SynthesisPloS one2018
The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Effects of health insurance on economic burden and health service utilization among people with noncommunicable diseases in low- and middle-income countries: a systematic review.BMC public health · 2026Pooled it
- Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis.Bulletin of the World Health Organization · 2022Pooled it
- Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis.Frontiers in public health · 2022Pooled it
- Out-of-Pocket, Catastrophic Health Expenditure and Distress Financing on Non-Communicable Diseases in India: A Systematic Review with Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2021Pooled it
- Primary healthcare system readiness for the prevention and management of non-communicable diseases in Nepal.Discover public health · 2026Article
- Exploring the effects catastrophic health expenditure due to non-communicable diseases and coping strategies: A case study among households in Bangladesh.Public health in practice (Oxford, England) · 2025Article
- Article
- Disease-specific distress healthcare financing and catastrophic out-of-pocket expenditure for hospitalization care in Bangladesh.Cost effectiveness and resource allocation : C/E · 2025Article
- Healthcare utilisation and economic burden of cancer on Indian households.Scientific reports · 2025Article
- Financial burden of cancer in Nepal: Factors associated with annual cost and catastrophic health expenditure.PloS one · 2025Article
- Medical Students' Perceptions of the Learning Environment in South Asia: A Systematic Review of Quantitative Studies.Advances in medical education and practice · 2025Review
- The financial burden of noncommunicable diseases from out-of-pocket expenditure in sub-Saharan Africa: a scoping review.Health promotion international · 2024Article
- A Scoping Review of Non-Communicable Diseases among the Workforce as a Threat to Global Peace and Security in Low-Middle Income Countries.International journal of environmental research and public health · 2024Article
- Risk factors for non-communicable diseases in Afghanistan: insights of the nationwide population-based survey in 2018.Journal of health, population, and nutrition · 2024Article
- Economic priorities over population health: A political dilemma in addressing noncommunicable diseases in developing countries.Health science reports · 2024Article
- Catastrophic health care spending in managing type 2 diabetes before and during the COVID-19 pandemic in Tanzania.PLOS global public health · 2023Article
- Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature.Health research policy and systems · 2022Article
- Article
- Exploring health-seeking behavior for non-communicable chronic conditions in northern Bangladesh.PLOS global public health · 2022Article
- Coping with access barriers to non-communicable disease medicines: qualitative patient interviews in eight counties in Kenya.BMC health services research · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOut of pocket payment (OOPP), is the major health financing mechanism in South Asia region. With the rising burden of non-communicable diseases (NCDs), the region is facing a high financial burden. However, the extent and nature of economic impact caused by treatment and management of NCDs at the household level is yet unknown.
methodWe conducted a systematic review using Medline and Embase databases. Only peer-reviewed quantitative studies published between January 2000 to December 2016 assessing OOPP or catastrophic health expenditure or impoverishment or financial coping strategy due to at least one of the four major NCDs-cardiovascular diseases(CVDs), diabetes, cancer, chronic respiratory disease in South Asia region was included in the review. The review is registered in PROSPERO no: CRD42017059345.
resultsA total of 21 studies (of 2693 records identified) met the inclusion criteria. The economic impact was most frequently studied in CVDs and in terms of OOPP. The studies collectively indicated high OOPP, higher likelihood of catastrophic expenditure and impoverishment for inpatient care for these major NCDs which was visible in all income levels. Borrowing and selling off assets were the most common forms of coping strategies adopted and varied inconsistently between urban and rural households. The true extent of the economic impact, however, remains difficult to determine due to methodological heterogeneity regarding outcomes reported and measures employed for calculation of OOPP, catastrophic expenditure, and impoverishment across these four major NCDs and between nations.
conclusionThe economic impact due to treatment and management of CVDs, diabetes, cancer and chronic respiratory diseases among households in South Asia seems dire. Given the lack of sufficient evidence the review stresses the need for further research in the region to develop evidence-informed nationally tailored prepayment mechanisms covering NCDs to reduce economic vulnerability and standardization of tools measuring the economic impact for generating comparable estimates.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.