Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer

Newton, Jade C.; Johnson, Claire; Hohnen, Harry; Bulsara, Max; Ives, Angela; McKiernan, Sandy; Platt, Violet; McConigley, Ruth; Slavova‐Azmanova, Neli; Saunders, Christobel

doi:10.1007/s00520-018-4205-2

Cited by 44 publications

(56 citation statements)

References 26 publications

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“…younger age, higher household income and longer distance from treatment centres (Baili et al, 2016;Davidoff et al, 2013;Newton et al, 2018;Pisu, Azuero, Benz, McNees, & Meneses, 2017;Valtorta & Hanratty, 2013). Furthermore, studies have found that low socioeconomic status is a risk factor for unemployment after a cancer diagnosis; for women, a cancer diagnosis results in a higher risk of unemployment, but mainly male cancer patients seem to be affected by a total decline in family income (Torp, Nielsen, Fosså, Gudbergsson, & Dahl, 2013;Zajacova et al, 2015).…”

Section: What This Paper Adds?mentioning

confidence: 99%

“…In addition to a deeper understanding of the costs that induce financial toxicity, identifying high‐risk patients is important (Carrera et al, ). Medical and non‐medical out‐of‐pocket costs have been found to be higher for patients with, for example, younger age, higher household income and longer distance from treatment centres (Baili et al, ; Davidoff et al, ; Newton et al, ; Pisu, Azuero, Benz, McNees, & Meneses, ; Valtorta & Hanratty, ). Furthermore, studies have found that low socioeconomic status is a risk factor for unemployment after a cancer diagnosis; for women, a cancer diagnosis results in a higher risk of unemployment, but mainly male cancer patients seem to be affected by a total decline in family income (Torp, Nielsen, Fosså, Gudbergsson, & Dahl, ; Zajacova et al, ).…”

Section: Introductionmentioning

confidence: 99%

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‘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: What This Paper Adds?mentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…This study is the rst to assess the incidence of CHE, associated factors and its coping strategies for cancer care in Ethiopia. The average overall cancer care expenditure was half of the average unadjusted household annual income and nearly three-fourth of the average unadjusted household annual expenditure which is higher as compared to Australian patients [25]. This was however; lower than the ndings of other studies in which patients spent 59.9% of household annual income [19].…”

Section: Discussionmentioning

confidence: 63%

Catastrophic Healthcare Expenditure and Coping Strategies among Patients Attending Cancer Treatment Services in Addis Ababa, Ethiopia

Kasahun

Gebretekle

Gecho

et al. 2020

Preprint

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Background: With the rapid increase in magnitude and mortality of cancer, which is costly disease to manage, several patients particularly in developing countries are facing a huge financial burden. The aim of the study was to examine the incidence of catastrophic health expenditure (CHE), identify associated factors and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia.Methods: A hospital based cross-sectional survey of patients with cancer was conducted in public and private hospitals between January and March 2018. Data was collected using a structured questionnaire. All direct medical and nonmedical expenditures were measured and reported as expenditure (US$) per patient (1US$ equivalent to 23.41 Ethiopian Birr). The CHE was estimated using a threshold of 10% of annual household income.Results: A total of 352 (response rate of 87.1%) participants were interviewed. Majority (73.3%) of the respondents were females; most (94%) from public hospitals and their mean (±SD) age was 48±13.2 years. Breast (36.9%) and Cervical (16.5%) cancers accounted the largest proportion. Vast majority (74.4%) of patients experienced CHE with mean overall expenditure of $2366 per patient (median: $1708). Medical expenditure sharedthe highest overall expenditure (83.6%) with mean medical and nonmedical costs of $1978 (median: $1394) and $388 (median: $222), respectively. Patients who took greater than six cycles of chemotherapy (AOR: 3.64; 95% CI: 1.11-11.92), and age (AOR: 1.03; 95% CI: 1.01-1.06) were significantly associated with CHE. Household saving (85.5%) followed by financial support (43.0%) were the main coping strategies.Conclusion: A substantial number of patients with cancer are exposed to CHE with considerable medical expenditure. Hence, while efficient mobilization of the over introduced health insurance scheme other better prepayment or insurance mechanisms should also be considered to ensure financial risk protection and realize universal health coverage for patients with cancer.

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“…A significant number of cancer survivors suffer financial hardship as a consequence of cancer treatment, previously described as 'financial toxicity' [23,24]. Out-of-pocket costs are a concern for cancer patients and recent Australian studies have described these important costs for indigenous vs non-indigenous cancer patients [25], Queenslanders with major cancer [26] and rural Western Australian cancer patients [27]. Other jurisdictions have also noted the financial hardship and high out-of-pocket expenditure due to cancer, such as the US, Germany and Canada [28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Lifetime Costs of Surviving Cancer—A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study

Merollini

Gordon

Aitken

et al. 2020

IJERPH

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Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997–2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease.

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Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer

Abstract: Rural WA cancer patients experience significant OOPE following their diagnosis. The impact these expenses have on patient wellbeing and their treatment decisions need to be further explored.

Cited by 44 publications

References 26 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

Catastrophic Healthcare Expenditure and Coping Strategies among Patients Attending Cancer Treatment Services in Addis Ababa, Ethiopia

Lifetime Costs of Surviving Cancer—A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study

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