{"id":"https://openalex.org/W7125597485","doi":"https://doi.org/10.1186/s12904-026-01985-6","title":"Healthcare burden and impoverishment among older adults with palliative care needs in India: findings from a nationally representative study","display_name":"Healthcare burden and impoverishment among older adults with palliative care needs in India: findings from a nationally representative study","publication_year":2026,"publication_date":"2026-01-24","ids":{"openalex":"https://openalex.org/W7125597485","doi":"https://doi.org/10.1186/s12904-026-01985-6","pmid":"https://pubmed.ncbi.nlm.nih.gov/41578256","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12930791"},"language":"en","primary_location":{"id":"doi:10.1186/s12904-026-01985-6","doi":"https://doi.org/10.1186/s12904-026-01985-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12904-026-01985-6","pdf_url":null,"source":{"id":"https://openalex.org/S169992948","display_name":"BMC Palliative Care","issn_l":"1472-684X","issn":["1472-684X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliative Care","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12904-026-01985-6","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5025259668","display_name":"Terrymize Immanuel","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I145286018","display_name":"SRM Institute of Science and Technology","ror":"https://ror.org/050113w36","country_code":"IN","type":"education","lineage":["https://openalex.org/I145286018"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Terrymize Immanuel","raw_affiliation_strings":["SRM School of Public Health, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu,, Tamil Nadu,, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"SRM School of Public Health, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu,, Tamil Nadu,, India","institution_ids":["https://openalex.org/I145286018"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5022605534","display_name":"Benson Thomas M","orcid":"https://orcid.org/0000-0002-2909-7171","observed_orcids":["https://orcid.org/0000-0002-2909-7171"]},"institutions":[{"id":"https://openalex.org/I145286018","display_name":"SRM Institute of Science and Technology","ror":"https://ror.org/050113w36","country_code":"IN","type":"education","lineage":["https://openalex.org/I145286018"]}],"countries":["IN"],"is_corresponding":true,"raw_author_name":"Benson Thomas M","raw_affiliation_strings":["SRM School of Public Health, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu,, Tamil Nadu,, India. bensontm@srmist.edu.in"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"SRM School of Public Health, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu,, Tamil Nadu,, India. bensontm@srmist.edu.in","institution_ids":["https://openalex.org/I145286018"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062944208","display_name":"Naveen S. Salins","orcid":"https://orcid.org/0000-0001-5237-9874","observed_orcids":["https://orcid.org/0000-0001-5237-9874"]},"institutions":[{"id":"https://openalex.org/I164861460","display_name":"Manipal Academy of Higher Education","ror":"https://ror.org/02xzytt36","country_code":"IN","type":"education","lineage":["https://openalex.org/I164861460"]},{"id":"https://openalex.org/I76414455","display_name":"Kasturba Medical College, Manipal","ror":"https://ror.org/05hg48t65","country_code":"IN","type":"education","lineage":["https://openalex.org/I164861460","https://openalex.org/I76414455"]}],"countries":["IN"],"is_corresponding":true,"raw_author_name":"Naveen Salins","raw_affiliation_strings":["Department of Palliative Medicine and Supportive Care, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, 576104, India. naveen.salins@manipal.edu"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, 576104, India. naveen.salins@manipal.edu","institution_ids":["https://openalex.org/I164861460","https://openalex.org/I76414455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091845501","display_name":"Jenifer Jeba Sundararaj","orcid":"https://orcid.org/0000-0002-7200-4452","observed_orcids":["https://orcid.org/0000-0002-7200-4452"]},"institutions":[{"id":"https://openalex.org/I172917736","display_name":"Christian Medical College, Vellore","ror":"https://ror.org/00c7kvd80","country_code":"IN","type":"education","lineage":["https://openalex.org/I172917736"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Jenifer Jeba Sundararaj","raw_affiliation_strings":["Department of Palliative