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美国头颈癌患者自我报告的经济压力相关的患病率、趋势及人口统计学特征。

Prevalence, trends, and demographic characteristics associated with self-reported financial stress among head and neck cancer patients in the United States of America.

作者信息

Jella Tarun K, Cwalina Thomas B, Sachdev Rishi, Otteson Todd, Fowler Nicole

机构信息

Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.

Department of Economics, Duke University, Durham, NC, United States of America.

出版信息

Am J Otolaryngol. 2021 Nov-Dec;42(6):103154. doi: 10.1016/j.amjoto.2021.103154. Epub 2021 Jun 24.

Abstract

BACKGROUND

Understanding the economic burden imposed by head and neck cancer diagnoses essential to contextualize healthcare decision-making for these patients.

METHODS

A retrospective, cross-sectional analysis of the US National Health Interview Survey was performed between 2013 and 2018. Demographic and socioeconomic characteristics of adult head and neck cancer patients were analyzed in relation to survey responses related to financial stress factors.

RESULTS

Among 710 head and neck cancer patients, 21.39% (95% Cl, 17.69%-25.09%) reported difficulty paying medical bills within the previous 12 months. Multivariable logistic regression revealed insurance status [aOR 2.17 (95% CI, 1.15-4.07), p < 0.001] and poverty status [aOR 2.55 (95% CI, 1.48-4.37), p = 0.017] to be significantly associated with difficulty paying medical bills.

CONCLUSION

A large proportion of HNC patients may experience financial stress related not only to out-of-pocket health care costs, but also exogenous financial challenges. These findings suggest that a significant proportion of HNC patients may experience financial stress related not only to out-of-pocket health care costs, but also exogenous financial challenges. Such barriers may impede patients' ability to access and adhere to treatment or force detrimental tradeoffs between health care and other essential needs.

摘要

背景

了解头颈癌诊断所带来的经济负担对于为这些患者进行医疗决策提供背景信息至关重要。

方法

对2013年至2018年美国国家健康访谈调查进行回顾性横断面分析。分析成年头颈癌患者的人口统计学和社会经济特征,并将其与与财务压力因素相关的调查回复进行关联分析。

结果

在710名头颈癌患者中,21.39%(95%置信区间,17.69%-25.09%)报告在过去12个月内支付医疗费用有困难。多变量逻辑回归显示,保险状况[aOR 2.17(95%置信区间,1.15-4.07),p<0.001]和贫困状况[aOR 2.55(95%置信区间,1.48-4.37),p = 0.017]与支付医疗费用困难显著相关。

结论

很大一部分头颈癌患者可能不仅会因自付医疗费用,还会因外部财务挑战而面临财务压力。这些发现表明,很大一部分头颈癌患者可能不仅会因自付医疗费用,还会因外部财务挑战而面临财务压力。此类障碍可能会阻碍患者获得和坚持治疗的能力,或迫使他们在医疗保健和其他基本需求之间做出有害的权衡。

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