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在一个公平获得医疗保健系统中接受前列腺癌治疗的男性中的经济毒性和压力。

Financial toxicity and strain among men receiving prostate cancer care in an equal access healthcare system.

机构信息

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.

Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Cancer Med. 2020 Dec;9(23):8765-8771. doi: 10.1002/cam4.3484. Epub 2020 Oct 17.

Abstract

PURPOSE

To examine financial toxicity and strain among men in an equal access healthcare system based on social determinants and clinical characteristics.

METHODS

Observational study among men receiving prostate cancer care (n = 49) at a Veterans Health Administration (VHA) facility. Financial hardship included overall financial strain and financial toxicity due to healthcare costs. Financial strain was measured with one item asking how much money they have leftover at the end of the month. Financial toxicity was measured with the Comprehensive Score for Financial Toxicity (COST) scale.

RESULTS

Comprehensive Score for Financial Toxicity scores among participants indicated moderate levels of financial toxicity (M = 24.4, SD = 9.9). For financial strain, 36% of participants reported that they did not have enough money left over at the end of the month. There were no racial or clinically related differences in financial toxicity, but race and income level had significant associations with financial strain.

CONCLUSION

Financial toxicity and strain should be measured among patients in an equal access healthcare system. Findings suggest that social determinants may be important to assess, to identify patients who may be most likely to experience financial hardship in the context of obtaining cancer care and implement efforts to mitigate the burden for those patients.

摘要

目的

基于社会决定因素和临床特征,考察在公平获得医疗保健体系中男性的经济毒性和压力。

方法

对在退伍军人事务部(VHA)医疗机构接受前列腺癌治疗的男性(n=49)进行观察性研究。经济困难包括整体经济压力和因医疗费用导致的经济毒性。经济压力通过询问他们每月月底剩余多少钱的一个项目来衡量。经济毒性通过全面经济毒性评分(COST)量表来衡量。

结果

参与者的全面经济毒性评分表明存在中度经济毒性(M=24.4,SD=9.9)。对于经济压力,36%的参与者表示他们每月月底没有足够的钱剩余。在经济毒性方面,没有种族或临床相关差异,但种族和收入水平与经济压力有显著关联。

结论

在公平获得医疗保健体系中,应测量患者的经济毒性和压力。研究结果表明,社会决定因素可能很重要,需要进行评估,以确定在获得癌症治疗过程中最有可能经历经济困难的患者,并为这些患者减轻负担。

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