Robles Joanna M, Dressler Emily V, Kittel Carol, Nightingale Chandylen L, Kyono Wade T, Santacroce Sheila J, Salsman John M, Montez Kimberly, Prasad Pinki, Sugalski Aaron J, Ohlsen Timothy J D, Zheng Daniel J, Parsons Susan K, Beauchemin Melissa P
Section of Pediatric Hematology Oncology, Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC.
Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC.
JCO Oncol Pract. 2025 May;21(5):629-636. doi: 10.1200/OP-24-00786. Epub 2025 Feb 6.
Cancer-related financial hardship is associated with poor quality of life, risk of household material hardship, and psychological distress for families affected by pediatric cancer. Current processes on financial distress screening and financial navigation across the pediatric National Cancer Institute Community Oncology Research Program (NCORP) network remain unknown.
Financial distress screening and financial navigation services among NCORP practices were assessed using two survey items from the 2022 NCORP Landscape Assessment Survey. Practices answering yes to providing oncology care for pediatric patients were included. Univariable models were used to test associations between practice characteristics and financial screening and financial navigation.
Of the 53 NCORP practices serving pediatric patients with cancer that responded to the survey, 44 (83%) reported routinely conducting financial distress screening. Most of the practices reported that financial screening is completed by social workers (n = 40/44, 91%). One third of practices reported financial screening using a survey completed by patients/caregivers (n = 14/44, 32%). Almost all practices (n = 51/53, 96%) reported responding to financial needs through a social worker. One third of the practices reported having a cancer-specific financial navigator (n = 17/53, 32%) or a nondedicated (not cancer-specific) financial navigator (n = 19/53, 36%). Practices that served a proportion of new patients with cancer at or above the national average of Hispanic individuals in the United States were as likely to screen for financial distress as practices below the national average (odds ratio, 2.42 [95% CI, 0.45 to 13.03]; = .30).
Most pediatric NCORP practices report screening for financial distress. Fewer groups offer dedicated cancer-specific financial navigation, and practices vary. Further research is needed to explore the development and implementation of standardized financial distress measures and financial navigation interventions within pediatric cancer care.
癌症相关的经济困难与生活质量差、家庭物质困难风险以及受儿童癌症影响家庭的心理困扰有关。目前，儿科国家癌症研究所社区肿瘤学研究项目（NCORP）网络中经济困难筛查和经济援助流程仍不为人所知。
使用2022年NCORP概况评估调查中的两个调查项目，对NCORP机构的经济困难筛查和经济援助服务进行评估。纳入那些回答为儿科患者提供肿瘤护理的机构。使用单变量模型来检验机构特征与经济筛查和经济援助之间的关联。
在回应调查的为患有癌症的儿科患者提供服务的53个NCORP机构中，44个（83%）报告常规进行经济困难筛查。大多数机构报告经济筛查由社会工作者完成（n = 40/44，91%）。三分之一的机构报告使用患者/护理人员完成的调查问卷进行经济筛查（n = 14/44，32%）。几乎所有机构（n = 51/53，96%）报告通过社会工作者来回应经济需求。三分之一的机构报告有癌症专项经济援助人员（n = 17/53，32%）或非专门（非癌症专项）经济援助人员（n = 19/53，36%）。为美国西班牙裔个体比例达到或高于全国平均水平的一部分新癌症患者提供服务的机构，与低于全国平均水平的机构进行经济困难筛查的可能性相同（优势比，2.42 [95% CI，0.45至13.03]；P = 0.30）。
大多数儿科NCORP机构报告进行经济困难筛查。提供专门癌症专项经济援助的机构较少，且各机构情况不同。需要进一步研究以探索儿科癌症护理中标准化经济困难衡量标准和经济援助干预措施的制定与实施。
