Arozullah Ahsan M, Calhoun Elizabeth A, Wolf Michael, Finley Denise K, Fitzner Karen A, Heckinger Elizabeth A, Gorby Nicolle S, Schumock Glen T, Bennett Charles L
VA Chicago Healthcare System, West Side and Lakeside Divisions, Division of General Internal Medicine of the Department of Medicine, Chicago, Illinois, USA.
J Support Oncol. 2004 May-Jun;2(3):271-8.
The financial impact of cancer can be large, even among persons with comprehensive health insurance policies. Prior studies have found that women with cancer are especially likely to suffer financial hardship. Although controversial, cancer insurance policies are designed to reduce the financial burden of cancer. In this study, we provide estimates of the costs incurred by a cohort of breast cancer patients who were covered by private, Medicare, or Medicaid health insurance. In all, 156 women were interviewed about cancer-related out-of-pocket costs and their knowledge and use of cancer insurance policies. Out-of-pocket expenditures and lost income costs averaged $1,455 per month and varied widely. The majority of out-of-pocket costs were for co-payments for hospitalizations and physician visits. The financial burden of breast cancer accounted for a mean of 98%, 41%, and 26% of monthly income among female breast cancer patients with annual household income levels of < or = $30,000, $30,001-$60,000, and > $60,000, respectively. Cancer insurance policies provided reimbursement for out-of-pocket expenditures for 3% of the women in our study. Our data indicate that even among women with comprehensive health insurance policies, the financial burden of breast cancer can be substantial. Affordable programs that provide reimbursement for medical and nonmedical costs incurred following a diagnosis of breast cancer should be developed, especially for lower income women.
癌症造成的经济影响可能很大，即使是在拥有全面医疗保险政策的人群中也是如此。先前的研究发现，患癌女性尤其容易遭遇经济困难。尽管存在争议，但癌症保险政策旨在减轻癌症带来的经济负担。在本研究中，我们估算了一组由私人医疗保险、医疗保险或医疗补助保险承保的乳腺癌患者所产生的费用。总共对156名女性进行了访谈，了解她们与癌症相关的自付费用以及她们对癌症保险政策的了解和使用情况。自付支出和收入损失成本平均每月为1455美元，且差异很大。大部分自付费用用于住院和看医生的共付费用。在家庭年收入水平分别为≤30000美元、30001 - 60000美元和＞60000美元的女性乳腺癌患者中，乳腺癌的经济负担分别平均占月收入的98%、41%和26%。在我们的研究中，癌症保险政策为3%的女性报销了自付支出。我们的数据表明，即使在拥有全面医疗保险政策的女性中，乳腺癌的经济负担也可能很大。应该制定负担得起的项目，为乳腺癌诊断后产生的医疗和非医疗费用提供报销，尤其是为低收入女性。
