Since the 1970s, remarkable advances have been made in the early diagnosis, treatment, and survival rates of patients with cancer. This has coincided with rapid changes in the healthcare industry. As cancer has been transformed into a chronic disease that generally is treated in the outpatient setting, the financial burden on patients with cancer and their families has grown. Insurance premiums, deductibles, copayments, transportation, lost income, and miscellaneous out-of-pocket expenses are just some of the hidden, nonreimbursable costs that significantly affect the financial stability of families over time. In addition, certain populations are at greater risk of financial burden, which may affect compliance with treatment as well as patient outcomes. This article presents an overview of these hidden costs, with implications and referral resources for oncology nurses. Healthcare providers have a responsibility to assess their patients for financial need and assist them in accessing resources.
Once a technique for controlling inappropriate care, second medical opinions have become a controversial practice under managed care.W a g n e r a n d L i s a S m it h W a g n e r
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