دورية أكاديمية
Cancer's Lasting Financial Burden: Evidence From a Longitudinal Assessment.
| العنوان: | Cancer's Lasting Financial Burden: Evidence From a Longitudinal Assessment. |
|---|---|
| المؤلفون: | Shih YT; Section of Cancer Economics and Policy, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Owsley KM; Department of Health Systems, Management, and Policy, University of Colorado Comprehensive Cancer Center and Colorado School of Public Health, Aurora, CO, USA., Nicholas LH; Department of Health Systems, Management, and Policy, University of Colorado Comprehensive Cancer Center and Colorado School of Public Health, Aurora, CO, USA., Yabroff KR; Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, GA, USA., Bradley CJ; Department of Health Systems, Management, and Policy, University of Colorado Comprehensive Cancer Center and Colorado School of Public Health, Aurora, CO, USA. |
| المصدر: | Journal of the National Cancer Institute [J Natl Cancer Inst] 2022 Jul 11; Vol. 114 (7), pp. 1020-1028. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 7503089 Publication Model: Print Cited Medium: Internet ISSN: 1460-2105 (Electronic) Linking ISSN: 00278874 NLM ISO Abbreviation: J Natl Cancer Inst Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2003-> : Cary, NC : Oxford University Press Original Publication: Bethesda, Md., U. S. Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health; Washington, for sale by the Supt. of Docs., U. S. Govt. Print. Off. |
| مواضيع طبية MeSH: | Financial Stress* , Neoplasms*/epidemiology , Neoplasms*/therapy, Health Expenditures ; Humans ; Insurance Coverage ; Poverty |
| مستخلص: | Background: The purpose of this study was to conduct a longitudinal analysis of out-of-pocket expenditure (OOPE) trajectories for the assessment of cancer's lasting financial impact. Methods: We identified newly diagnosed cancer patients and constructed matched control group of noncancer participants from the 2002-2018 Health and Retirement Study. Outcomes included monthly OOPE for prescription drugs (RX-OOPE_MONTHLY) and OOPE for medical services other than drugs in the past 2 years (non-RX-OOPE_2YR), consumer debt, and new individual retirement account (IRA) withdrawals. Generalized linear models were used to compare OOPEs between cancer and matched control groups. Logistic regressions were used to compare household-level consumer debt or early IRA withdrawal. Subgroup analysis stratified patients by age, health status, and household income, with the low-income group stratified by Medicaid coverage. All statistical tests were 2-sided. Results: The study cohort included 2022 cancer patients and 10 110 participants in the matched noncancer control group. Mean non-RX-OOPE_2YR of cancer patients was similar to that of participants in the matched control group before diagnosis but statistically significantly higher at diagnosis ($1157, P < .001), 2 ($511, P < .001) years, 4 ($360, P = .006) years, and 6 ($430, P = .01) years after diagnosis. A similar pattern was observed in RX-OOPE_MONTHLY. A statistically significantly higher proportion of cancer patients incurred consumer debt at diagnosis (34.5% vs 29.9%; P < .001) and 2 years after (32.5% vs 28.2%; P = .002). There was no statistically significant difference in new IRA withdrawals. Patients experienced lasting financial consequences following cancer diagnosis that were most pronounced among patients aged 65 years and older, in good-to-excellent health at baseline, and with low income, but without Medicaid coverage. Conclusions: Policies to reduce costs and expand insurance coverage options while reducing cost-sharing are needed. (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| References: | JAMA Netw Open. 2020 Nov 2;3(11):e2024366. (PMID: 33151317) JAMA Oncol. 2017 Jun 01;3(6):757-765. (PMID: 27893028) Res Social Adm Pharm. 2021 Jul;17(7):1300-1305. (PMID: 33054991) JCO Oncol Pract. 2021 Aug;17(8):e1094-e1109. (PMID: 33555936) MMWR Morb Mortal Wkly Rep. 2019 Jun 07;68(22):494-499. (PMID: 31170127) Lancet Oncol. 2011 Sep;12(10):933-80. (PMID: 21958503) Am J Prev Med. 2021 Jan;60(1):104-109. (PMID: 33191064) J Natl Cancer Inst. 2020 Jul 1;112(7):688-697. (PMID: 31688923) J Natl Cancer Inst. 2020 Aug 1;112(8):779-791. (PMID: 32277814) J Palliat Med. 2014 May;17(5):506-11. (PMID: 24694096) J Natl Cancer Inst. 2022 Mar 8;114(3):372-380. (PMID: 34981117) J Natl Cancer Inst. 2021 Jul 14;:. (PMID: 34259321) J Oncol Pract. 2018 Sep;14(9):e533-e546. (PMID: 30138052) J Natl Compr Canc Netw. 2019 Oct 1;17(10):1184-1192. (PMID: 31590147) Value Health. 2004 Mar-Apr;7(2):186-94. (PMID: 15164808) JAMA. 2021 Jul 20;326(3):250-256. (PMID: 34283184) |
| معلومات مُعتمدة: | P30 CA016672 United States CA NCI NIH HHS; P30 CA046934 United States CA NCI NIH HHS; R01 CA225646 United States CA NCI NIH HHS; R01 CA225647 United States CA NCI NIH HHS |
| تواريخ الأحداث: | Date Created: 20220324 Date Completed: 20220714 Latest Revision: 20240214 |
| رمز التحديث: | 20240214 |
| مُعرف محوري في PubMed: | PMC9275752 |
| DOI: | 10.1093/jnci/djac064 |
| PMID: | 35325197 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1460-2105 |
|---|---|
| DOI: | 10.1093/jnci/djac064 |