Matthias Büttner1,2, Hans-Helmut König3, Margrit Löbner4, Susanne Briest5, Alexander Konnopka3, Andreas Dietz6, Steffi Riedel-Heller4, Susanne Singer7,8. 1. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Division of Epidemiology and Health Services Research, University Medical Center Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany. matbuett@uni-mainz.de. 2. University Cancer Centre, University Medical Center Mainz, Mainz, Germany. matbuett@uni-mainz.de. 3. Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Institute of Social Medicine, Occupational Health and Public Health (ISAP), University Medical Center Leipzig, Leipzig, Germany. 5. Leipzig Breast Cancer Center, University Medical Center Leipzig, Leipzig, Germany. 6. Clinic for Otolaryngology, Head and Neck Surgery, University Medical Center Leipzig, Leipzig, Germany. 7. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Division of Epidemiology and Health Services Research, University Medical Center Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany. 8. University Cancer Centre, University Medical Center Mainz, Mainz, Germany.
Abstract
PURPOSE: Cancer patients in Germany often face payments related to their disease or treatment which are not covered by their health insurance. The aim of this study was to analyze the amount of out-of-pocket payments (OOPPs) among cancer patients in Germany, to explore potential socioeconomic determinants of OOPPs, and to identify how cancer patients are burdened by these payments. METHODS: Cancer ptients were consecutively enrolled in 16 clinics in Leipzig, Germany. Data on OOPPs for the past 3 months and on socioeconomic status were obtained at the end of their hospital stay (t0) and 3 (t1) and 15 months (t2) after t0. Financial burden was calculated by dividing the monthly OOPPs by the midpoint of the income category, and the perceived burden was assessed by using the financial difficulties scale of the EORTC QLQ-C30. A two-part regression model was used to estimate the determinants of OOPPs. RESULTS: At baseline (t0), 502 cancer patients participated in the study and provided data on OOPPs and socioeconomic status. The mean 3-month OOPPs were the following: €205.8 at baseline, €179.2 at t1, and €148.1 at t2. Compared to the lowest income group (< €500 monthly), all other income groups (€500-999, €1000-1499, and ≥ €1500) had higher 3-month OOPPs of €52.3 (p = 0.241), €90.2 (p = 0.059), or €62.2 (p = 0.176). Financial burden at t0 was 6.4% (SD 9.2%) on average, 5.4% (SD 9.9%) at t1, and to 3.9% (SD 7.0%) of monthly income at t2. CONCLUSION: German cancer patients face relatively high OOPPs during their cancer journey. These payments may burden cancer patients, especially certain subgroups like low-income groups.
PURPOSE:Cancerpatients in Germany often face payments related to their disease or treatment which are not covered by their health insurance. The aim of this study was to analyze the amount of out-of-pocket payments (OOPPs) among cancerpatients in Germany, to explore potential socioeconomic determinants of OOPPs, and to identify how cancerpatients are burdened by these payments. METHODS:Cancer ptients were consecutively enrolled in 16 clinics in Leipzig, Germany. Data on OOPPs for the past 3 months and on socioeconomic status were obtained at the end of their hospital stay (t0) and 3 (t1) and 15 months (t2) after t0. Financial burden was calculated by dividing the monthly OOPPs by the midpoint of the income category, and the perceived burden was assessed by using the financial difficulties scale of the EORTC QLQ-C30. A two-part regression model was used to estimate the determinants of OOPPs. RESULTS: At baseline (t0), 502 cancerpatients participated in the study and provided data on OOPPs and socioeconomic status. The mean 3-month OOPPs were the following: €205.8 at baseline, €179.2 at t1, and €148.1 at t2. Compared to the lowest income group (< €500 monthly), all other income groups (€500-999, €1000-1499, and ≥ €1500) had higher 3-month OOPPs of €52.3 (p = 0.241), €90.2 (p = 0.059), or €62.2 (p = 0.176). Financial burden at t0 was 6.4% (SD 9.2%) on average, 5.4% (SD 9.9%) at t1, and to 3.9% (SD 7.0%) of monthly income at t2. CONCLUSION: German cancerpatients face relatively high OOPPs during their cancer journey. These payments may burden cancerpatients, especially certain subgroups like low-income groups.
Authors: Paolo Giorgi Rossi; Monica Beccaro; Guido Miccinesi; Piero Borgia; Massimo Costantini; Francesco Chini; Diego Baiocchi; Giovanna De Giacomi; Maria Grimaldi; Maurizio Montella Journal: J Epidemiol Community Health Date: 2007-06 Impact factor: 3.710
Authors: Andreas Mielck; Raphael Kiess; Olaf von dem Knesebeck; Irina Stirbu; Anton E Kunst Journal: BMC Health Serv Res Date: 2009-03-23 Impact factor: 2.655
Authors: Alexander Fabian; Justus Domschikowski; Wolfgang Greiner; Gunnar Bockelmann; Elias Karsten; Alexander Rühle; Nils H Nicolay; Anca L Grosu; Jürgen Dunst; David Krug Journal: Strahlenther Onkol Date: 2022-04-25 Impact factor: 3.621
Authors: N Riccetti; R Felberbaum; F Flock; T Kühn; E Leinert; L Schwentner; S Singer; K Taylor; A Wöckel; W Janni Journal: Support Care Cancer Date: 2022-05-04 Impact factor: 3.359
Authors: Christopher J Longo; Margaret I Fitch; Laura Banfield; Paul Hanly; K Robin Yabroff; Linda Sharp Journal: Support Care Cancer Date: 2020-07-11 Impact factor: 3.603
Authors: Silvia Riva; Jane Bryce; Francesco De Lorenzo; Laura Del Campo; Massimo Di Maio; Fabio Efficace; Luciano Frontini; Diana Giannarelli; Lara Gitto; Elisabetta Iannelli; Claudio Jommi; Vincenzo Montesarchio; Francesca Traclò; Concetta Maria Vaccaro; Ciro Gallo; Francesco Perrone Journal: BMJ Open Date: 2019-09-09 Impact factor: 2.692