Medicine, Christian Medical College Vellore, Tamil Nadu, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Palliative Medicine, Christian Medical College Vellore, Tamil Nadu, India","institution_ids":["https://openalex.org/I172917736"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5066381894","display_name":"Roop Gursahani","orcid":"https://orcid.org/0000-0002-6092-1595","observed_orcids":["https://orcid.org/0000-0002-6092-1595"]},"institutions":[{"id":"https://openalex.org/I2800474033","display_name":"P. D. Hinduja Hospital and Medical Research Centre","ror":"https://ror.org/00a6fbp85","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I2800474033"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Roop Gursahani","raw_affiliation_strings":["Department of Neurology, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurology, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India","institution_ids":["https://openalex.org/I2800474033"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5022605534","https://openalex.org/A5062944208"],"corresponding_institution_ids":["https://openalex.org/I145286018","https://openalex.org/I164861460","https://openalex.org/I76414455"],"apc_list":{"value":2990,"currency":"USD","value_usd":2990},"apc_paid":{"value":2990,"currency":"USD","value_usd":2990},"fwci":15.0789,"has_fulltext":false,"cited_by_count":3,"citation_normalized_percentile":{"value":0.9853112,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":96,"max":97},"biblio":{"volume":"25","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.9775000214576721,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.9775000214576721,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12708","display_name":"Economic and Financial Impacts of Cancer","score":0.012400000356137753,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12781","display_name":"Global Health Care Issues","score":0.003599999938160181,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/out-of-pocket-health-expenditure","display_name":"out-of-pocket health expenditure","score":0.8659999966621399},{"id":"https://openalex.org/keywords/palliative-care-needs","display_name":"palliative care needs","score":0.8040000200271606},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.9980000257492065},{"id":"https://openalex.org/keywords/impoverishment","display_name":"impoverishment","score":0.8270000219345093},{"id":"https://openalex.org/keywords/household-health-expenditure","display_name":"household health expenditure","score":0.5540000200271606},{"id":"https://openalex.org/keywords/hospitalization-costs","display_name":"hospital costs","score":0.9049999713897705},{"id":"https://openalex.org/keywords/outpatient-costs","display_name":"outpatient costs","score":0.9309999942779541},{"id":"https://openalex.org/keywords/distress-financing","display_name":"distress financing","score":0.7239999771118164},{"id":"https://openalex.org/keywords/cancer","display_name":"cancer","score":0.5059999823570251},{"id":"https://openalex.org/keywords/heart-disease","display_name":"heart disease","score":0.8180000185966492},{"id":"https://openalex.org/keywords/stroke","display_name":"stroke","score":0.8610000014305115},{"id":"https://openalex.org/keywords/health-insurance","display_name":"health insurance","score":0.7179999947547913},{"id":"https://openalex.org/keywords/india","display_name":"India","score":0.4749999940395355}],"concepts":[{"id":"https://openalex.org/C2994186709","wikidata":"https://www.wikidata.org/wiki/Q29483","display_name":"Palliative care","level":2,"score":0.8810999989509583},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7204999923706055},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6272000074386597},{"id":"https://openalex.org/C2991975920","wikidata":"https://www.wikidata.org/wiki/Q621261","display_name":"Pain medicine","level":3,"score":0.4875999987125397},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.4474000036716461},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.42879998683929443},{"id":"https://openalex.org/C28718268","wikidata":"https://www.wikidata.org/wiki/Q4118620","display_name":"Needs assessment","level":2,"score":0.367000013589859},{"id":"https://openalex.org/C161681244","wikidata":"https://www.wikidata.org/wiki/Q5194613","display_name":"Curative care","level":4,"score":0.36640000343322754},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.36230000853538513},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.34369999170303345},{"id":"https://openalex.org/C2778000068","wikidata":"https://www.wikidata.org/wiki/Q5051575","display_name":"Catastrophic