Analysis of Inpatient Hospital-Based Palliative Care Costs for Patients with Cancer in Bangladesh: A Multicenter...

In Bangladesh, where healthcare financing heavily relies on out-of-pocket expenditure (OOPE), access to palliative care remains limited, fragmented, and economically burdensome for many families. This study aims to estimate the cost of inpatient hospital-based palliative care for cancer patients and identify the major cost components contributing to this burden.

This prospective, multicenter study was conducted in 2 palliative care centers-one government-run and one privately operated by a trust-in Dhaka, Bangladesh. A total of 151 adult cancer patients receiving inpatient palliative care were enrolled. Data were collected from hospital records and patient interviews, and costs were categorized into direct and indirect components. Statistical analysis included descriptive statistics, decomposition analysis, and gamma generalized linear regression models with log link.

The average cost of inpatient hospital-based palliative care was 41 170 BDT (≈339 USD). OOPE accounted for 73.5% of the total cost. Medication and patient wage loss were the highest contributors to direct and indirect costs respectively. Economic status and hospital type significantly influenced cost burdens. Higher income was linked to higher total and OOPE, with wealthier patients preferring high-cost private facilities.

Inpatient hospital-based palliative care in Bangladesh imposes a substantial financial burden on patients, driven largely by high OOPE. These findings provide evidence to support long-term efforts for financial protection, medicine access, and equitable palliative care, informing future policy and subsequent research.