Centre for Applied Psychological Research, University of Huddersfield, Queensgate, UK.
Eur J Oncol Nurs. 2011 Sep;15(4):302-10. doi: 10.1016/j.ejon.2010.10.005. Epub 2010 Nov 19.
To review out-of-pocket costs related to cancer that are borne by patients and their families.
A literature search using key terms relating to out-of-pocket costs incurred by cancer patients and their families was undertaken to generate a comprehensive narrative synthesis of the information available.
Four themes were identified: measuring costs; sources of costs; the impact of costs and reducing costs. The wide variety of measures for ascertaining hidden costs makes comparison of findings difficult; some articles cover a very narrow range of costs. Qualitative research is useful for elucidating a wide range of costs. Costs pertaining to hospital visits, nutrition and clothing are widely mentioned. Low additional expenditure may indicate that needs/wants are going unmet. Financial capacity to cope and subjective perception of impact are important. Low income, younger age, chemotherapy and living rurally are associated with greater impact. Extra expense can exert long-term effects on family finances. Primary care follow-up, telemedicine and treatments that entail fewer visits may serve to reduce patient costs.
The key question is how to organise/deliver cancer care in order to reduce additional expenses to patients and families. Future research could identify critical time-points and demographic groups susceptible to significant additional costs, in order to target support at those most in need.
回顾癌症患者及其家庭所承担的自付费用。
使用与癌症患者及其家庭自付费用相关的关键词进行文献检索，以生成对现有信息的全面叙述性综合分析。
确定了四个主题：费用的衡量、费用的来源、费用的影响和降低费用。确定隐性成本的各种衡量标准差异很大，使得比较结果变得困难；一些文章仅涵盖非常狭窄的费用范围。定性研究对于阐明广泛的费用很有用。与医院就诊、营养和服装相关的费用被广泛提及。低额外支出可能表明需求/欲望未得到满足。应对财务能力和主观感受的影响很重要。收入低、年龄较小、化疗和居住在农村地区与更大的影响相关。额外费用可能会对家庭财务产生长期影响。初级保健随访、远程医疗和需要就诊次数较少的治疗方法可能有助于降低患者的费用。
关键问题是如何组织/提供癌症护理，以减少患者及其家庭的额外费用。未来的研究可以确定易发生重大额外费用的关键时间点和人口群体，以便将支持针对最需要的人群。
