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患者对乳腺癌手术的经济成本和负担的看法。

Patient Perspectives on the Financial Costs and Burdens of Breast Cancer Surgery.

机构信息

Duke University School of Medicine, Durham, NC.

Biostatistics Shared Resource, Duke Cancer Institute, Duke University, Durham, NC.

出版信息

JCO Oncol Pract. 2021 Jun;17(6):e872-e881. doi: 10.1200/OP.20.00780. Epub 2021 Feb 10.

Abstract

PURPOSE

Although financial toxicity is a well-documented aspect of cancer care, little is known about how patients narratively characterize financial experiences related to breast cancer treatment. We sought to examine these patient experiences through mixed methods analysis.

METHODS

Women (≥ 18 years old) with a history of breast cancer were recruited from the Love Research Army and Sisters Network to complete an 88-item electronic survey including an open-ended response. Quantitative data were used to sort and stratify responses to the open-ended question, which comprised the qualitative data evaluated here. Descriptive statistics and qualitative content analysis were used to evaluate the financial costs and other burdens resulting from breast cancer surgery.

RESULTS

In total, 511 respondents completed the survey in its entirety and wrote an open-ended response. Participants reported significant financial burden in different categories including direct payments for medical care and indirect costs such as lost wages and travel expenses. Treatment-related costs burdened participants for years after diagnosis, forming a for many participants. Discrepancies existed between the degree of financial burden reported on multiple-choice questions and participants' corresponding open-ended descriptions of financial burden. Participants described a lack of communication surrounding costs with their providers and difficulty negotiating payments with insurance.

CONCLUSION

Breast cancer care can result in ongoing financial burden years after diagnosis among all patients, even those with adequate insurance patient populations.

摘要

目的

尽管财务毒性是癌症护理中一个有据可查的方面,但对于患者如何叙述与乳腺癌治疗相关的财务经历知之甚少。我们试图通过混合方法分析来研究这些患者的经历。

方法

从“爱研究军队”(Love Research Army)和“姐妹网络”(Sisters Network)招募了有乳腺癌病史的女性(≥ 18 岁),让她们完成一份包含 88 个项目的电子调查问卷,其中包括一个开放式回答。定量数据用于对开放式问题的回答进行分类和分层,这些回答构成了这里评估的定性数据。使用描述性统计和定性内容分析来评估乳腺癌手术带来的财务成本和其他负担。

结果

共有 511 名受访者完整地完成了调查,并对开放式问题进行了回答。参与者报告了在不同类别中存在重大的财务负担,包括直接支付医疗费用和间接成本,如工资损失和差旅费。与诊断后多年相关的治疗费用使许多参与者背上了沉重的负担。参与者在多项选择题中报告的财务负担程度与他们对财务负担的开放式描述之间存在差异。参与者描述了他们与提供者之间在费用方面缺乏沟通,以及与保险公司协商支付费用的困难。

结论

即使在有足够保险的患者群体中,乳腺癌治疗也会导致所有患者在诊断后多年持续面临财务负担。

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