INTRODUCTION: Financial distress has been established as a clinically relevant patient-reported outcome associated with worse mortality and quality of life. Our goal was to define factors associated with financial burden (FB) in a public health care system. MATERIALS AND METHODS: Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FB was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0 to 44, with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP), and private insurance coverage were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FB (COST < 21). RESULTS: Of 251 patients approached, 200 (80%) participated. The median age of the cohort was 65 years; 56% were female. The median total OOP ranged between $1000 and $5000 CAD. The median COST score was 21 (range, 0-44). FB was associated with age, with patients < 65 years reporting greater FB than older patients (COST, 18.0 vs. 24.0; P < .0001). In multivariable logistic regression analysis, younger age was associated with greater FB, when adjusting for income, employment status, OOP, and private insurance coverage (odds ratio, 3.6; 95% confidence interval, 1.5-9.1; P < .0001). CONCLUSION: Age is significantly associated with FB in the Canadian (Ontario) public health care system, with younger patients with lung cancer reporting greater financial distress. This study highlights priority patient populations where FB should be routinely assessed and appropriate resources for support offered.
INTRODUCTION: Financial distress has been established as a clinically relevant patient-reported outcome associated with worse mortality and quality of life. Our goal was to define factors associated with financial burden (FB) in a public health care system. MATERIALS AND METHODS:Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FB was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0 to 44, with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP), and private insurance coverage were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FB (COST < 21). RESULTS: Of 251 patients approached, 200 (80%) participated. The median age of the cohort was 65 years; 56% were female. The median total OOP ranged between $1000 and $5000 CAD. The median COST score was 21 (range, 0-44). FB was associated with age, with patients < 65 years reporting greater FB than older patients (COST, 18.0 vs. 24.0; P < .0001). In multivariable logistic regression analysis, younger age was associated with greater FB, when adjusting for income, employment status, OOP, and private insurance coverage (odds ratio, 3.6; 95% confidence interval, 1.5-9.1; P < .0001). CONCLUSION: Age is significantly associated with FB in the Canadian (Ontario) public health care system, with younger patients with lung cancer reporting greater financial distress. This study highlights priority patient populations where FB should be routinely assessed and appropriate resources for support offered.
Authors: Elizabeth S Ver Hoeve; Leila Ali-Akbarian; Sarah N Price; Nurhyikmah M Lothfi; Heidi A Hamann Journal: Support Care Cancer Date: 2020-05-03 Impact factor: 3.359
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