Financial Toxicity of Cancer Care: An Analysis of Financial Burden in Three Distinct Health Care Systems
| Autor: | Manali I. Patel, Debeshi Maitra, James Dickerson, Sangeeta Aggarwal, Fa-Chyi Lee, Meera Vimala Ragavan, Ritika Dutta, Jeffrey Edwards, Divya Ahuja Parikh |
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| Rok vydání: | 2021 |
| Předmět: |
MEDLINE
Medicare ORIGINAL CONTRIBUTIONS 03 medical and health sciences 0302 clinical medicine Cost of Illness Neoplasms Health care Humans Medicine 030212 general & internal medicine Aged Finance Oncology (nursing) business.industry Health Policy Cancer medicine.disease United States Distress Cross-Sectional Studies Oncology 030220 oncology & carcinogenesis Toxicity Health Expenditures business |
| Zdroj: | JCO Oncol Pract |
| ISSN: | 2688-1535 2688-1527 |
| Popis: | PURPOSE: The financial toxicity of cancer care is a source of significant distress for patients with cancer. The purpose of this study is to understand factors associated with financial toxicity in three distinct care systems. METHODS: We conducted a cross-sectional survey of patients in three care systems, Stanford Cancer Institute (SCI), VA Palo Alto Health Care System (VAPAHCS), and Santa Clara Valley Medical Center (SCVMC), from October 2017 to May 2019. We assessed demographic factors, employment status, and out-of-pocket costs (OOPCs) and administered the validated COmprehensive Score for financial Toxicity tool. We calculated descriptive statistics and conducted linear regression models to analyze factors associated with financial toxicity. RESULTS: Four hundred forty-four of 578 patients (77%) completed the entire COmprehensive Score for financial Toxicity tool and were included in the analysis. Most respondents at SCI were White, with annual household income (AHI) > $50,000 USD and Medicare insurance. At the VAPAHCS, most were White, with AHI ≤ $50,000 USD and insured by the Veterans Administration. At SCVMC, most were Asian and/or Pacific Islander, with AHI ≤ $25,000 USD and Medicaid insurance. Low AHI ( P < .0001), high OOPCs ( P = .003), and employment changes as a result of cancer diagnosis ( P < .0001) were associated with financial toxicity in the pooled analysis. There was variation in factors associated with financial toxicity by site, with employment changes significant at SCI, OOPCs at SCVMC, and no significant factors at the VAPAHCS. CONCLUSION: Low AHI, high OOPCs, and employment changes contribute to financial toxicity; however, there are variations based on site of care. Future studies should tailor financial toxicity interventions within care delivery systems. |
| Databáze: | OpenAIRE |
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