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Financial and family burden associated with cancer treatment in Ontario, Canada
Authors:Christopher J Longo  Margaret Fitch  Raisa B Deber  A Paul Williams
Institution:(1) Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Health Sciences Building, 4th floor, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada;(2) Health Services Management, DeGroote School of Business (MGD 210), McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada;(3) Faculty of Nursing, University of Toronto, Toronto, ON, M5T 3M6, Canada;(4) Department of Graduate Studies, University of Toronto, Toronto, ON, M5T 3M6, Canada;(5) Psychosocial and Behavioural Research Unit, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada;(6) Oncology Nursing and Supportive Care, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
Abstract:Goals of work To determine the financial and family resources burden associated with the treatment of cancer. A questionnaire was developed to determine the direct monthly “out-of-pocket costs” (OOPC), the indirect costs, and the associated perceived family burden.Materials and methods A self-administered questionnaire using a quota sample from five cancer clinics in Ontario, Canada was given to 282 cancer patients (74 breast, 70 colorectal, 68 lung, and 70 prostate). Monthly OOPC were obtained for: drugs, home care, homemaking, complementary and alternative medicines, vitamins and supplements, family care, travel, parking, accommodations, devices, and others. The questionnaire asked if OOPC for treatment were a burden, and if others took time from work to provide caregiving.Main results The mean monthly OOPC was $213, with an additional $372 related to imputed travel costs. For those patients who responded that the burden was “significant” (16.5%), their OOPC was $452. In the case of patients responding that their burden was “unmanageable” (3.9%), their OOPC was $544. The survey showed that 35.6% of patients required others to take time from work and this was higher in the under-65 category. The mean number of days lost from work in the previous 30 days for these caregivers was 7 days.Conclusions These results suggest the financial burden is problematic for 20% of this sample. The caregivers’ lost time from work influence this burden, and for 36% of this sample, it amounts to one third of their working days in any given month. Policies and programs to address these gaps are needed.
Keywords:Cancer  Self-administered questionnaire  Out-of-pocket costs  Financial burden
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