Impact of socioeconomic and geographical factors on clinical care of biliary atresia patients: a cross-sectional study
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In brief
In brief
This cross-sectional study examines how socioeconomic status and geographic location affect biliary atresia outcomes in India, where most patients are from rural, lower-income backgrounds. Despite Kasai portoenterostomy availability, follow-up compliance declined and only one patient accessed liver transplantation due to cost and accessibility barriers.
- Majority of biliary atresia patients in India come from rural areas and lower-middle socioeconomic status, creating access barriers.
- Patient compliance with follow-up care decreases over time, primarily due to financial constraints and geographical distance from care centers.
- Only 1 of 48 patients underwent liver transplantation due to prohibitive costs and limited accessibility in low-resource settings.
- Timely Kasai portoenterostomy is critical, yet socioeconomic factors delay presentation and reduce treatment adherence in LMIC contexts.
- Improving healthcare infrastructure, financial support programs, and patient education are essential to enhance biliary atresia outcomes in India.
Written by the GCMD Library team from the article.
Abstract
Purpose
Biliary atresia (BA) is a critical pediatric condition requiring timely intervention through Kasai portoenterostomy (KPE), and up to two-thirds of patients need liver transplantation (LT). The outcomes for BA patients still need improvement in low- and middle-income countries. This study aims to assess the socioeconomic and geographical profile of BA patients in India, focusing on their compliance with follow-up care, treatment-seeking behaviour, and acceptability of LT in addition, it provides recommendations to overcome identified challenges.
Methods
A retrospective observational study was conducted in a tertiary care centre in India, including 48 patients who underwent KPE between 2018 and 2022. SES was assessed using the modified Kuppuswamy scale, and geographical areas were classified as per the criteria of the Indian Census 2011. Compliance with follow-up, treatment-seeking behaviour, and LT acceptability were evaluated.
Results
The majority of patients belonged to rural areas and lower middle SES. Compliance with follow-up decreased over time, with financial and geographical barriers being significant challenges. Only one patient underwent LT due to prohibitive costs and limited accessibility.
Conclusion
Socioeconomic and geographical factors significantly impact the clinical outcomes of BA patients in India. Improving education, healthcare infrastructure, and financial support is crucial for enhancing patient compliance and access to necessary treatments.