illness","level":2,"score":0.31380000710487366},{"id":"https://openalex.org/C2983635472","wikidata":"https://www.wikidata.org/wiki/Q334911","display_name":"Health insurance","level":3,"score":0.31189998984336853},{"id":"https://openalex.org/C2777995714","wikidata":"https://www.wikidata.org/wiki/Q18209059","display_name":"Advance care planning","level":3,"score":0.3107999861240387},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.304500013589859},{"id":"https://openalex.org/C3019806175","wikidata":"https://www.wikidata.org/wiki/Q11974939","display_name":"Health professionals","level":3,"score":0.2915000021457672},{"id":"https://openalex.org/C524218345","wikidata":"https://www.wikidata.org/wiki/Q31218","display_name":"Health economics","level":3,"score":0.28700000047683716},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.2799000144004822},{"id":"https://openalex.org/C3019887659","wikidata":"https://www.wikidata.org/wiki/Q191089","display_name":"Older people","level":2,"score":0.2745000123977661},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.2648000121116638}],"mesh":[{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000369","descriptor_name":"Aged, 80 and over","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005102","descriptor_name":"Health Expenditures","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007194","descriptor_name":"India","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008137","descriptor_name":"Longitudinal Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010166","descriptor_name":"Palliative Care","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D010166","descriptor_name":"Palliative Care","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D010166","descriptor_name":"Palliative Care","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D011203","descriptor_name":"Poverty","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D011203","descriptor_name":"Poverty","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D017281","descriptor_name":"Cost of Illness","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":4,"locations":[{"id":"doi:10.1186/s12904-026-01985-6","doi":"https://doi.org/10.1186/s12904-026-01985-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12904-026-01985-6","pdf_url":null,"source":{"id":"https://openalex.org/S169992948","display_name":"BMC Palliative Care","issn_l":"1472-684X","issn":["1472-684X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliative Care","raw_type":"journal-article"},{"id":"pmid:41578256","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41578256","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC palliative care","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12930791","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12930791/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliat Care","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:775d7927dcf2405d9f0203cd37882184","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/775d7927dcf2405d9f0203cd37882184","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Palliative Care, Vol 25, Iss 1 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s12904-026-01985-6","doi":"https://doi.org/10.1186/s12904-026-01985-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12904-026-01985-6","pdf_url":null,"source":{"id":"https://openalex.org/S169992948","display_name":"BMC Palliative Care","issn_l":"1472-684X","issn":["1472-684X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Palliative Care","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.98580002784729,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"},{"score":0.8928999900817871,"id":"https://metadata.un.org/sdg/1","display_name":"No poverty"},{"score":0.4074000120162964,"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320317486","display_name":"SRM Institute of Science and