Elliott Peter A, Hoffman Jacquelyn, Abad-Santos Matthew, Herndon Christopher, Katz Patricia P, Smith James F
Department of Urology, Kaiser Permanente, Los Angeles, California.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, San Francisco, California.
Urol Pract. 2016 Jul;3(4):256-261. doi: 10.1016/j.urpr.2015.07.010. Epub 2016 Apr 21.
We determined the out-of-pocket expenses, measures taken to finance these expenses and associated financial strain for men seeking fertility care.
In this retrospective cohort the patients completed questionnaires recording the total amount of money spent on infertility care and on what aspect of care the money was spent. Participants also recorded measures taken to finance these costs, the amount of financial strain experienced, and how this strain impacted decisions to seek and continue care. Multivariable logistic regression was performed to assess the relationships of fertility characteristics to financial costs and financial strain.
A total of 111 participants completed the full survey. During the course of care 16% of patients spent more than $50,000 dollars. 16% spent between $30,000 and $49,999, 32% spent between $15,000 and $29,999, and 37% spent less than $15,000. Procedures comprised the largest component of costs. Of the subjects 47% reported financial strain. On multivariate analysis patients who used savings and went into debt were significantly more likely to experience financial strain (p = 0.03 and <0.001, respectively).
This study elucidates the previously uncharacterized economic hardships of male infertility care. Overall 64% of men who pursued fertility treatment had out-of-pocket expenses exceeding $15,000 dollars. Almost half reported financial strain and limitation of treatment options due to these expenses. These data give men and their partners a realistic expectation of the cost of pursuing fertility treatment, the extreme measures that many patients take to finance care and the financial strain associated with such options.
我们确定了寻求生育治疗的男性的自付费用、为支付这些费用所采取的措施以及相关的经济压力。
在这项回顾性队列研究中，患者完成了问卷调查，记录了在不孕治疗上花费的总金额以及这些钱花在了治疗的哪些方面。参与者还记录了为支付这些费用所采取的措施、所经历的经济压力程度，以及这种压力如何影响寻求和继续治疗的决定。进行多变量逻辑回归以评估生育特征与经济成本和经济压力之间的关系。
共有111名参与者完成了全面调查。在治疗过程中，16%的患者花费超过50,000美元。16%的患者花费在30,000美元至49,999美元之间，32%的患者花费在15,000美元至29,999美元之间，37%的患者花费少于15,000美元。手术费用是成本的最大组成部分。47%的受试者报告有经济压力。在多变量分析中，使用储蓄和负债的患者经历经济压力的可能性显著更高（分别为p = 0.03和<0.001）。
本研究阐明了男性不孕治疗此前未被描述的经济困难。总体而言，寻求生育治疗的男性中有64%的自付费用超过15,000美元。近一半的人报告因这些费用而有经济压力并限制了治疗选择。这些数据让男性及其伴侣对寻求生育治疗的成本、许多患者为支付治疗费用所采取的极端措施以及与此类选择相关的经济压力有了现实的预期。
