Townsville University Hospital, Townsville, QLD 4814, Australia.
College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia.
Curr Oncol. 2023 May 10;30(5):4922-4935. doi: 10.3390/curroncol30050371.
To quantify financial toxicity and out-of-pocket costs for patients with HNC in Australia and explore their relationship with health-related quality of life (HRQoL).
A cross-sectional survey was administered to patients with HNC 1-3 years after radiotherapy at a regional hospital in Australia. The survey included questions on sociodemographics, out-of-pocket expenses, HRQoL, and the Financial Index of Toxicity (FIT) tool. The relationship between high financial toxicity scores (top quartile) and HRQoL was explored.
Of the 57 participants included in the study, 41 (72%) reported out-of-pocket expenses at a median of AUD 1796 (IQR AUD 2700) and a maximum of AUD 25,050. The median FIT score was 13.9 (IQR 19.5) and patients with high financial toxicity ( = 14) reported poorer HRQoL (76.5 vs. 114.5, < 0.001). Patients who were not married had higher FIT scores (23.1 vs. 11.1, = 0.01), as did those with lower education (19.3 vs. 11.1, = 0.06). Participants with private health insurance had lower financial toxicity scores (8.3 vs. 17.6, = 0.01). Medications (41%, median AUD 400), dietary supplements (41%, median AUD 600), travel (36%, median AUD 525), and dental (29%, AUD 388) were the most common out-of-pocket expenses. Participants living in rural locations (≥100 km from the hospital) had higher out-of-pocket expenses (AUD 2655 vs. AUD 730, = 0.01).
Financial toxicity is associated with poorer HRQoL for many patients with HNC following treatment. Further research is needed to investigate interventions aimed at reducing financial toxicity and how these can best be incorporated into routine clinical care.
量化澳大利亚头颈部癌症（HNC）患者的财务毒性和自付费用，并探讨其与健康相关生活质量（HRQoL）的关系。
对澳大利亚一家地区医院放疗后 1-3 年的 HNC 患者进行横断面调查。调查内容包括社会人口统计学、自付费用、HRQoL 和财务毒性指数（FIT）工具。探讨高财务毒性评分（四分位最高）与 HRQoL 之间的关系。
在纳入研究的 57 名参与者中，41 名（72%）报告自付费用中位数为 1796 澳元（IQR 澳元 2700），最高为 25050 澳元。FIT 评分中位数为 13.9（IQR 19.5），财务毒性高的患者（=14）报告 HRQoL 更差（76.5 比 114.5，<0.001）。未婚患者的 FIT 评分更高（23.1 比 11.1，=0.01），教育程度较低的患者也是如此（19.3 比 11.1，=0.06）。有私人医疗保险的参与者财务毒性评分较低（8.3 比 17.6，=0.01）。药物（41%，中位数澳元 400）、膳食补充剂（41%，中位数澳元 600）、旅行（36%，中位数澳元 525）和牙科（29%，澳元 388）是最常见的自付费用。居住在距医院 100 公里以上的农村地区的患者自付费用更高（澳元 2655 比澳元 730，=0.01）。
治疗后，许多 HNC 患者的财务毒性与较差的 HRQoL 相关。需要进一步研究旨在降低财务毒性的干预措施，以及如何将这些干预措施最好地纳入常规临床护理。
