Understanding the full breadth of cancer-related patient costs in Ontario: a qualitative exploration

Longo, Christopher J.; Fitch, Margaret I.; Grignon, Michel; McAndrew, Alison

doi:10.1007/s00520-016-3293-0

Cited by 21 publications

(47 citation statements)

References 17 publications

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“…The reasons for direct non-medical costs have been found to include costs generated from travel and parking, increased household bills, new clothing, healthier food, household-and childcare-related services, fitness classes, relocation, house modifications and family and friends (Amir, Wilson, Hennings, & Young, 2012;Céilleachair et al, 2012;Longo, Fitch, Grignon, & McAndrew, 2016;McGrath, 2016b;Moffatt, Noble, & Exley, 2010;Timmons, Gooberman-Hill, & Sharp, 2013b). Knowledge of the expected costs is crucial for cancer patients to reduce their financial distress (Peppercorn, 2014) because experiencing a higher than expected financial burden has been found to increase experiences of financial distress (Chino et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

‘It was a big monetary cut’—A qualitative study on financial toxicity analysing patients’ experiences with cancer costs in Germany

Lueckmann

Schumann

Hoffmann

et al. 2020

Health Soc Care Community

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Receiving information about expected costs promptly after a cancer diagnosis through psycho‐oncology care or social counselling is crucial for patients to be prepared for the financial impact. Nevertheless, less is known about financial impacts for cancer patients in countries with statutory health insurance. This study aims to explore the full scope of costs that constitute the financial impact of a cancer diagnosis in Germany and to identify the reasons for high financial decline. Semistructured interviews with 39 cancer patients were conducted between May 2017 and April 2018. Narratives were analysed via qualitative content analysis. Several factors influenced cancer patients’ indirect costs and direct medical and non‐medical costs. For many patients, these changes resulted in higher indirect costs caused by income losses, especially when surcharges for shift work, travel expenses or company benefits ceased and were not reimbursed. Higher direct medical costs were caused by co‐payments and additional non‐refundable costs. Non‐medical costs were reported to increase for some patients and to decrease for others, as for example, leisure activity costs either increasing because of pampering oneself to cope with the diagnosis and undergoing therapy or decreasing because of not being able to participate in leisure activities during therapy. When analysing the financial impacts of individuals' total costs, we found that some patients experienced no financial decline or an overall financial increase. Most patients experienced overall higher costs, and income loss was the main driver of a high financial decline. Nevertheless, decreased non‐medical costs due to lower work‐related and leisure activity costs could compensate for these higher costs. Cancer patients are confronted with a variety of changes in their financial situations, even in countries with statutory health insurance. Screening for cancer patients with a high risk of financial decline should consider any effects on indirect costs and direct medical and nonmedical costs.

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Section: Introductionmentioning

confidence: 99%

‘It was a big monetary cut’—A qualitative study on financial toxicity analysing patients’ experiences with cancer costs in Germany

Lueckmann

Schumann

Hoffmann

et al. 2020

Health Soc Care Community

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“…We reduced the number of papers to 98 by reading the titles and abstracts. Subsequently, an additional 84 studies were excluded after reading the full texts, and 14 studies remained …”

Section: Resultsmentioning

confidence: 99%

“…This synthesized finding was derived from 26 findings and was grouped into two categories: medical expenditures and nonmedical expenditures. Six studies noted a range of medical expenditures, including hospital bills, consultant fees, primary care physician fees, diagnostic costs, prescription charges, over‐the‐counter medications for symptom control and side effect treatment, expensive treatments (eg, hematological disorders, immunosuppressants), complementary therapies, home‐use medical devices, and personal items (eg, wigs, prosthetic bras, incontinence products) . Six studies noted nonmedical expenditures including but not limited to telephone bills, travel and transport, overnight accommodations, hospital parking, healthy foods, nutritional supplements, healthy physical exercise, eating out, double grocery bills, heating bills, childcare, homecare or housekeeping, home modifications or maintenance, and relocation (for special treatment) …”

