Financial Burden Among Patients With Lung Cancer in a Publically Funded Health Care System |
| |
Authors: | Doreen A. Ezeife Brandon Josh Morganstein Sally Lau Jennifer H. Law Lisa W. Le Jason Bredle David Cella Mark K. Doherty Penelope Bradbury Geoffrey Liu Adrian Sacher Frances A. Shepherd Natasha B. Leighl |
| |
Affiliation: | 1. Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada;2. Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada;3. FACIT.org, Elmhurst, IL;4. Northwestern University, Evanston, IL;5. Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada |
| |
Abstract: | IntroductionFinancial distress has been established as a clinically relevant patient-reported outcome associated with worse mortality and quality of life. Our goal was to define factors associated with financial burden (FB) in a public health care system.Materials and MethodsPatients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FB was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0 to 44, with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP), and private insurance coverage were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FB (COST < 21).ResultsOf 251 patients approached, 200 (80%) participated. The median age of the cohort was 65 years; 56% were female. The median total OOP ranged between $1000 and $5000 CAD. The median COST score was 21 (range, 0-44). FB was associated with age, with patients < 65 years reporting greater FB than older patients (COST, 18.0 vs. 24.0; P < .0001). In multivariable logistic regression analysis, younger age was associated with greater FB, when adjusting for income, employment status, OOP, and private insurance coverage (odds ratio, 3.6; 95% confidence interval, 1.5-9.1; P < .0001).ConclusionAge is significantly associated with FB in the Canadian (Ontario) public health care system, with younger patients with lung cancer reporting greater financial distress. This study highlights priority patient populations where FB should be routinely assessed and appropriate resources for support offered. |
| |
Keywords: | Address for correspondence: Doreen A. Ezeife, MD, FRCPC, Division of Medical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, ON M5G 2M9 Canada Cost of cancer care Financial distress |
本文献已被 ScienceDirect 等数据库收录! |
|