The Burden of Health-Related Out-of-Pocket Cancer Costs in Canada: A Case-Control Study Using Linked Data.

Autor: Essue BM; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.; Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada., Oliveira C; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.; Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada.; Centre for Health Economics and Hull York Medical School, University of York, Heslington, York YO10 5DD, UK.; Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON M6J 1H4, Canada., Bushnik T; Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada., Fung S; Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada., Hwee J; Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada., Sun Z; Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada., Navas EG; Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada., Yong JHE; Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada., Garner R; Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2022 Jun 27; Vol. 29 (7), pp. 4541-4557. Date of Electronic Publication: 2022 Jun 27.
DOI: 10.3390/curroncol29070359
Abstrakt: Background: The burden of out-of-pocket costs among cancer patients/survivors in Canada is not well understood. The objective of this study was to examine the health-related out-of-pocket cost burden experienced by households with a cancer patient/survivor compared to those without, examine the components of health-related costs and determine who experiences a greater burden.
Data and Methods: This study used a data linkage between the Survey of Household Spending and the Canadian Cancer Registry to identify households with a cancer patient/survivor (cases) and those without (controls). The out-of-pocket burden (out-of-pocket costs measured relative to household income) and mean costs were described and regression analyses examined the characteristics associated with the household out-of-pocket burden and annual out-of-pocket costs.
Results: The health-related out-of-pocket cost burden and annual costs measured in households with a cancer patient/survivor were 3.08% (95% CI: 2.55-3.62%) and CAD 1600 (95% CI: 1456-1759), respectively, compared to a burden of 2.84% (95% CI: 2.31-3.38) and annual costs of CAD 1511 (95% CI: 1377-1659) measured in control households, respectively. Households with a colorectal cancer patient/survivor had a significantly higher out-of-pocket burden compared to controls (mean difference: 1.0%, 95% CI: 0.18, 0.46). Among both cases and controls, the lowest income quintile households experienced the highest health-related out-of-pocket cost burden.
Interpretation: Within a universal health care system, it is still relevant to monitor health-related out-of-pocket spending that is not covered by existing insurance mechanisms; however, this is not routinely assessed in Canada. We demonstrate the feasibility of measuring such costs in households with a cancer patient/survivor using routinely collected data. While the burden and annual health-related out-of-pocket costs of households with a cancer patient/survivor were not significantly higher than control households in this study, the routine measurement of out-of-pocket costs in Canada could be systemized, providing a novel, system-level, equity-informed performance indicator, which is relevant for monitoring inequities in the burden of out-of-pocket costs.
Databáze: MEDLINE
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