Technology","ror":"https://ror.org/037skf023"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":38,"referenced_works":["https://openalex.org/W2000391517","https://openalex.org/W2759469004","https://openalex.org/W2770086481","https://openalex.org/W2801838590","https://openalex.org/W2888710249","https://openalex.org/W2912650333","https://openalex.org/W2936084556","https://openalex.org/W2971526312","https://openalex.org/W2982261856","https://openalex.org/W2994843925","https://openalex.org/W2997154655","https://openalex.org/W3170122149","https://openalex.org/W4205980546","https://openalex.org/W4210275673","https://openalex.org/W4225654678","https://openalex.org/W4226360241","https://openalex.org/W4283656842","https://openalex.org/W4292707876","https://openalex.org/W4294884747","https://openalex.org/W4311875064","https://openalex.org/W4323317110","https://openalex.org/W4381250748","https://openalex.org/W4382237540","https://openalex.org/W4383293709","https://openalex.org/W4385576162","https://openalex.org/W4385987049","https://openalex.org/W4386980226","https://openalex.org/W4387399104","https://openalex.org/W4393037673","https://openalex.org/W4402528756","https://openalex.org/W4403496244","https://openalex.org/W4404887861","https://openalex.org/W4405414062","https://openalex.org/W4406398980","https://openalex.org/W4407318025","https://openalex.org/W4409819280","https://openalex.org/W4411969529","https://openalex.org/W4414043963"],"related_works":["https://openalex.org/W4400508087","https://openalex.org/W7220834260","https://openalex.org/W4414721402","https://openalex.org/W4289879048","https://openalex.org/W4414395055","https://openalex.org/W7213556227","https://openalex.org/W3130690995","https://openalex.org/W7160500102","https://openalex.org/W4385355566","https://openalex.org/W1975398584"],"abstract_inverted_index":{"BACKGROUND:":[0],"Out-of-pocket":[1],"health":[2,9,147,209,267],"expenditure":[3,86,134,148],"(OOPE)":[4],"is":[5,47],"a":[6],"significant":[7],"public":[8],"concern":[10],"in":[11,56,132,216,245],"India,":[12],"with":[13,68,140,152,181,221,248],"an":[14],"estimated":[15,90],"55":[16],"million":[17],"individuals":[18],"pushed":[19],"into":[20],"poverty":[21],"due":[22],"to":[23,129,213,269],"healthcare":[24,85,230,256],"expenses.":[25],"Evidence":[26],"on":[27],"the":[28,41,52,73,98,110,259],"burden":[29],"and":[30,40,66,75,87,95,102,123,135,161,171,187,199,266],"patterns":[31],"of":[32,169,173,207,218,223,232,242],"OOPE":[33,88,101,165],"among":[34],"older":[35,61,150,214,233,249],"adults":[36,62,151,215,234,250],"requiring":[37,235],"palliative":[38,69,153,219,236,252,263],"care,":[39,220],"financial":[42],"strain":[43],"faced":[44],"by":[45],"them,":[46],"limited.":[48],"METHODS:":[49],"Data":[50],"from":[51],"Longitudinal":[53],"Ageing":[54],"Study":[55],"India":[57],"(LASI)":[58],"identified":[59],"2903":[60],"aged":[63],"60":[64],"years":[65],"more":[67],"care":[70,94,154,160,237,253,264],"needs":[71,155,231],"using":[72],"Supportive":[74],"Palliative":[76],"Care":[77],"Indicator":[78],"Tool":[79],"for":[80,92,109,149,158,163,167,261],"Low-Income":[81],"Settings":[82],"(SPICT-LIS).":[83],"Annual":[84],"were":[89,107,127,179,203],"separately":[91],"outpatient":[93,159,170],"hospitalisation.":[96,164],"At":[97],"household":[99,137,208],"level,":[100],"Catastrophic":[103],"Healthcare":[104],"Expenditure":[105],"(CHE)":[106],"calculated":[108],"last":[111],"month.":[112],"CHE":[113],"prevalence":[114],"was":[115,156,211],"mapped":[116],"across":[117],"India's":[118],"states.":[119],"The":[120,144,229],"Kruskal-Wallis":[121],"test":[122],"Multivariate":[124],"logistic":[125],"regression":[126],"used":[128],"assess":[130],"differences":[131],"mean":[133,145],"identify":[136],"factors":[138],"associated":[139,180],"CHE,":[141],"respectively.":[142],"RESULTS:":[143],"annual":[146],"\u20b95002":[157],"\u20b936,263":[162],"accounted":[166],"94%":[168],"82%":[172],"hospitalisation":[174,177],"costs.":[175],"Significant":[176],"costs":[178],"cancers":[182],"(\u20b9267,797),":[183],"heart":[184],"diseases":[185],"(\u20b993,003),":[186],"stroke/neurological":[188],"illnesses":[189],"(\u20b954,913).":[190],"Distress":[191],"financing":[192],"methods,":[193],"such":[194],"as":[195],"liquidating":[196],"savings":[197],"(24.4%)":[198],"taking":[200],"loans":[201],"(26.5%),":[202],"standard.":[204],"Nearly":[205],"one-third":[206],"spending":[210],"attributed":[212],"need":[217,260],"21.6%":[222],"these":[224],"households":[225,247],"facing":[226],"CHE.":[227],"CONCLUSION:":[228],"are":[238],"predominantly":[239],"funded":[240],"out":[241],"pocket.":[243],"One":[244],"five":[246],"needing":[251],"faces":[254],"catastrophic":[255],"expenses,":[257],"highlighting":[258],"expanded":[262],"programs":[265],"insurance":[268],"alleviate":[270],"economic":[271],"hardships.":[272]},"counts_by_year":[{"year":2026,"cited_by_count":3}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-01-25T00:00:00"}