DOI: 10.14457/nida.the.2016.2
title: Economic burden on households with people with non-communicable diseases, with special reference to cancer: priorities for policy options pertaining to the Sri Lankan context

description: Non-communicable diseases have become a major threat to Sri Lanka as wellas all developing and developed countries. Though the government provides all healthfacilities free of charge at public hospitals, people have to bear the out-of-pocketexpenditure. The expenditure compared to other diseases is double the burden fromnon-communicable diseases||Based on a literature review, it was found that there is a lack of studies on theeconomic burden on households with individuals with non-communicable diseases,with specific reference to cancer in Sri Lanka. This study has focused on assessing theeconomic burden on households. In addition it has tried to identify the determinantseffect of the economic burden on households. This study focuses on the demographic,economic, and disease characteristics of patients. Identifying the major effects ofcancer is helpful for prioritizing policy options in order to reduce the burden onhouseholds. Furthermore, the analysis is concerned with the challenges faced bypatients in order to provide better policy options. Finally, based on the findings itprioritizes policy options.||Primary data were collected from a semi-structured questionnaire. After thepilot study, 400 respondents were selected using the stratified sampling method. Themixed method mainly, focused on the quantitative method, was adopted for the study.Qualitative analysis was used to triangulate the quantitative findings.||Both bivariate and multivariate analyses confirmed the same findings
description: somenull hypotheses were rejected and some were not. Gender, distance, income, types ofcancer, severity of disease, and period of suffering are significant effects in terms ofthe economic burden on households with cancer patients. Further, sources offinancing are significant regarding the economic burden and in terms of direct costand indirect costs as well.||It was found that there are many challenges faced by the respondents, and highopportunity costs in obtaining government allowances led the respondents not toapply or use the allowance. Some people have lack of information about sources offinancing and health issues. The findings of the study provide priorities that canhelpful for decision-makers in creating policy options to reduce the economic burdenon households. Since direct costs have become higher compared to other types ofcosts, and it is necessary to focus on direct medical costs, travel costs, and the cost ofspecial foods in order to reduce the burden. Both direct medical costs and travel costscan be reduced by a more fair distribution of resources to the nearest hospital and byfacilitating easy accessibility for patients. One option is to reform the present systemof allowing medical or sick leaves for patients. The introduction of special insuranceschemes for the self-employed sector would be useful for self-employed patients thatwould suffer from non-communicable diseases. Beginning the treatment process atthe earliest possible stage could reduce a huge burden at later stages for both affectedhouseholds and the government. Therefore, it is necessary to have continuousawareness campaigns in all corners of Sri Lanka, reaching all the people. In addition,free periodical cancer screening tests could help early detection and treatment, whichcould either eliminate or reduce the burden on households in the country as a whole||This study contributes both theoretically and practically, and as well as showssome of the unchartered areas for future research. The study shows the relationshipbetween the determinants and economic burden on households. The practicalcontribution is comprised of suggestions regarding policy options to the government,highlighting priorities to be considered and the selection of cost-effective policyoptions amongst them. There are some other aspects that have not come under thescope of the study. The social costs for the households could affect them, and this is avery important area for future research. Proper qualitative analysis also can be carriedout in future research.