Evidence mapPaperPMID 40660255Full record

ArticleHealth and quality of life outcomes2025

Association between out-of-pocket expenditure and health-related quality of life among patients receiving cancer treatment: a cross-sectional study from Nepal.

Pratik Khanal, Suman Sapkota, Nirmal Poudel, Achyut Raj Pandey, Bidwata Bhattarai, Etna Khatiwada, Ravi Kant Mishra, Biraj Man Karmacharya, Shiva Raj Adhikari, Kjell Arne Johansson and 1 more

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Article in Health and quality of life outcomes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Pratik KhanalBergen Centre for Ethics and Priority Setting in Health (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. iampratikkhanal@gmail.com.
Suman SapkotaNepal Health Economics Association, Kathmandu, Nepal.
Nirmal PoudelNepal Health Economics Association, Kathmandu, Nepal.
Achyut Raj PandeyBergen Centre for Ethics and Priority Setting in Health (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Bidwata BhattaraiNepal Health Economics Association, Kathmandu, Nepal.
Etna KhatiwadaNepal Health Economics Association, Kathmandu, Nepal.
Ravi Kant MishraBergen Centre for Ethics and Priority Setting in Health (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Biraj Man KarmacharyaDepartment of Public Health and Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Shiva Raj AdhikariNepal Health Economics Association, Kathmandu, Nepal.
Kjell Arne JohanssonBergen Centre for Ethics and Priority Setting in Health (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Krishna Kumar AryalBergen Centre for Ethics and Priority Setting in Health (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe financial burden of cancer care may significantly impair patients' health-related quality of life (HRQoL), yet the extent and nature of this relationship remain underexplored, particularly in low-resource settings. This study aimed to report the HRQoL of patients currently receiving treatment for selected cancers (breast, cervical, lung, oesophageal and stomach) in Nepal. We further investigate the association of out-of-pocket expenditure (OOPE) with HRQoL.

methodsA cross-sectional survey was conducted from April to May 2024 among 353 patients undergoing cancer treatment in two tertiary cancer hospitals in Nepal. We used the European Quality of Life 5 dimensions (EQ-5D-5L) and the European Quality of Life Visual Analogue Scale (EQ-VAS) to obtain their HRQoL. Similarly, we collected sociodemographic and treatment-related data, including OOPE and patient satisfaction. We used the ordinary least squares estimation with robust standard errors to identify the association between OOPE and HRQoL (EQ-5D-5L index score).

resultsThe mean (SD) EQ-5D-5L index score was 0.39 (0.42), and the mean (SD) EQ-VAS score was 56.65 (21.71). Anxiety/depression and pain/discomfort were the most common reported problems (> 90% of the study participants), whereas pain/discomfort had the greatest disability weight (0.17). In the regression analysis, the logarithms of OOPE (β = -0.086; 95% CI: -0.132 to -0.040) was significantly associated with a lower EQ-5D-5L index score. Other significant covariates included being currently not married (β = -0.149; 95% CI: -0.274 to -0.024), having stage IV cancer during diagnosis (β = -0.212; 95% CI: -0.364 to -0.061) and patient satisfaction score (β = 0.015; 95% CI: 0.001 to 0.030).

conclusionsThe study revealed a moderate quality of life among patients currently receiving cancer treatment in Nepal. Higher OOPE along with stage IV cancer during diagnosis and being currently not married were associated with lower HRQoL, whereas higher patient satisfaction score was associated with higher HRQoL. These insights might be helpful for providing targeted interventions such as emphasizing early diagnosis and management and focusing on patient satisfaction and those at financial risk to improve the HRQoL of people with cancer.

Indexed as

Health ExpendituresNeoplasmsQuality of LifeAdultAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedNepalPatient SatisfactionSurveys and QuestionnairesCancerEQ-5D-5 LHealth-related quality of lifeNepalOut-of-pocket expenditurePatient satisfaction

Identifiers

PMID40660255
PMCPMC12261754

What Socratic holds

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.