Financial Hardship, Healthcare Utilization, and Health Among U.S. Cancer Survivors
| Autor: | Ahmedin Jemal, Jingxuan Zhao, Xuesong Han, Stacey A. Fedewa, K. Robin Yabroff, Weishan Song, Matthew P. Banegas, Ashish Rai, Reginald D. Tucker-Seeley, Zhiyuan Zheng |
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| Rok vydání: | 2020 |
| Předmět: |
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Finance Epidemiology business.industry media_common.quotation_subject 010102 general mathematics Public Health Environmental and Occupational Health MEDLINE Emergency department 01 natural sciences Health equity 03 medical and health sciences 0302 clinical medicine Health care National Health Interview Survey Medicine 030212 general & internal medicine Ordered logit 0101 mathematics Worry business human activities health care economics and organizations media_common |
| Zdroj: | American Journal of Preventive Medicine. 59:68-78 |
| ISSN: | 0749-3797 |
| Popis: | Introduction This study examined associations of both medical and nonmedical financial hardships with healthcare utilization and self-rated health among cancer survivors. Methods The National Health Interview Survey (2013–2017) was used to identify cancer survivors (aged 18–64 years: n=4,939; aged ≥65 years: n=6,972). A total of 4 levels of medical financial hardship intensities were created with measures from material, psychological, and behavioral domains. A total of 5 levels of nonmedical financial hardship intensities were created with measures in food insecurity and worry about other economic needs (e.g., housing expenses). Generalized ordinal logistic regression examined associations between medical and nonmedical financial hardship intensities and emergency department visits, use of preventive services and cancer screenings, and self-rated health. All analyses were performed in 2019. Results In adjusted analyses, cancer survivors with higher medical financial hardship intensity (Level 4 vs Level 1; aged 18–64 years: 42% vs 26.2%, p Conclusions Higher medical and nonmedical financial hardships are independently associated with more emergency department visits, lower receipt of some preventive services, and worse self-rated health in cancer survivors. With growing healthcare costs, unmet medical and nonmedical financial needs may worsen health disparities among cancer survivors. |
| Databáze: | OpenAIRE |
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