The financial impact of a terminal cancer on patient's families in Colombia - A survey study

Aim of the study: The socio-economic impact of caring for a cancer patient in the family is unknown in Colombia. This survey aimed to evaluate the existence of financial burden caused by cancer on the caregiving families of terminally ill patients. Methods: We used the Covinsky Family Impact Scale in a telephone survey with families of patients who died from cancer between May 2019 and June 2020 in three Colombian hospitals. Results: We obtained answers of 176 caregivers, of whom 74.4 % indicated to have experienced at least one hardship of the Covinsky items. The most commonly reported financial hardship involved the use of all or most of the family savings for the care provided to the patient (45.6 %); 27.6 % indicated that a major source of family income was lost. A quarter (25 %) postponed educational or other important plans of family members and 10-11 % indicated to have moved to another home or postponed medical treatments. Conclusion: In Colombia, a country with universal health coverage, substantial financial impacts of terminal cancer care exist not only for patients, but also for family members and other caregivers. The system is failing to avoid financial toxicity of cancer among this group. Policy summary statement: Informal caregivers are of vital importance for cancer patients but also to the healthcare system, particularly in LMICs. It is very important for policy makers to consider the hardships, not only emotionally but also financially, that the care for a (terminally ill) cancer patient implies on caregivers.