Financial burden, distress, and toxicity in cardiovascular disease

Slavin, Samuel D.; Khera, Rohan; Zafar, S. Yousuf; Nasir, Khurram; Warraich, Haider J.

doi:10.1016/j.ahj.2021.04.011

Cited by 38 publications

(35 citation statements)

References 79 publications

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“…Cost-sharing has resulted in patients shouldering a greater proportion of the financial burden related to medical care [ 2 – 4 ]. Treatment-related financial hardship is best described within cancer care due to an aging patient population and advances in costly therapies; however, a similar phenomenon has been observed in other areas of medical care, including among individuals with chronic health conditions [ 5 – 9 ]. Significant to catastrophic financial burden is associated with increased patient mortality and treatment non-adherence, as well as a notable decrease in quality of life [ 10 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation of an educational intervention to improve medical student cost awareness: a prospective cohort study

et al. 2023

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Background In the context of rising healthcare costs, formal education on treatment-related financial hardship is lacking in many medical schools, leaving future physicians undereducated and unprepared to engage in high-value care. Method We performed a prospective cohort study to characterize medical student knowledge regarding treatment-related financial hardship from 2019 to 2020 and 2020–2021, with the latter cohort receiving a targeted educational intervention to increase cost awareness. Using Kirkpatrick’s four-level training evaluation model, survey data was analyzed to characterize the acceptability of the intervention and the impact of the intervention on student knowledge, attitudes, and self-reported preparedness to engage in cost-conscious care. Results Overall, N = 142 medical students completed the study survey; 61 (47.3%) in the non-intervention arm and 81 (66.4%) in the intervention arm. Of the 81 who completed the baseline survey in the intervention arm, 65 (80.2%) completed the immediate post-intervention survey and 39 (48.1%) completed the two-month post-intervention survey. Following the educational intervention, students reported a significantly increased understanding of common financial terms, access to cost-related resources, and level of comfort and preparedness in engaging in discussions around cost compared to their pre-intervention responses. The majority of participants (97.4%) reported that they would recommend the intervention to future students. A greater proportion of financially stressed students reported considering patient costs when making treatment decisions compared to their non-financially stressed peers. Conclusions Targeted educational interventions to increase cost awareness have the potential to improve both medical student knowledge and preparedness to engage in cost-conscious care. Student financial stress may impact high-value care practices. Robust curricula on high-value care, including treatment-related financial hardship, should be formalized and universal within medical school training.

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Section: Introductionmentioning

confidence: 99%

Implementation of an educational intervention to improve medical student cost awareness: a prospective cohort study

et al. 2023

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“…Despite the growing recognition of the increasing economic burden of chronic liver disease globally, we lack a comprehensive understanding of its financial impact on patients and their families. While there has been an increasing recognition of the financial impact of cancer [ 5 ] and cardiovascular disease [ 6 ] on patients and their families, we currently lack an understanding of the costs experienced by patients with chronic liver disease and their families across the following domains: Financial burden: patient and family income consumed by health care costs [ 7–9 ] Financial distress: material, behavioral, and psychological consequences of financial burden [ 7–11 ] Financial toxicity: adverse health outcomes of financial distress [ 5,8,12 ] To address this gap, we performed a scoping review of the financial impact of chronic liver disease on patients and families to broadly explore key concepts and available evidence on this topic. [ 13 ] Our specific scoping review objectives were to (1) identify the types of financial burden and distress experienced by patients with chronic liver disease and their family caregivers; (2) identify risk factors for financial burden and distress; and (3) describe financial toxicity outcomes in this population.…”

Section: Introductionmentioning

confidence: 99%

Financial burden in adults with chronic liver disease: A scoping review

et al. 2022

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The economic burden of chronic liver disease is rising; however, the financial impact of chronic liver disease on patients and families has been underexplored. We performed a scoping review to identify studies examining financial burden (patient/family health care expenditures), financial distress (material, behavioral, and psychological consequences of financial burden), and financial toxicity (adverse health outcomes of financial distress) experienced by patients with chronic liver disease and their families. We searched MEDLINE, Embase, Cochrane Library, and the Web of Science online databases for articles published since the introduction of the Model for End‐Stage Liver Disease score for liver transplantation allocation in February 2002 until July 2021. Final searches were conducted between June and July 2021. Studies were included if they examined the prevalence or impact of financial burden or distress among patients with chronic liver disease and/or their caregivers. A total of 19 observational studies met inclusion criteria involving 24,549 patients and 276 caregivers across 5 countries. High rates of financial burden and distress were reported within the study populations, particularly among patients with hepatic encephalopathy, hepatocellular carcinoma, and liver transplantation recipients. Financial burden and distress were associated with increased pre‐ and posttransplantation health care utilization and poor health‐related quality of life as well as caregiver burden, depression, and anxiety. None of the included studies evaluated interventions to alleviate financial burden and distress. Observational evidence supports the finding that financial burden and distress are underrecognized but highly prevalent among patients with chronic liver disease and their caregivers and are associated with poor health outcomes. There is a critical need for interventions to mitigate financial burden and distress and reduce financial toxicity in chronic liver disease care.

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“…HCWs who sustained the injury might develop stress, and this will affect the quality of their work, which might increase the chance of another sharp injury occurrence. If the HCWs contracted a blood-borne infection as a result of a sharp injury, they will need to begin treatment, and this will add to the country’s financial burden [ 10 , 11 ]. HCWs who become infected are more likely to take medical leave, hence reducing human resources.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated with Defaulted Follow-Up and Sharp Injury Management among Health Care Workers in a Teaching Hospital in Northeastern Malaysia

Kutubudin

Mohammad

Noor

et al. 2022

IJERPH

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Sharp injury is a serious occupational risk for healthcare workers (HCWs). This study aimed to determine the distribution and associated factors of sharp injury cases among HCWs working at a teaching hospital in northeastern Malaysia. This was a retrospective cohort study on all reported sharp injury cases from 2015 to 2020. The secondary data were examined using descriptive and multiple logistic regression. Statistical significance was determined for associated factors of HCWs who did not attend immediate treatment after a sharp injury or any of the subsequent follow-up variables, with a p-value of less than 0.05. A total of 286 cases fulfilled the study criteria. The mean (SD) age of sharp injury was 29.4 (5.38) years. The overall defaulted rate for follow-up was 51.4%. Multiple logistic regression revealed a significant relationship between defaulted follow up on sharp injury management and job category as well as the type of device used. Being a doctor (Adj OR 2.37; 95% CI: 1.40, 4.03; p = 0.010) and those using other sharp instruments such as Coupland and drip sets (Adj OR 4.55; 95% CI: 1.59, 13.02; p = 0.005) had a higher odds to default follow up on sharp injury management. In conclusion, although there is a link between defaulting the follow-up and both the work category and the type of device that caused the injury, a deeper analysis is needed to uncover any additional factors and determine the appropriate intervention strategies to ensure follow up adherence.

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Financial burden, distress, and toxicity in cardiovascular disease

Cited by 38 publications

References 79 publications

Implementation of an educational intervention to improve medical student cost awareness: a prospective cohort study

Implementation of an educational intervention to improve medical student cost awareness: a prospective cohort study

Financial burden in adults with chronic liver disease: A scoping review

Risk Factors Associated with Defaulted Follow-Up and Sharp Injury Management among Health Care Workers in a Teaching Hospital in Northeastern Malaysia

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