Current Practices for Screening and Addressing Financial Hardship within the NCI Community Oncology Research Program.
Current Practices for Screening and Addressing Financial Hardship within the NCI Community Oncology Research Program.
复制标题
DOI：
10.1158/1055-9965.epi-20-1157
复制
发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Weaver KE
中科院分区：
文献类型：
--
作者：
McLouth LE;Nightingale CL;Dressler EV;Snavely AC;Hudson MF;Unger JM;Kazak AE;Lee SJC;Edward J;Carlos R;Kamen CS;Neuman HB;Weaver KE
癌症相关的经济困难与护理结果不佳以及患者和家庭生活质量下降有关。可扩展的干预发展，以解决财政困难，需要了解目前的筛查实践和社区癌症护理服务。美国国家癌症研究所的社区肿瘤学研究计划（NCORP）2017年景观评估调查评估了美国社区肿瘤学实践中的财务筛选和财务导航实践。Logistic模型评估了经济困难筛查与癌症特异性财务导航员的可用性和实践组特征（例如，安全网的指定、紧急医院、接受服务的种族和少数民族病人的比例）。在221个参与NCORP的实践小组中，72%的人报告了财务筛选过程，50%的人有癌症特异性财务导航器。超过10%的新癌症患者参加了医疗补助（adjOR = 2.81，p = 0.02）和少于30%的种族/少数民族癌症患者组成（adjOR = 3.91，p <0.01）的实践组更有可能筛选财务问题。少数民族癌症患者比例低于30%的实践组（adjOR = 2.37，p <0.01）更有可能为癌症患者提供专门的财务导航员或顾问。大多数NCORP实践小组筛选财务问题，一半有癌症特定的财务导航。为更多种族或少数民族患者服务的做法不太可能进行筛选，并指定财务导航员。财务筛查和导航减轻经济困难的有效性可以在NCORP中进行测试，沿着解决癌症护理不公平的具体干预措施。
Cancer-related financial hardship is associated with poor care outcomes and reduced quality-of-life for patients and families. Scalable intervention development to address financial hardship requires knowledge of current screening practices and services within community cancer care. The National Cancer Institute’s Community Oncology Research Program (NCORP) 2017 Landscape Assessment survey assessed financial screening and financial navigation practices within U.S. community oncology practices. Logistic models evaluated associations between financial hardship screening and availability of a cancer-specific financial navigator and practice group characteristics (e.g., safety-net designation, critical access hospital, proportion of racial and ethnic minority patients served). Of 221 participating NCORP practice groups, 72% reported a financial screening process and 50% had a cancer-specific financial navigator. Practice groups with more than 10% of new cancer patients enrolled in Medicaid (adjOR = 2.81, p = .02) and with less than 30% racial/ethnic minority cancer patient composition (adjOR = 3.91, p <.01) were more likely to screen for financial concerns. Practice groups with less than 30% racial/ethnic minority cancer patient composition (adjOR = 2.37, p <.01) were more likely to have a dedicated financial navigator or counselor for cancer patients. Most NCORP practice groups screen for financial concerns and half have a cancer-specific financial navigator. Practices serving more racial or ethnic minority patients are less likely to screen and have a designated financial navigator. The effectiveness of financial screening and navigation for mitigating financial hardship could be tested within NCORP, along with specific interventions to address cancer care inequities.