Parsons Helen M, Gupta Arjun, Jewett Patricia, Vogel Rachel I
Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States.
Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.
J Natl Cancer Inst. 2025 Apr 1;117(4):595-600. doi: 10.1093/jnci/djae252.
Cancer and its care create substantial financial, time, and administrative burdens both for patients and their loved ones. Although cancer-related financial burdens have been well documented in the past decade, time and administrative burdens of cancer care have received substantially less attention. We define time burdens as the burden patients and caregivers experience due to the time needed to complete cancer-related treatment and tasks that take away from other life responsibilities. Relatedly, we conceptualize administrative burdens as those burdens patients and caregivers experience due to cancer-related, resource-consuming bureaucratic and logistical tasks. Finally, financial hardship can be conceptualized as problems patients experience related to the cost of medical care. These burdens do not exist in isolation; time, administrative, and financial burdens intersect with and compound each other. Currently, we have limited evidence-based measures on the objective (eg, scheduling time, transportation, wait time) and subjective (eg, mental, emotional and physical stress) measures of time and administrative burden. We have even more limited evidence of the risk factors for and outcomes from increased time and administrative burdens, and how they differentially impact populations across social and demographic groups. In this commentary, we present a research agenda to map, measure, evaluate, and mitigate the time, administrative, and financial burdens of cancer and its care.
癌症及其治疗给患者及其亲人带来了巨大的经济、时间和行政负担。尽管在过去十年中,与癌症相关的经济负担已有详尽记录,但癌症治疗的时间和行政负担却很少受到关注。我们将时间负担定义为患者和护理人员因完成与癌症相关的治疗以及那些占用其他生活责任时间的任务而经历的负担。与此相关,我们将行政负担概念化为患者和护理人员因与癌症相关的、耗费资源的官僚和后勤任务而经历的负担。最后,经济困难可被概念化为患者因医疗费用而经历的问题。这些负担并非孤立存在;时间、行政和经济负担相互交织并相互加剧。目前,我们在时间和行政负担的客观(如安排时间、交通、等待时间)和主观(如心理、情感和身体压力)衡量方面,基于证据的措施有限。我们对于时间和行政负担增加的风险因素及其后果,以及它们如何对不同社会和人口群体产生不同影响的证据更是有限。在这篇评论中,我们提出了一个研究议程,以规划、衡量、评估和减轻癌症及其治疗的时间、行政和经济负担。