According to previous research, financial toxicity, the financial stress experienced by patients accessing health care, affects a large population of cancer patients. A new study, published in JACC: CardioOncology, finds that financial toxicity is often higher among heart disease patients compared to cancer patients, and those with both conditions suffer the highest burden.
“Cor disease i cancer are the leading causes of death in the United States, but most financial toxicity research has focused on cancer patients. It is important to note that cancer patients may have brief bursts of high spending on treatments, while patients with heart disease they are often incurring a more chronic financial burden due to costs of medications, procedures, doctor visits and hospital stays, ”said Khurram Nasir, MD, MPH, MSc, head of the Cardiovascular Prevention and Wellness Division of the DeBakey Methodist Center for Heart and lead author of the paper. “In addition, as the cancer survival rate grows, the patient population with both heart disease and the cancer grows. The financial burden created by these diseases manifests itself as another form of affliction. Without the ability to pay, our patients may suffer financial, health and unrelated health difficulties. health care The field must be prepared to tackle it. It does very little good if we can treat cancer or heart disease, but the patient cannot afford to eat or pay their mortgage. “
Financial toxicity is defined as having any of the following: Difficulty paying medical bills, inability to pay them, high financial distress, inadequacy of cost-related medication, food insecurity, and / or delayed or lost care due to cost .
Using data from the 2013-2018 National Health Interview Survey, the researchers included 141,826 non-elderly (18 to
The National Health Interview Survey is conducted by the National Center for Health Statistics / Centers for Disease Control and Prevention and is a weighted survey, which means it is a nationally representative survey. It contains four components: Home composition, Family nucleus, Sample child nucleus and Sample adult nucleus. The Household Composition collects basic information and information about the relationship of all people in a household. The Family Core component includes sociodemographic characteristics, basic indicators of health status, activity limitations, injuries, health insurance coverage, and access to and use of health care services. For the children’s sample and adult core sample, a child and an adult are randomly selected to gather more detailed information. The study used baseline information from adult examples with relevant information from basic household and family components, which the researchers complemented with demographic and socioeconomic characteristics, health status, health care services, and related behaviors. with health in the US adult population.
Most people with cancer and / or ASCVD in the study population were between 40 and 64 years old, were insured and were white. Participating women were more likely to report having cancer, with a majority coming from middle / high-income households and with a higher level of education. Those who reported ASCVD, with or without cancer, were evenly distributed by sex, education levels, and income, but had a more unfavorable cardiovascular risk profile. The most reported cancers included non-melanoma skin, breast, cervix, prostate, and “others,” which was also observed among those who reported both TCAV and cancer.
Financial toxicity is more likely to occur in patients with ASCVD and cancer, those with ASCVD, those with cancer, and those without cancer or ASCVD. The difficulty in paying bills was significantly higher in patients with ASCVD with and without cancer compared to patients with cancer alone. In general, the same pattern was observed (ASCVD and cancer> ASCVD> cancer> none) for high financial distress, lack of adherence to cost-related medications, food insecurity, and delayed / lost health care. due to cost, when comparing those who reported ASCVD with or without cancer versus cancer. Cancer patients and ASCVD were more likely to experience any financial toxicity measured in the study. In a subanalysis of elderly patients, the same pattern was observed for all measures of financial toxicity at significantly lower rates.
“There is an urgent need for effective methods to alleviate financial toxicity for patients with heart disease and cancer. Health system, there are already small and large-scale strategies to identify and combat financial toxicity. This has already been observed among oncologists when they were asked to talk about it with their patients financial burden in the office, “Nasir said.” It is especially important for clinicians caring for patients with heart disease and / or cancer, given the high financial burden on these patients. “
“The current manuscript provides us with an overview of the economic burden on patients with heart disease and / or cancer nationwide, and to address the two leading causes of death in the United States, we need to consider financial toxicity more aggressively. associated with these two diseases and their treatment, ”said Javier Valero-Elizondo, MD, MPH, of the Division of Cardiovascular Prevention and Wellness at Houston’s DeBakey Heart and Vascular Methodological Center and lead author of the work. “While this study is one of the first of its kind, we hope it will help not only build on the current literature, but also serve as an idea that will generate paper to combat financial toxicity.”
Limitations of the study include the self-reported nature of ASCVD and / or cancer; the limited number of financial toxicity characteristics assessed; and that the National Health Interview Survey assessed whether anyone in the household had financial difficulties and excluded the assessment of the proportion of medical bills directly related to ASCVD and / or cancer and their contribution to financial difficulties. Researchers also noted that strategies are possible to mitigate funding toxicity in cancer patients have begun to give positive results, which can be reflected in the analysis.
JACC: CardioOncology, www.jacc.org/doi/10.1016/j.jaccao.2021.02.006
American College of Cardiology
Citation: Similar or higher financial distress for heart disease patients compared to cancer (2021, June 15) recovered on June 16, 2021 at https://medicalxpress.com/news/2021-06-financial-distress -similar-greater-patients .html
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