Financial Toxicity and Out-of-Pocket Costs for Patients with Head and Neck Cancer

Smith, Justin; Yu, Justin; Gordon, Louisa G.; Chilkuri, Madhavi

doi:10.3390/curroncol30050371

Cited by 5 publications

(3 citation statements)

References 25 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…lost income) and the direct costs of treatment, especially the out-of-pocket expenses for care undertaken in the private health system. 7,8 The funding arrangements for Australia's hybrid public-private system are incredibly complex and patient (and referrers) unfamiliarity with this system can mean high, and often unexpected, out-of-pocket costs. 9 Pricing transparency over the full cycle of care is needed for patients to make informed decisions that take account of their financial circumstances, but is often lacking.…”

Section: Introductionmentioning

confidence: 99%

Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program

Zissiadis,

Ballal,

Forsyth

et al. 2024

Aust. Health Rev.

View full text Add to dashboard Cite

We present a case study on the design and implementation of a value-based bundled package of care for patients with early-stage breast cancer treated in the private health sector in Australia. Value-based healthcare is an essential change to how we deliver healthcare, shifting the focus from paying for individual services provided to a focus on the health outcomes gained over a full cycle of care. The Australian health system has unintentionally created barriers to value-based cancer care through fragmented care pathways and complex funding arrangements where patients can unexpectedly encounter high out-of-pocket costs. A team of clinicians, service providers, health systems and funding experts, private health insurers and consumers have collaborated to design and pilot a complete bundled package of care for breast cancer patients which aims to address these challenges. With 40 patients recruited to date, early evaluation results show positive patient experience of ‘joined-up’ care and financial transparency. This case study provides a high-level overview of the approach taken to design and implement the Breast Cancer Bundle and the lessons learned for its expansion in both public and private settings.

show abstract

Section: Introductionmentioning

confidence: 99%

Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program

Zissiadis,

Ballal,

Forsyth

et al. 2024

Aust. Health Rev.

View full text Add to dashboard Cite

show abstract

“…With recent advances in cancer treatment and HNC management, the 5-year survival rate of HNC is estimated as 40-50% (3,4). Financial toxicity is a significant issue for some HNC patients, which is associated with a reduced health-related quality of life (5). Additionally, patients with HNC are at significant risk of cardiovascular events; hence, cardiovascular risk mitigation is essential to survivorship care (6).…”

Section: Introductionmentioning

confidence: 99%

Development of mobile health-based interventions to promote physical activity in patients with head and neck cancer: a qualitative study

Ning,

Dong,

Jia

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

BackgroundDespite the well-grounded benefits of physical activity (PA), poor compliance with the PA guidelines has been reported among head and neck cancer (HNC) patients. Mobile health (mHealth)-based interventions can help cancer survivors increase their PA levels and increase the reach or efficiency of rehabilitation services. However, there is limited knowledge about the needs and perceptions of HNC patients regarding these interventions. This study explored the perceptions and needs of HNC patients regarding mHealth-based PA programs before developing such interventions to ensure their improved effectiveness.Study designA constructivist qualitative study.MethodsWe purposively selected 17 adult HNC patients aged 40–80 years to determine their needs and perceptions of future mHealth-based PA programs. Semi-structured face-to-face interviews were conducted, and the data were analyzed via thematic analysis. The report followed the Consolidated Criteria for Qualitative Research Reports guidelines.ResultsFour themes were analyzed from the interview transcripts regarding the needs and perceptions of mHealth-based PA programs: (1) functionality needs; (2) system usage requirements; (3) social support; and (4) perceived barriers and facilitators. HNC patients expect highly customized and specialized mHealth interventions that consider individual factors, address their concerns about security, network, and cost, and prefer improved comfort. Moreover, they expect to receive support from their healthcare providers, families, and peers.ConclusionThe study provides pragmatic ready-to-use recommendations to design interventions for inactive HNC patients to achieve the recommended PA levels. Future mHealth interventions should be tailored according to the needs of the HNC patients by utilizing perceived facilitators and removing perceived barriers to help them engage in PA actively.

show abstract

“…Several studies of out‐of‐pocket costs for cancer care in Australia have been based on these co‐payments, providing valuable information but potentially missing other health care‐related out‐of‐pocket costs, such as unsubsidised care and treatment‐related travel and accommodation 5 . Other studies have included a broader range of cost types, but were limited to selected cancer types or a single rural area 6‐8 . Nevertheless, some studies have reported very high out‐of‐pocket health care costs 9,10 that could lead to inequities in health care, particularly if timely access to all treatment options is available only to people with adequate financial resources 11 .…”

mentioning

confidence: 99%

Out‐of‐pocket health care expenses for people with and without cancer, New South Wales, 2020: a cross‐sectional study

Goldsbury,

Haywood,

Pearce

et al. 2024

Medical Journal of Australia

Self Cite

View full text Add to dashboard Cite

ObjectivesTo investigate self‐reported out‐of‐pocket health care expenses, both overall and by cost type, for a large population‐based sample of Australians, by cancer status and socio‐demographic and medical characteristics.Study designCross‐sectional study.Setting, participantsNew South Wales residents participating in the 45 and Up Study (recruited aged 45 years or older during 2005–2009) who completed the 2020 follow‐up questionnaire; survey responses linked with New South Wales Cancer Registry data.Main outcome measuresProportions of respondents who reported that out‐of‐pocket health care expenses during the preceding twelve months exceeded $1000 or $10 000; adjusted odds ratios (aORs) for associations with socio‐demographic and medical characteristics.ResultsOf the 267 357 recruited 45 and Up Study participants, 45 061 completed the 2020 survey (response rate, 53%); 42.7% (95% confidence interval [CI], 42.2–43.1%) reported that overall out‐of‐pocket health care expenses during the previous year exceeded $1000, including 55.4% (52.1–58.7%) of participants diagnosed in the preceding two years and 44.9% (43.7–46.1%) of participants diagnosed with cancer more than two years ago. After adjustment for socio‐demographic factors, out‐of‐pocket expenses greater than $1000 were more likely to be reported by participants with cancer than by those without cancer (diagnosis in past two years: aOR, 2.06 [95% CI, 1.77–2.40]; diagnosis more than two years ago: aOR, 1.22 [95% CI, 1.15–1.29]). The odds of out‐of‐pocket expenses exceeding $1000 increased with area‐based socio‐economic advantage and household income, and were higher for people with private health insurance (v people with Medicare coverage only: aOR, 1.64; 95% CI, 1.53–1.75). Out‐of‐pocket expenses exceeding $10 000 were also more likely for participants diagnosed with cancer during the past two years (v no cancer: aOR, 3.30; 95% CI, 2.56–4.26).ConclusionsPeople diagnosed with cancer during the past two years were much more likely than people without cancer to report twelve‐month out‐of‐pocket health care expenses that exceeded $1000. Out‐of‐pocket expenses for people with cancer can exacerbate financial strain at a time of vulnerability, and affect health care equity because some people cannot pay for all available treatments.

show abstract

Financial Toxicity and Out-of-Pocket Costs for Patients with Head and Neck Cancer

Cited by 5 publications

References 25 publications

Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program

Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program

Development of mobile health-based interventions to promote physical activity in patients with head and neck cancer: a qualitative study

Out‐of‐pocket health care expenses for people with and without cancer, New South Wales, 2020: a cross‐sectional study

Contact Info

Product

Resources

About