Coughlin Steven S, Dean Lorraine T, Cortes Jorge E
Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.
Curr Cancer Rep. 2021;3(1):119-123. doi: 10.25082/ccr.2021.01.007. Epub 2021 Sep 17.
The high costs of oncology care can lead to financial stress and have deleterious effects on the well-being of patients and their families. However, only a handful of financial assistance programs for cancer patients have been implemented and evaluated to date.
Key features of reported programs include instrumental support through financial navigation or education for patients, and financial or charitable support for healthcare costs. Only one of the programs successfully reduced actual out-of-pocket costs for patients, though others were associated with psychosocial benefits or increased knowledge of financial resources. Four of the 5 programs evaluated to date were pilot studies with small sample sizes, and most lack control groups for comparison.
Additional studies are needed that include larger sample sizes and with comparison groups of cancer patients in order to determine whether the counseling and navigator programs are effective in addressing financial distress in this patient population. Of particular interest are programs designed for low-income patients and those who lack health care insurance. Financial assistance programs that implement solutions at different levels of the healthcare system (individual patients, providers, healthcare institutions) are more likely to be effective. Multi-level interventions are needed that address the systems in which patients access care, the actual costs of services and drugs, and the individual needs of patients in order to reduce financial hardship for cancer patients.
肿瘤护理的高昂费用可能导致经济压力，并对患者及其家庭的福祉产生有害影响。然而，迄今为止，仅实施并评估了少数针对癌症患者的经济援助项目。
已报道项目的关键特征包括通过为患者提供财务指导或教育给予工具性支持，以及为医疗费用提供财务或慈善支持。尽管其他项目与心理社会益处或对财务资源的了解增加有关，但只有一个项目成功降低了患者的实际自付费用。迄今为止评估的5个项目中有4个是小样本量的试点研究，且大多数缺乏对照组进行比较。
需要开展更多研究，纳入更大样本量，并设置癌症患者对照组，以确定咨询和指导项目是否能有效解决该患者群体的经济困境。特别值得关注的是为低收入患者和缺乏医疗保险的患者设计的项目。在医疗系统不同层面（个体患者、医疗服务提供者、医疗机构）实施解决方案的经济援助项目更有可能取得成效。需要采取多层次干预措施，解决患者获得护理的系统、服务和药物的实际成本以及患者的个体需求，以减轻癌症患者的经济困难。
