Evidence map›Paper›PMID 40581876›Full record

ArticleWorld journal of surgery2025

Global Variation in Out-of-Pocket Payments for Cancer Surgery.

Joana F F Simoes, Maria Picciochi, Adesoji Ademuyiwa, Adewale Adisa, Theophilus Anyomih, Aneel Bhangu, Jose A Calvache, Dhruva Ghosh, Kate Jolly, Mwayi Kachapila and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Joana F F SimoesNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Maria PicciochiNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0003-0397-5076
Adesoji AdemuyiwaNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Adewale AdisaNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Theophilus AnyomihNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Aneel BhanguNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Jose A CalvacheDepartment of Anaesthesiology, Universidad del Cauca, Popayán, Colombia.
Dhruva GhoshNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Kate JollySchool of Health Sciences, University of Birmingham, Birmingham, UK.
Mwayi KachapilaHealth Economics Unit, Department of Applied Health Sciences, University of Birmingham, Birmingham, UK.
Ismail LawaniNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Dmitri NepogodievNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Faustin NtirenganyaNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Raymond OppongHealth Economics Unit, Department of Applied Health Sciences, University of Birmingham, Birmingham, UK.
Stephen TabiriNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
Antonio Ramos-De la MedinaNIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK.
NIHR Global Health Research Unit on Global Surgery

Funding

Programme Grants for Applied Research NIHR 133364
6 · The paper itself

Abstract

introductionCancer is one of the most expensive global health challenges and surgery is needed in most cases. This study aimed to describe out-of-pocket payments for cancer surgery across country income groups.

methodsThis was a preplanned secondary analysis from an international prospective cohort study of consecutive patients undergoing cancer surgery in October 2020. Out-of-pocket payments (OOPP) to cover most of the cost of cancer surgery were compared across country income groups. Other funding sources were also described as follows: public funds, insurance, or others. A logistic regression model was used to identify variables independently associated with OOPP in low- and middle-income countries.

resultsThere were 24,498 patients included from 1332 hospitals from 108 countries. Overall, 6.4% (1571/24,498) had OOPP to cover most of the cost of their cancer surgery. OOPP rates varied across country income groups: 0.5% (89/16,680) in HICs, 5.7% (272/4784) in UMICs, 38.6% (1008/2614) in LMICs, and 48.1% (202/429) in LICs. Besides the country income, male sex (OR 1.16, 95% CI 1.02-1.32, and p = 0.024) and elective surgery (OR 1.31, 1.04-1.67, and p = 0.022) were associated with OOPP for cancer surgery. DISCUSSION: Patients accessing cancer surgery in LMICs are at an increased risk of catastrophic expenditure. Governments should prevent this by developing health insurance plans that cover elective cancer surgery, possibly involving diverse stakeholders. The interpretation of gender-related risks demands deeper understanding of the ability to pay out-of-pocket and access care.

Indexed as

Financing, PersonalGlobal HealthHealth ExpendituresNeoplasmsAdultAgedDeveloping CountriesFemaleHumansMaleMiddle AgedProspective Studiescancercatastrophic expenditureglobal surgery

Identifiers

PMID40581876
PMCPMC12338400

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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 OpenQuestion graph.