SynthesisFrontiers in public health2025
Understanding out-of-pocket expenditure in India: a systematic review.
Synthesis in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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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
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Out-of-pocket expenditure on medicine for chronic patients and its economic impact on Indian households: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Cultural and socioeconomic determinants of family satisfaction with ICU care across the globe: a scoping review.Frontiers in medicine · 2025Pooled it
- Gaps in access and trust: essential medicine availability, affordability, and barriers to generic medicine use.Public health action · 2026Article
- Counting the Cost: Examining Out-of-Pocket Spending on Emergency Care in Newfoundland and Labrador, Canada.Journal of the American College of Emergency Physicians open · 2026Article
- Assessing the effects of population aging on health financing structures: evidence from APEC countries using panel data.Scientific reports · 2026Article
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- Bridging the Gap: Addressing Geographic and Socioeconomic Inequities in Access to Cardiac Catheterization in India.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
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- Can a bigger budget shrink the bill at the bedside? Public health financing as a route to lower out-of-pocket spending in India.Frontiers in public health · 2026Article
- Examining the cost of outpatient care for female patients: insights from private healthcare services.BMJ global health · 2025Article
- Patient Engagement in Treatment and its Determinants among Rural Indian Adults with Hypertension and Diabetes.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Out-of-pocket expenditure (OOPE) constitutes a substantial portion of healthcare costs in India, accounting for 47.1% of the Total Health Expenditure in 2019-20. Despite a decline from previous years, OOPE remains a significant financial burden, contributing to catastrophic health expenditures and impoverishment for households. Methods: A systematic review was conducted to analyze factors influencing out-of-pocket expenditures (OOPE) in India. The review adhered to predefined inclusion and exclusion criteria. Search terms were tailored to the syntax of each database to maximize retrieval, using combinations of keywords such as "out of pocket," "India," and "national survey." A total of 702 citations were retrieved (PubMed: 185, Web of Science: 183, Scopus: 334), with 316 identified as duplicates. After title and abstract screening of 386 citations, 128 articles were subjected to full-text review, leading to the inclusion of 36 studies. A narrative synthesis and thematic analysis identified determinants of OOPE in the Indian healthcare context, with findings organized in tables and descriptive formats to address study heterogeneity and enhance interpretation. Results: This systematic and rigorous methodology ensures a comprehensive and reliable understanding of the determinants of OOPE in the Indian healthcare context. Eleven themes emerged from the review: (1) source of care and disease/ condition, (2) place of residence, (3) economic status, (4) components of OOPE, (5) age, (6) gender, (7) strategies for coping with OOPE, (8) educational attainment, (9) OOPE and institutional deliveries, (11) health insurance. Discussion: India's heavy reliance on OOPE emphasizes healthcare gaps, necessitating reforms in public investment, insurance, primary care, and affordable access to ensure equity and financial protection. The lack of equitable healthcare financing instigates the challenges, leading to widespread reliance on distress financing methods.
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