纽芬兰和拉布拉多的乳腺癌和前列腺癌患者对自付费用的反应。
Responses by breast and prostate cancer patients to out-of-pocket costs in Newfoundland and Labrador.
机构信息
Newfoundland and Labrador Centre for Health Information, St. John's, NL.
出版信息
Curr Oncol. 2013 Jun;20(3):158-65. doi: 10.3747/co.20.1197.
PURPOSE
Cancer patients face substantial care-related out-of-pocket (oop) costs that may influence treatment decisions, attitudes, and use of drug- or appointment-related cost-saving strategies. We examined the relationship between oop costs and care-related responses by patients.
METHODS
We surveyed 170 prostate and 131 breast cancer patients presenting at clinics or support groups, or listed on the cancer registry in Newfoundland and Labrador.
RESULTS
In the 3-month period before the survey, 18.8% of prostate and 25.2% of breast cancer patients had oop costs greater than $500. Those oop costs consumed more than 7.5% of quarterly household income for 15.9% of prostate and 19.1% of breast cancer patients. Few patients (8.8% prostate, 15.3% breast) ever adopted any drug- or appointment-related cost-saving strategy. Few patients (7.2% prostate, 9.6% breast) said oop costs influenced treatment decisions, told their physicians about their oop costs (27.0% prostate, 21.1% breast), or were aware of available financial assistance programs (27.3% prostate, 36.9% breast). Compared with patients having low or moderate oop costs (22.9% prostate, 16.7% breast, and 25.7% prostate, 58.3% breast respectively), a larger proportion of prostate (56.0%) and breast (58.3%) cancer patients with high oop costs said that those costs created stress. Among prostate cancer patients, a larger proportion of those having high oop costs (compared with low or moderate costs) used drug-related (22.2% vs. 3.3% and 9.6% respectively) and appointment-related (11.1% vs. 1.1% and 3.8% respectively) cost-saving strategies, said oop costs created an unusual amount of stress (48.0% vs. 18.4% and 10.4%), and had difficulty paying those costs (29.2% vs. 6.2% and 10.4%).
CONCLUSIONS
For a small group of breast and prostate cancer patients, oop costs are high, but rarely lead to the use of care-related cost-saving strategies or influence care decisions.
目的
癌症患者面临大量与治疗相关的自付费用（oop），这些费用可能会影响治疗决策、态度以及药物或预约相关节省成本策略的使用。我们研究了oop 费用与患者相关护理反应之间的关系。
方法
我们调查了在纽芬兰和拉布拉多的诊所或支持小组就诊或在癌症登记处登记的 170 名前列腺癌患者和 131 名乳腺癌患者。
结果
在调查前的 3 个月内，18.8%的前列腺癌患者和 25.2%的乳腺癌患者的oop 费用超过 500 美元。这些 oop 费用占前列腺癌患者季度家庭收入的 7.5%以上，占乳腺癌患者的 15.9%。很少有患者（8.8%的前列腺癌患者，15.3%的乳腺癌患者）曾经采取任何药物或预约相关的节省成本策略。很少有患者（7.2%的前列腺癌患者，9.6%的乳腺癌患者）表示oop 费用影响了治疗决策，告诉医生他们的oop 费用（27.0%的前列腺癌患者，21.1%的乳腺癌患者），或了解可用的财务援助计划（27.3%的前列腺癌患者，36.9%的乳腺癌患者）。与oop 费用较低或中等（22.9%的前列腺癌患者，16.7%的乳腺癌患者和 25.7%的前列腺癌患者，58.3%的乳腺癌患者）的患者相比，较大比例的前列腺癌（56.0%）和乳腺癌（58.3%）患者表示高 oop 费用给他们带来了压力。在前列腺癌患者中，与低或中等 oop 费用相比，较高 oop 费用的患者更倾向于使用药物相关（22.2%比 3.3%和 9.6%）和预约相关（11.1%比 1.1%和 3.8%）的节省成本策略，他们表示 oop 费用带来了异常的压力（48.0%比 18.4%和 10.4%），并且难以支付这些费用（29.2%比 6.2%和 10.4%）。
结论
对于一小部分乳腺癌和前列腺癌患者来说，oop 费用较高，但很少导致使用与护理相关的节省成本策略或影响护理决策。
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