Exploring barriers to the receipt of necessary medical care among cancer survivors under age 65 years
Exploring barriers to the receipt of necessary medical care among cancer survivors under age 65 years
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DOI：
10.1007/s11764-017-0640-1
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发表时间：
2018-02-01
影响因子：
3.7
通讯作者：
Yabroff, K. Robin
中科院分区：
文献类型：
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作者：
Banegas, Matthew P.;Dickerson, John F.;Yabroff, K. Robin
随着美国癌症护理成本的增加和患者成本分担的增加，了解癌症幸存者获得医疗服务的情况势在必行。本研究的目的是确定经济，心理社会和癌症相关的障碍，接受医疗保健，测试，或治疗的医生或患者认为必要的癌症年龄< 65岁的幸存者。我们使用的数据4321癌症幸存者年龄18-64岁谁完成了2012年生活强调查。多变量逻辑回归分析采用拓扑，经济困难，债务金额，照顾者的地位，和癌症相关的变量。确定与接受必要的医疗护理相关的风险因素，包括社会因素大约28%的癌症幸存者在调查时距离上次治疗不到1年，43%在1至5年之间。近9%的癌症幸存者报告没有得到必要的医疗护理。与没有经济困难的幸存者相比，经济困难的幸存者得不到必要医疗护理的可能性随着债务数额的增加而显著增加（RR债务<10，000美元的经济困难= 1.94，95% CI 1.55-2.42，RR债务<10，000美元的经济困难= 3.41，95% CI 2.69-4.33，p < 0.001）。幸存者报告说，没有照顾者，没有保险，没有得到帮助理解医疗账单的人更有可能得不到必要的医疗护理。我们确定了关键的财务和保险风险因素，这些因素可能成为年龄<大多数癌症幸存者报告接受他们或他们的医生认为必要的医疗护理。然而，确定65岁以下癌症幸存者接受必要的癌症医疗护理的潜在可改变的障碍，对于制定干预措施以确保公平获得护理和减少癌症差异至关重要。
With increasing cancer care costs and greater patient cost-sharing in the USA, understanding access to medical care among cancer survivors is imperative. This study aims to identify financial, psychosocial, and cancer-related barriers to the receipt of medical care, tests, or treatments deemed necessary by the doctor or patient for cancer among cancer survivors age < 65 years.We used data on 4321 cancer survivors aged 18-64 years who completed the 2012 LIVESTRONG Survey. Multivariable logistic regression was used toographic, financial hardship, debt amount, caregiver status, and cancer-related variables. identify risk factors associated with the receipt of necessary medical care, including sociodemApproximately 28% of cancer survivors were within 1 year, and 43% between 1 and 5 years, since their last treatment at the time of survey. Nearly 9% of cancer survivors reported not receiving necessary medical care. Compared to survivors without financial hardship, the likelihood of not receiving necessary medical care significantly increased as the amount of debt increased among those with financial hardship (RRFinancial hardship w/< $10,000 debt = 1.94, 95% CI 1.55-2.42, and RR RRFinancial hardship w/ae $10,000 debt = 3.41, 95% CI 2.69-4.33, p < 0.001). Survivors who reported lack of a caregiver, being uninsured, and not receiving help understanding medical bills were significantly more likely to not receive necessary medical care.We identified key financial and insurance risk factors that may serve as significant barriers to the receipt of necessary medical care among cancer survivors age < 65 in the USAThe majority of cancer survivors reported receiving medical care either they or their doctors deemed necessary. However, identifying potentially modifiable barriers to receipt of necessary medical cancer care among cancer survivors age < 65 is imperative for developing interventions to ensure equitable access to care and reducing cancer disparities.