期刊
JOURNAL OF ONCOLOGY PRACTICE
卷 9, 期 5, 页码 251-+出版社
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JOP.2013.000929
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类别
资金
- American Society of Clinical Oncology Career Development Award
- National Cancer Institute (NCI) Grant [K07CA136995-01]
- American Recovery and Reinvestment Act Supplement
- NCI Cancer Center Support Grant [P30CA06927]
- Cancer Center Support Grant [P30 CA43703]
Purpose: Health care providers are accustomed to identifying populations for whom cost-related concerns may be a significant barrier, such as the poor, but few empiric data have been collected to substantiate such assumptions, particularly among insured patients. Methods: Patients with cancer from academic and community hospitals completed a questionnaire that included closedended items concerning demographic variables, optimism, numeracy, and concerns about present and future medical costs. In addition, they answered open-ended questions regarding cost concerns and medical expenses. Results: Nearly all (99%) participants were insured. In response to the closed-ended questions, 30.3% of patients reported concern about paying for their cancer treatment, 22.3% reported that their family had made sacrifices to pay for their care, and 8.3% stated that their insurance adequately covered their current health care costs, and 17.3% reported concerns about coverage for their costs in the future. On open-ended questions, 35.3% reported additional expenses, and 47.5% reported concerns about health care costs. None of the assessed patient characteristics proved to be a robust predictor across all cost-related concerns. There was a strong association between the identification of concerns or expenses on the open-ended questions and concerns on closed-ended questions. Conclusion: Cost concerns are common among patients with cancer who have health insurance. Health care providers may alleviate concerns by discussing cost-related concerns with all patients, not only those of lower socioeconomic status or those without insurance. A closed-ended screening question may help to initiate these conversations. This may identify potential resources, lower distress, and enable patients to make optimal treatment decisions.
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