Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA.
The University of Kansas Cancer Center, Kansas City, Kansas, USA.
Cancer Med. 2023 Feb;12(4):4638-4646. doi: 10.1002/cam4.5049. Epub 2022 Jul 19.
This research study aimed to evaluate the financial burden among older cancer patients and its corresponding risk factors. Factors such as increasing treatment costs and work limitations often lead cancer patients to bankruptcy and poor quality of life. These consequences, in turn, can cause higher mortality rates among these patients.
This retrospective cohort study utilized data from the Health Retirement Study (HRS), conducted by the University of Michigan (N = 18,109). Eligible participants had responses captured from years 2002 to 2016. Participants were classified according to any self-reported cancer diagnosis (yes or no) and were compared on the basis of financial, work, and health-related outcomes. Propensity score (PS) matching was applied to reduce the effects of potential confounding factors. Also only, individuals with an age ≥50 and ≤85 during Wave 6 were retained.
Multivariate analysis with random effects revealed several indicators of financial burden when comparing participants with a cancer diagnosis to those with no history of cancer. Mean out-of-pocket costs associated with a cancer diagnosis were $1058 higher when compared to participants with no history of cancer, suggesting that even cancer patients with insurance coverage faced out-of-pocket costs. Respondents with cancer patients had higher odds of encountering financial hardship if they are facing Work Limitations (OR = 2.714), Regular use of Medications (OR = 2.518), Hospital Stays (OR = 2.858), Declining Health (OR = 2.349), or were being covered under government health insurance (OR = 5.803) than respondents who did not have cancer, or suffered from mental health issues such as Depression (OR = 0.901).
Cancer patients contend with increasing financial costs during their treatment. However, most newly diagnosed patients are not aware of these costs and are given few resources to handle them.
本研究旨在评估老年癌症患者的经济负担及其相关风险因素。治疗费用的增加和工作限制等因素常常导致癌症患者破产和生活质量下降。这些后果反过来又会导致这些患者的死亡率上升。
本回顾性队列研究使用了密歇根大学（University of Michigan）进行的健康退休研究（Health Retirement Study，HRS）的数据（N=18109）。合格的参与者必须在 2002 年至 2016 年期间有过回复。参与者根据是否有自我报告的癌症诊断（是或否）进行分类，并根据经济、工作和健康相关结果进行比较。应用倾向评分（propensity score，PS）匹配来减少潜在混杂因素的影响。仅保留第 6 波年龄在 50 岁至 85 岁之间的个体。
在将有癌症诊断的参与者与没有癌症史的参与者进行比较时，多变量分析（with random effects）显示了几个经济负担的指标。与没有癌症史的参与者相比，癌症诊断相关的自付费用高出 1058 美元，这表明即使有保险的癌症患者也面临自付费用。如果面临工作限制（OR=2.714）、经常使用药物（OR=2.518）、住院（OR=2.858）、健康状况下降（OR=2.349）或参加政府健康保险（OR=5.803），癌症患者比没有癌症或患有心理健康问题（如抑郁症，OR=0.901）的患者更有可能遇到经济困难。
癌症患者在治疗过程中面临着不断增加的经济成本。然而，大多数新诊断的患者并不知道这些成本，也没有得到多少资源来应对这些成本。
