Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Cancer Med. 2021 Jun;10(11):3726-3740. doi: 10.1002/cam4.3913. Epub 2021 May 10.
Cancer treatments often require intensive use of healthcare services and limit patients' ability to work, potentially causing them to become financially vulnerable. The present study is the first attempt to measure, on the German national level, the magnitude of absolute income loss after a cancer diagnosis.
This study analyzes data from the Socio-Economic Panel (SOEP) survey, one of the largest and most comprehensive household surveys in Germany, consisting of approximately 20,000 individuals, who are traced annually. The empirical strategy consists of ordinary least squares (OLS) and multinomial logistic estimators to measure changes in job income, work status, working hours, and pension as a result of reporting a cancer diagnosis for the period between 2009 and 2015. Sample consistency checks were conducted to limit measurement error biases.
Our results show that job incomes dropped between 26% and 28% within the year a cancer diagnosis was reported. The effect persisted for two years after the diagnosis and was no longer observable after four years. The finding was linked to an increased likelihood of unemployment and a reduction of working hours by 24%. Pension levels, on the other hand, were not affected by a cancer diagnosis.
These findings suggest that many cancer patients are exposed to financial hardship in Germany, particularly when the cancer diagnosis occurs during their working age and before requirements to obtain a pension are met. Further research seems warranted to identify particularly vulnerable patient groups.
癌症治疗通常需要大量使用医疗保健服务，并限制患者的工作能力，可能使他们面临经济脆弱性。本研究首次尝试在德国全国范围内衡量癌症诊断后的绝对收入损失程度。
本研究分析了德国最大和最全面的家庭调查之一社会经济面板（SOEP）调查的数据，该调查由大约 20000 人组成，每年进行跟踪。实证策略包括普通最小二乘法（OLS）和多项逻辑回归估计器，以衡量报告癌症诊断后在 2009 年至 2015 年期间工作收入、工作状态、工作时间和养老金的变化。进行了样本一致性检查以限制测量误差偏差。
我们的结果表明，在报告癌症诊断的那一年，工作收入下降了 26%至 28%。这种影响持续了两年，四年后不再观察到。这一发现与失业可能性增加和工作时间减少 24%有关。另一方面，养老金水平不受癌症诊断的影响。
这些发现表明，德国许多癌症患者面临经济困难，特别是当癌症诊断发生在他们的工作年龄期间并且尚未满足获得养老金的要求时。进一步的研究似乎是必要的，以确定特别脆弱的患者群体。
