ECONOMIC BURDEN OF CANCER AND PAYMENT COPING MECHANISM
ABSTRACT
The economic burden of cancer and the stress of payment require that, health care providers provide quality cost-effective care that will shorten the stay of patients in the hospital and reduce the frequency of visit to health facilities. This study investigated the economic burden of cancer patients and payment coping mechanism in Jos University Teaching Hospital, Plateau State. Four objectives and two hypotheses were raised to guide the study. Cost-of-illness framework was used to assess the economic burden of cancer patients and payment coping mechanism. A cross-sectional descriptive survey design was used for the study. A sample of 179 cancer patients was drawn consecutively from an estimated population of 276 that used the hospital in one year. Data were analyzed descriptively using frequencies, percentages, mean and standard deviation. Chi-square was used to determine the association between socio-economic groups and payment coping mechanisms utilized by cancer patients and between the cost distributions among different socio-economic groups. Majority of respondents were ranked among the poorest, the mean monthly total income of the patients is N65,978.74 + 104,036.97, mean monthly total expenses is N43,916.28 + 56,070.33, the mean monthly patients’ expenditure is N43,916.28 + 56,070.33, the mean total annual loss was N217,515.19 + 798,708.95, the mean patients’ annual loss as a percentage of their mean annual income is 11.38 + 19.13% while as a percentage of their mean annual expenditure was 50.06 + 421.98. There was a significant difference in the cost distribution of different socio-economic groups in terms of monthly patients’ total income, monthly earnings of persons accompanying patients, patients’ monthly loss, accompanying persons’ monthly loss, total monthly loss, patients’ annual loss, accompanying persons’ annual loss and total annual loss (P < 0.05). Payment coping mechanism utilized by most (78.8%) of the patients was their own money (i.e. salary, earnings and/or savings). There was a significant difference between payment coping mechanism of cancer patients (borrowed money/loan, sales of land) and different socio-economic groups (P < 0.05). There is need for government to intervene by subsidizing the cost of cancer treatment. There is need for the formation of a strong cancer Association in Plateau State so that cancer patients could pool their resources together as a strong social support to help themselves.
CHAPTER ONE
INTRODUCTION
Background to the Study
Cancer is the second leading cause of death and disability in the world followed by heart disease (Mathers & Lancer, 2006). It is a major public health issue and represents a significant burden of disease. Based on the most complete and current data available, cancer accounts for one out of every eight deaths annually (Mathers & Lancer, 2006). The incidence and death rates from cancer remain significantly higher in the developing world including Nigeria (Boyle & Levin, 2008). It is responsible for more deaths than all the deaths due to HIV/AIDS, TB and malaria combined (Okoye, 2010).
Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells (Global cancer facts and figures, 2011). It affects different parts of the body and the name of the cancer is given in relation to the part that is affected. It is a global disease that consumes resources. The cost of cancer treatment globally is reported to be high. Records have it that developed countries spend more on cancer treatment than developing countries; for example in the United States of America, the economic burden from cancer is tagged at $895 billion nearly 20% more than heart diseases toll ($753 billion) (John & Ross, 2009). The cancers which account for the largest costs on a global scale, and the greatest burden in developed nations are; lung, colorectal and breast while in low-income countries, the cancer with the greatest impact are cancer of the mouth and oropharynx, cancer of the cervix, breast and prostate cancer (John & Rose, 2009).