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血液系统恶性肿瘤患者是否承受经济负担?一项针对通过公共资助医疗系统寻求治疗的患者的横断面研究。

Do patients with haematological malignancies suffer financial burden? A cross-sectional study of patients seeking care through a publicly funded healthcare system.

作者信息

Parker Catriona, Ayton Darshini, Zomer Ella, Liew Danny, Vassili Catherine, Fong Chun Yew, Wei Andrew

机构信息

Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia; The Alfred Hospital, Department of Haematology, Melbourne, Australia.

Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia; Monash Partners Academic Health Centre, Clayton, Australia.

出版信息

Leuk Res. 2022 Jan;112:106748. doi: 10.1016/j.leukres.2021.106748. Epub 2021 Nov 10.

Abstract

BACKGROUND

It is increasingly appreciated that some patients with cancer will experience financial burden due to their disease but little is known specifically about patients with haematological malignancies. Therefore, this study aimed to measure financial toxicity experienced by patients with haematological malignancies in the context of a publicly funded health care system.

METHOD

All current patients diagnosed with leukaemia, lymphoma or multiple myeloma, from two major metropolitan health services in Melbourne, Australia were invited to complete a survey capturing; patient demographics, employment status, income sources, financial coping and insurances, OOP expenses and self-reported financial toxicity using a validated measure.

RESULTS

Of the 240 people approached, 113 (47 %) participated and most had leukaemia (62 %). Forty-seven (42 %) participants experienced some degree of financial toxicity using the Comprehensive Score for financial toxicity (COST) instrument. On multivariate linear regression, older age (>65 years, p = 0.007), higher monthly income (>$8000, p = 0.008), not having and being forced into unemployment or early retirement (p < 0.001) remained significantly associated with less financial toxicity.

CONCLUSION

Financial toxicity is present in Australian haematology patients and those at higher risk may be patients of working age, those without private health insurance and patients that have been forced to retire early or have become unemployed due to their diagnosis.

摘要

背景

越来越多的人认识到,一些癌症患者会因疾病而承受经济负担,但对于血液系统恶性肿瘤患者的具体情况却知之甚少。因此,本研究旨在衡量在公共资助的医疗保健系统背景下血液系统恶性肿瘤患者所经历的经济毒性。

方法

邀请了澳大利亚墨尔本两大都市医疗服务机构中所有目前被诊断为白血病、淋巴瘤或多发性骨髓瘤的患者完成一项调查,该调查涵盖患者人口统计学特征、就业状况、收入来源、财务应对方式和保险情况、自付费用以及使用经过验证的量表进行自我报告的经济毒性。

结果

在240名被邀请者中,113人(47%)参与了调查,其中大多数患有白血病(62%)。使用经济毒性综合评分(COST)工具,47名(42%)参与者经历了某种程度的经济毒性。在多变量线性回归分析中,年龄较大(>65岁,p = 0.007)、月收入较高(>8000美元,p = 0.008)、没有且被迫失业或提前退休(p < 0.001)仍然与较低的经济毒性显著相关。

结论

澳大利亚血液学患者存在经济毒性,高危人群可能是工作年龄的患者、没有私人医疗保险的患者以及因诊断而被迫提前退休或失业的患者。

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