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Stump TK , Eghan N , Egleston BL , Hamilton O , Pirollo M , Schwartz JS , Armstrong K , Beck JR , Meropol NJ , Wong YN
Cost concerns of patients with cancer
J Oncol Pract. 2013 Sep;9(5) :251-7
PMID: 23943901   
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Abstract
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 closed-ended 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.
Notes
1935-469x Stump, Tammy K Eghan, Naa Egleston, Brian L Hamilton, Olivia Pirollo, Melanie Schwartz, J Sanford Armstrong, Katrina Beck, J Robert Meropol, Neal J Wong, Yu-Ning K07CA136995-01/CA/NCI NIH HHS/United States P30 CA006927/CA/NCI NIH HHS/United States P30 CA43703/CA/NCI NIH HHS/United States P30CA06927/CA/NCI NIH HHS/United States Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't United States J Oncol Pract. 2013 Sep;9(5):251-7. doi: 10.1200/JOP.2013.000929. Epub 2013 Jul 16.