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Published online: 2024-03-18

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An observational study of socioeconomic status and demographic profile of advanced cancer patients receiving palliative care in tertiary care institution of Bihar, India

Mumtaz Hussain1, Puja Kumari1, Vinod Kumar Verma1, Nidhi Arun1


Introduction: Access to high-quality healthcare without financial constraints is necessary for inclusive universal health coverage. Low socioeconomic status (SES) individuals have less access to palliative care services. The study was conducted to evaluate the demographics and socioeconomic status of palliative care patients with advanced cancer.

Patients and methods: The prospective observational study included 118 patients with advanced cancer receiving palliative treatment. Their clinical, demographic, and socioeconomic data were collected in predesigned social assessment sheets and medical records. The socioeconomic status was evaluated using the modified Kuppuswamy scale. Descriptive statistics was performed. Student’s t test and Chi-square tests were performed to compare continuous and categorical variables respectively.

Results: Out of the total 118 patients, 71 (60.2%) were females and 47 (39.8%) were males. The mean age of the patients was 49.9 ± 13.9 years. Out of the total study participants, 54 (45.8%) were illiterate. Most of the participants had social insecurities like financial insecurity (n = 50, 42.4%), followed by insecurities regarding the future of the family members (n = 37, 31.4%). The frequency of lung cancer (n = 30, 25.4%) was the highest among the participants, followed by breast (n = 20, 17%) and gall bladder cancer (n = 15, 12.7%). The mean family income of the patients was Indian Rupees (INR) 10 847.5 ± 8 026.3 ($130.61 ± 96.64). Most of the participants (38, 32.2%) belonged to lower middle SES. Type of cancer, social insecurities, and type of caregiver were significantly associated with gender (p < 0.05).

Conclusions: Majority of patients and their families were financially limited, and a significant portion of patients expressed financial insecurities and social stress about the future of their families. Gender was significantly associated with type of cancer, social insecurities, and type of caregiver.

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  1. Jane Bates M, Gordon MRP, Gordon SB, et al. Palliative care and catastrophic costs in Malawi after a diagnosis of advanced cancer: a prospective cohort study. Lancet Glob Health. 2021; 9(12): e1750–e1757.
  2. Cancer/WHO fact sheet. (25.02.2024).
  3. Jacob J, Palat G, Verghese N, et al. Correction to: health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: evidence from the APPROACH cross-sectional survey in Hyderabad-India. BMC Palliat Care. 2020; 19(1): 11.
  4. Knaul F, Bhadelia A, Rodriguez N, et al. The lancet commission on palliative care and pain relief — findings, recommendations, and future directions. Lancet Global Health. 2018; 6(S1): S5–S6.
  5. Hapuarachchi T, Fernando G, Weerasingha S, et al. Disparities in end-of-life outcomes among advanced cancer patients in Sri Lanka: Results from the APPROACH study. Palliat Support Care. 2022; 20(6): 832–838.
  6. Davies JM, Sleeman KE, Leniz J, et al. Socioeconomic position and use of healthcare in the last year of life: a systematic review and meta-analysis. [published correction appears in PLoS Med. 2019; 16 (7): e1002878]. PLoS Med. 2019; 16(4): e1002782.
  7. Sampedro Pilegaard M, Knold Rossau H, Lejsgaard E, et al. Rehabilitation and palliative care for socioeconomically disadvantaged patients with advanced cancer: a scoping review. Acta Oncol. 2021; 60(1): 112–123.
  8. Bairwa M, Rajput M, Sachdeva S. Modified Kuppuswamy's socioeconomic scale: social researcher should include updated income criteria, 2012. Indian J Community Med. 2013; 38(3): 185–186.
  9. Bowers SP, Chin M, O'Riordan M, et al. The end of life experiences of people living with socio-economic deprivation in the developed world: an integrative review. BMC Palliat Care. 2022; 21(1): 193.
  10. Lloyd-Williams M, Shiels C, Dowrick C, et al. Socio-Economic deprivation and symptom burden in UK hospice patients with advanced cancer-findings from a longitudinal study. Cancers (Basel). 2021; 13(11): 2537.
  11. Bus P, Aarts MJ, Lemmens VE, et al. The effect of socioeconomic status on staging and treatment decisions in esophageal cancer. J Clin Gastroenterol. 2012; 46(10): 833–839.
  12. Abodunrin F, Adeoye O, Krishnan M, et al. Socioeconomic disparities in the receipt of palliative care in biliary tract cancers. J Clin Oncol. 2022; 40(S28): 80–80.
  13. Asthana S, Bhatia S, Dhoundiyal R, et al. Quality of life and needs of the Indian advanced cancer patients receiving palliative care. Cancer Res Stat Treat. 2019; 2(2): 138–144.
  14. Chen H, Nicolson DJ, Macleod U, et al. Does the use of specialist palliative care services modify the effect of socioeconomic status on place of death? A systematic review. Palliat Med. 2016; 30(5): 434–445.
  15. Dreyer MS, Nattinger AB, McGinley EL, et al. Socioeconomic status and breast cancer treatment. Breast Cancer Res Treat. 2018; 167(1): 1–8.
  16. Guadamuz JS, Wang X, Ryals CA, et al. Socioeconomic status and inequities in treatment initiation and survival among patients with cancer, 2011-2022. JNCI Cancer Spectr. 2023; 7(5).
  17. Kumar G, Panda N, Roy R, et al. An observational study to assess the socioeconomic status and demographic profile of advanced cancer patients receiving palliative care in a tertiary-level cancer hospital of Eastern India. Indian J Palliat Care. 2018; 24(4): 496–499.
  18. Bergqvist J, Hedman C, Schultz T, et al. Equal receipt of specialized palliative care in breast and prostate cancer: a register study. Support Care Cancer. 2022; 30(9): 7721–7730.
  19. Schock T, Geoenvironmental. Socioeconomic Status and Cancer Outcomes in the United States: Examining Geographic Dissidence in Incidence and Mortality Rates. In. 2016. (24.06.2023).
  20. Wright EP, Kiely MA, Lynch P, et al. Social problems in oncology. Br J Cancer. 2002; 87(10): 1099–1104.
  21. Saeed F, Hoerger M, Norton SA, et al. Preference for palliative care in cancer patients: are men and women alike? J Pain Symptom Manage. 2018; 56(1): 1–6.e1.
  22. Yang WJ, Kang D, Song MG, et al. The impact of socioeconomic status on mortality in patients with hepatocellular carcinoma: a Korean national cohort study. Gut Liver. 2022; 16(6): 976–984.
  23. Parajuli J, Tark A, Jao YL, et al. Barriers to palliative and hospice care utilization in older adults with cancer: A systematic review. J Geriatr Oncol. 2020; 11(1): 8–16.
  24. Clark D, Baur N, Clelland D, et al. Mapping levels of palliative care development in 198 countries: the situation in 2017. J Pain Symptom Manage. 2020; 59(4): 794–807.e4.
  25. Kebudi R, Cakir FB, Silbermann M. Palliative care in high and low resource countries. Curr Pediatr Rev. 2021; 17(3): 220–224.

Palliative Medicine in Practice