Cost Concerns of Patients With Cancer
- Tammy K. Stump, MS,
- Naa Eghan,
- Brian L. Egleston, PhD,
- Olivia Hamilton,
- Melanie Pirollo, MS, RN,
- J. Sanford Schwartz,
- Katrina Armstrong,
- J. Robert Beck, MD,
- Neal J. Meropol, MD and
- Yu-Ning Wong, MD, MSCE⇑
+ Author Affiliations
- University of Utah, Salt Lake City, UT; Premier Research Group Limited; Fox Chase Cancer Center; University of Pennsylvania, Philadelphia, PA; South Jersey Healthcare, Vineland, NJ; and University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
- Corresponding author: Yu-Ning Wong, MD, MSCE, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA 19111; e-mail: Yufirstname.lastname@example.org.
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.
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