOPE and EQ-5D-5L index score was observed (β =-0.086; 95% CI: -0.132 to -0.040). Among the covariates, currently married status and increasing patient satisfaction score was significantly associated with higher EQ-5D-5L while increasing cancer staging at diagnosis was negatively associated.
CONCLUSIONS:
The findings suggest that OOPE has a negative effect on the HRQoL of patients undergoing cancer treatment in Nepal. Given limited financial risk protection for cancer, we suggest policymakers prioritize cancer interventions in health benefit packages and reduce financial burden on patients to improve their HRQoL.
| eISSN: | 2654-1459 |
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