Rutgers School of Public Health, Piscataway, NJ, USA.
Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Support Care Cancer. 2021 Nov;29(11):6613-6623. doi: 10.1007/s00520-021-06232-7. Epub 2021 May 4.
To identify predictors of financial hardship, operationalized as foregoing health care, making financial sacrifices, and being concerned about having inadequate financial and insurance information.
Cancer survivors (n = 346) identified through the New Jersey State Cancer Registry were surveyed from August 2018 to September 2019. Multivariable logistic regression analyses were performed.
Cancer survivors with household incomes less than $50,000 annually were more likely than those earning $50,0000-$90,000 to report foregoing health care (15.8 percentage points, p < 0.05). Compared to retirees, survivors who were currently unemployed, disabled, or were homemakers were more likely to forego doctor's visits (11.4 percentage points, p < 0.05), more likely to report borrowing money (16.1 percentage points, p < 0.01), and more likely to report wanting health insurance information (25.7 percentage points, p < 0.01). Employed survivors were more likely than retirees to forego health care (16.8 percentage points, p < 0.05) and make financial sacrifices (20.0 percentage points, p < 0.01). Survivors who never went to college were 9.8 percentage points (p < 0.05) more likely to borrow money compared to college graduates. Black survivors were more likely to want information about dealing with financial and insurance issues (p < 0.01); men were more likely to forego health care (p < 0.05).
Findings highlight the role of employment status and suggest that education, income, race, and gender also shape cancer survivors' experience of financial hardship. There is a need to refine and extend financial navigation programs. For employed survivors, strengthening family leave policies would be desirable.
确定经济困难的预测因素，具体表现为放弃医疗保健、做出经济牺牲以及担心缺乏财务和保险信息。
通过新泽西州癌症登记处确定癌症幸存者（n=346），并于 2018 年 8 月至 2019 年 9 月进行调查。进行多变量逻辑回归分析。
年收入低于 50,000 美元的癌症幸存者比收入在 50,000-90,000 美元之间的幸存者更有可能报告放弃医疗保健（15.8%，p<0.05）。与退休人员相比，目前失业、残疾或家庭主妇的幸存者更有可能不去看医生（11.4%，p<0.05），更有可能借钱（16.1%，p<0.01），并且更有可能想要健康保险信息（25.7%，p<0.01）。与退休人员相比，在职幸存者更有可能放弃医疗保健（16.8%，p<0.05）和做出经济牺牲（20.0%，p<0.01）。与大学毕业生相比，从未上过大学的幸存者更有可能借钱（9.8%，p<0.05）。黑人幸存者更有可能希望获得有关处理财务和保险问题的信息（p<0.01）；男性更有可能放弃医疗保健（p<0.05）。
研究结果强调了就业状况的作用，并表明教育、收入、种族和性别也会影响癌症幸存者的经济困难经历。需要完善和扩展财务导航计划。对于在职幸存者，加强家庭休假政策将是可取的。
