Pauge Sophie, Surmann Bastian, Mehlis Katja, Zueger Andrea, Richter Luise, Menold Natalja, Greiner Wolfgang, Winkler Eva C
Department for Health Economics and Health Care Management, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany.
Section of Translational Medical Ethics, Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany.
Cancers (Basel). 2021 Oct 7;13(19):5015. doi: 10.3390/cancers13195015.
Financial toxicity is a side effect of cancer that results from the perceived financial distress an individual may experience in the course of the disease. The purpose of this paper is to analyse underlying factors related to subjective financial distress in high-income countries with universal healthcare coverage. A systematic literature review was conducted to identify qualitative and quantitative studies of cancer patient-reported subjective financial distress by performing a search in the databases of PubMed, PsycINFO and CINAHL up to December 2020. A qualitative synthesis was performed linking the time-dependent occurrence of risk factors to derived categories of risk factors. Out of 4321 identified records, 30 quantitative and 16 qualitative studies were eligible. Classification of risk factors resulted in eight categories with a total of 34 subcategories. Subjective financial distress is primarily determined by pre-diagnosis sociodemographic- factors as well as financial and work factors that might change during the course of the disease. The design of healthcare and social security systems shapes the country-specific degree of subjective financial distress. Further research should focus on evolving multidisciplinary intervention schemes and multidimensional instruments for subjective financial distress to account for identified risk factors in universal healthcare systems more precisely.
经济毒性是癌症的一种副作用，源于个体在疾病过程中可能经历的经济困境。本文旨在分析在具有全民医保覆盖的高收入国家中，与主观经济困境相关的潜在因素。通过在PubMed、PsycINFO和CINAHL数据库中进行检索，直至2020年12月，开展了一项系统的文献综述，以识别癌症患者报告的主观经济困境的定性和定量研究。进行了定性综合分析，将风险因素随时间的发生情况与推导得出的风险因素类别相联系。在4321条已识别记录中，有30项定量研究和16项定性研究符合条件。风险因素分类产生了8个类别，共34个子类别。主观经济困境主要由诊断前的社会人口学因素以及疾病过程中可能发生变化的财务和工作因素决定。医疗保健和社会保障系统的设计塑造了特定国家的主观经济困境程度。进一步的研究应侧重于制定不断发展的多学科干预方案和针对主观经济困境的多维工具，以便更精确地考虑全民医保系统中已识别的风险因素。
