Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors
Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors
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DOI：
10.1002/cncr.29808
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发表时间：
2016-04-15
期刊：
影响因子：
6.2
通讯作者：
Carroll, Norman V.
中科院分区：
文献类型：
--
作者：
Kale, Hrishikesh P.;Carroll, Norman V.
背景与癌症相关的经济负担与癌症幸存者（CS）放弃/延迟医疗护理、跳过随访和停止用药有关。据作者所知，关于经济负担对 CS 健康相关生活质量的影响知之甚少。方法作者分析了 2011 年医疗支出小组调查数据。如果报告存在以下问题之一，则存在经济负担：借钱/宣布破产、担心支付大额医疗费用、无法支付医疗费用或其他经济牺牲。评估了以下结果：12 项简短健康调查 (SF-12) 的身体成分评分 (PCS) 和精神成分评分 (MCS)、抑郁情绪、心理困扰以及与癌症复发相关的担忧。作者还评估了财务问题的数量对这些结果的影响。 结果 在分析的 1960 万 CS 中，28.7% 的人报告了财务负担。其中，有经济负担的人的平均PCS（42.3 vs 44.9）和MCS（48.1 vs 52.1）低于无经济负担的人。在调整分析中，有经济负担的 CS 的 PCS (=-2.45) 和 MCS (=-3.05) 显着较低，抑郁情绪的几率增加（比值比，1.95），并且更有可能担心癌症复发（比值比，3.54）。报告 3 财务问题的幸存者与没有财务问题的幸存者相比，平均 PCS 和 MCS 存在统计学显着性和临床意义的差异（3 分）。结论癌症相关的财务负担与癌症相关生活质量较低、抑郁情绪风险增加以及癌症复发担忧频率较高相关。癌症 2016；122：1283-9。 (c) 2015 年美国癌症协会。美国大约 29% 的癌症幸存者报告至少有 1 个与癌症相关的财务问题。患有与癌症相关的经济问题的幸存者，尤其是那些问题较多的幸存者，身心健康相关的生活质量较低，情绪抑郁的风险增加，并且更频繁地担心癌症复发。
BACKGROUNDCancer-related financial burden has been linked to cancer survivors (CS) forgoing/delaying medical care, skipping follow-up visits, and discontinuing medications. To the authors' knowledge, little is known regarding the effect of financial burden on the health-related quality of life of CS.METHODSThe authors analyzed 2011 Medical Expenditure Panel Survey data. Financial burden was present if one of the following problems was reported: borrowed money/declared bankruptcy, worried about paying large medical bills, unable to cover the cost of medical care visits, or other financial sacrifices. The following outcomes were evaluated: Physical Component Score (PCS) and Mental Component Score (MCS) of the 12-Item Short-Form Health Survey (SF-12), depressed mood, psychological distress, and worry related to cancer recurrence. The authors also assessed the effect of the number of financial problems on these outcomes.RESULTSOf the 19.6 million CS analyzed, 28.7% reported financial burden. Among them, the average PCS (42.3 vs 44.9) and MCS (48.1 vs 52.1) were lower for those with financial burden versus those without. In adjusted analyses, CS with financial burden had significantly lower PCS (=-2.45), and MCS (=-3.05), had increased odds of depressed mood (odds ratio, 1.95), and were more likely to worry about cancer recurrence (odds ratio, 3.54). Survivors reporting3 financial problems reported statistically significant and clinically meaningful differences (3 points) in the mean PCS and MCS compared with survivors without financial problems.CONCLUSIONSCancer-related financial burden was associated with lower health-related quality of life, increased risk of depressed mood, and a higher frequency of worrying about cancer recurrence among CS. Cancer 2016;122:1283-9. (c) 2015 American Cancer Society.Approximately 29% of cancer survivors in the United States report at least 1 cancer-related financial problem. Survivors with cancer-related financial problems, especially those with a greater number of problems, have lower physical and mental health-related quality of life, an increased risk of depressed mood, and more frequently worry about cancer recurrence.