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美国癌症幸存者的医疗经济困难和粮食安全问题。

Medical Financial Hardship and Food Security among Cancer Survivors in the United States.

机构信息

College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas.

Brown School, Washington University, St. Louis, Missouri.

出版信息

Cancer Epidemiol Biomarkers Prev. 2023 Aug 1;32(8):1038-1047. doi: 10.1158/1055-9965.EPI-22-1044.

Abstract

BACKGROUND

Some cancer survivors experience medical financial hardship, which may reduce their food security. The purpose of this study was to explore whether medical financial hardship is related to food security among cancer survivors.

METHODS

The study was based on cross-sectional data from the 2020 National Health Interview Survey. We used ordinal logistic regression to examine the relationship between material, psychological, and behavioral medical financial hardships and household food security (i.e., high, marginal, low, or very low) among individuals ages ≥18 years who reported a cancer diagnosis from a health professional (N = 4,130).

RESULTS

The majority of the sample reported high household food security (88.5%), with 4.8% reporting marginal, 3.6% reporting low, and 3.1% reporting very low household food security. In the adjusted model, the odds of being in a lower food security category were higher for cancer survivors who had problems paying or were unable to pay their medical bills compared with those who did not [OR, 1.73; 95% confidence interval (CI), 1.06-2.82, P = 0.027], who were very worried about paying their medical bills compared with those who were not at all worried (OR, 2.88; 95% CI, 1.64-5.07; P < 0.001), and who delayed medical care due to cost compared with those who did not (OR, 2.56; 95% CI, 1.29-5.09; P = 0.007).

CONCLUSIONS

Food insecurity is rare among cancer survivors. However, medical financial hardship is associated with an increased risk of lower household food security among cancer survivors.

IMPACT

A minority of cancer survivors experience medical financial hardship and food insecurity; social needs screenings should be conducted.

摘要

背景

一些癌症幸存者面临医疗财务困难,这可能会降低他们的粮食安全保障。本研究旨在探讨癌症幸存者的医疗财务困难是否与粮食安全有关。

方法

本研究基于 2020 年全国健康访谈调查的横断面数据。我们使用有序逻辑回归来检验物质、心理和行为医疗财务困难与报告有癌症诊断的 18 岁及以上个体的家庭粮食安全(即高、边缘、低或极低)之间的关系(N=4130)。

结果

大多数样本报告家庭粮食安全状况较高(88.5%),有 4.8%报告边缘,3.6%报告低,3.1%报告极低。在调整后的模型中,与没有支付或无法支付医疗费用的癌症幸存者相比,有这些问题的癌症幸存者处于较低粮食安全类别的可能性更高[比值比(OR),1.73;95%置信区间(CI),1.06-2.82,P=0.027],与没有任何担心的癌症幸存者相比,非常担心支付医疗费用的癌症幸存者可能性更高[OR,2.88;95%CI,1.64-5.07;P<0.001],与没有因为费用而延迟医疗护理的癌症幸存者相比,因为费用而延迟医疗护理的癌症幸存者可能性更高[OR,2.56;95%CI,1.29-5.09;P=0.007]。

结论

癌症幸存者中粮食不安全的情况很少见。然而,医疗财务困难与癌症幸存者家庭粮食安全状况较低的风险增加有关。

意义

少数癌症幸存者面临医疗财务困难和粮食不安全问题;应进行社会需求筛查。

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