Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors

被引：282

作者：

Kale, Hrishikesh P. ^{[1
]}

Carroll, Norman V. ^{[1
]}

机构：

[1] Virginia Commonwealth Univ, Sch Pharm, Div Pharmacoecon & Hlth Outcomes, McGuire Hall,Rm 211,1112 East Clay St,Box 980533, Richmond, VA 23298 USA

来源：

CANCER | 2016年 / 122卷 / 08期

关键词：

bankruptcy; cancer; depression; financial burden; health-related quality of life (HRQOL); mental health; out-of-pocket costs; psychological; quality of life; stress;

D O I：

10.1002/cncr.29808

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BACKGROUNDCancer-related financial burden has been linked to cancer survivors (CS) forgoing/delaying medical care, skipping follow-up visits, and discontinuing medications. To the authors' knowledge, little is known regarding the effect of financial burden on the health-related quality of life of CS. METHODSThe authors analyzed 2011 Medical Expenditure Panel Survey data. Financial burden was present if one of the following problems was reported: borrowed money/declared bankruptcy, worried about paying large medical bills, unable to cover the cost of medical care visits, or other financial sacrifices. The following outcomes were evaluated: Physical Component Score (PCS) and Mental Component Score (MCS) of the 12-Item Short-Form Health Survey (SF-12), depressed mood, psychological distress, and worry related to cancer recurrence. The authors also assessed the effect of the number of financial problems on these outcomes. RESULTSOf the 19.6 million CS analyzed, 28.7% reported financial burden. Among them, the average PCS (42.3 vs 44.9) and MCS (48.1 vs 52.1) were lower for those with financial burden versus those without. In adjusted analyses, CS with financial burden had significantly lower PCS (=-2.45), and MCS (=-3.05), had increased odds of depressed mood (odds ratio, 1.95), and were more likely to worry about cancer recurrence (odds ratio, 3.54). Survivors reporting3 financial problems reported statistically significant and clinically meaningful differences (3 points) in the mean PCS and MCS compared with survivors without financial problems. CONCLUSIONSCancer-related financial burden was associated with lower health-related quality of life, increased risk of depressed mood, and a higher frequency of worrying about cancer recurrence among CS. Cancer 2016;122:1283-9. (c) 2015 American Cancer Society. Approximately 29% of cancer survivors in the United States report at least 1 cancer-related financial problem. Survivors with cancer-related financial problems, especially those with a greater number of problems, have lower physical and mental health-related quality of life, an increased risk of depressed mood, and more frequently worry about cancer recurrence.

引用

页码：283 / 289

页数：7

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