Section: Resultsmentioning

confidence: 99%

“…Supplemental insurance can be helpful and take many forms, not just extended hospital care but coverage for critical illness or long‐term care as well. Purchasing insurance would have minimized the financial challenges they were currently experiencing …”

Section: Resultsmentioning

confidence: 99%

“…This synthesized finding was derived from seven findings and was grouped into two categories: information needs and practical needs. Cancer patients lack information about treatment costs, cancer's potential effect on their finances, insurance coverage, and supportive agencies or programs . Unmet practical needs included affordable insurance, social resources (social workers, navigators, support groups), and upfront money …”

Section: Resultsmentioning

confidence: 99%

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Cancer survivors' experiences with financial toxicity: A systematic review and meta‐synthesis of qualitative studies

Zhu

Xing

et al. 2020

Psycho-Oncology

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Objective The aim of this study was to synthesize qualitative research evidence on cancer survivors' experiences with financial toxicity (FT). Methods We carried out a systematic review of qualitative studies using a meta‐aggregation approach. Papers published prior to 31 August 2019, were collected from electronic databases, including PubMed/MEDLINE, MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), Web of Science, ProQuest Dissertations and Theses, and Cochrane Library (Wiley). Results Six synthesized findings were derived from 14 studies covering cancer patients' awareness of FT, cancer‐related expenditures, and the risk factors, impacts, coping strategies, and unmet needs related to FT. Conclusions Cancer survivors incur FT; however, their awareness of FT is limited. Cancer‐related FT has multiple impacts on survivors' lives. Although cancer survivors try to cope with FT through adjustments, they still have unmet needs for the management of FT. Nurses and social workers can play a critical role in helping survivors manage FT by increasing pre‐awareness of FT, strengthening emotional empowerment, and providing personalized informative support.

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Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada

et al. 2020

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IMPORTANCE Understanding the challenges faced by an increasing number of cancer survivors can guide the development and implementation of effective survivorship care models. OBJECTIVE To identify the physical, emotional, and practical concerns and associated unmet needs reported by cancer survivors. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional survey study obtained data from the Experiences of Cancer Patients in Transitions Study of the Canadian Partnership Against Cancer, in collaboration with cancer agencies in the 10 Canadian provinces, that was disseminated in 2016. This analysis included only adult survivors aged 30 years or older who underwent chemotherapy, radiation therapy, surgical treatment, or a combination of these therapies for breast, prostate, colorectal, melanoma, or hematological cancer within the past 1 to 3 years. Data synthesis and quality assessment were conducted in 2017. Data analysis was completed in July 2019. MAIN OUTCOMES AND MEASURES The outcomes were the (1) quantification of the magnitude and multiplicity of the physical, emotional, and practical concerns of adult survivors of breast, colorectal, prostate, melanoma, or hematological cancer; (2) exploration of the magnitude of associated unmet needs; and (3) identification of patient-, treatment-, and cancer-specific factors associated with the reporting of unmet needs. RESULTS Overall, 10 717 adult respondents were included (5660 [53%] female and 6367 [60%] aged Ն65 years). The median number of concerns per respondent was 6 (interquartile range [IQR], 3-10). Among respondents with concerns, help was sought for a median of 2 (IQR, 0-4) concerns. Unmet needs were reported for a median of 4 (IQR, 2-7) concerns. Emotional concerns were reported by 8330 respondents (78%), physical concerns by 9236 respondents (86%), and practical concerns by 4668 respondents (44%). At least 1 unmet need was reported by 7033 survivors (84%) with emotional concerns, 7475 (81%) with physical concerns, and 3459 (74%) with practical concerns. Age, sex, annual income, marital status, geographic location, language, and treatment type

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Understanding the full breadth of cancer-related patient costs in Ontario: a qualitative exploration

Cited by 21 publications

References 17 publications

‘It was a big monetary cut’—A qualitative study on financial toxicity analysing patients’ experiences with cancer costs in Germany

‘It was a big monetary cut’—A qualitative study on financial toxicity analysing patients’ experiences with cancer costs in Germany

Cancer survivors' experiences with financial toxicity: A systematic review and meta‐synthesis of qualitative studies

Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada

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