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  • American Association for Cancer Research (AACR)  (5)
  • Zhao, Jingxuan  (5)
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  • American Association for Cancer Research (AACR)  (5)
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  • 1
    Online-Ressource
    Online-Ressource
    Medical Financial Hardship Intensity and Financial Sacrifice Associated with Cancer in the United States
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 2 ( 2020-02-01), p. 308-317
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 2 ( 2020-02-01), p. 308-317
    Kurzfassung: With rising costs of cancer care, this study aims to estimate the prevalence of, and factors associated with, medical financial hardship intensity and financial sacrifices due to cancer in the United States. Methods: We identified 963 cancer survivors from the 2016 Medical Expenditures Panel Survey - Experiences with Cancer. Medical financial hardship due to cancer was measured in material (e.g., filed for bankruptcy), psychological (e.g., worry about paying bills and finances), and behavioral (e.g., delaying or forgoing care due to cost) domains. Nonmedical financial sacrifices included changes in spending and use of savings. Multivariable logistic models were used to identify characteristics associated with hardship intensity and sacrifices stratified by age group (18–64 or 65+ years). Results: Among cancer survivors ages 18 to 64 years, 53.6%, 28.4%, and 11.4% reported at least one, two, or all three domains of hardship, respectively. Among survivors ages 65+ years, corresponding percentages were 42.0%, 12.7%, and 4.0%, respectively. Moreover, financial sacrifices due to cancer were more common in survivors ages 18 to 64 years (54.2%) than in survivors 65+ years (38.4%; P & lt; 0.001). Factors significantly associated with hardship intensity in multivariable analyses included low income and educational attainment, racial/ethnic minority, comorbidity, lack of private insurance coverage, extended employment change, and recent cancer treatment. Most were also significantly associated with financial sacrifices. Conclusions: Medical financial hardship and financial sacrifices are substantial among cancer survivors in the United States, particularly for younger survivors. Impact: Efforts to mitigate financial hardship for cancer survivors are warranted, especially for those at high risk.
    Materialart: Online-Ressource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-19-0460
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2020
    ZDB Id: 2036781-8
    ZDB Id: 1153420-5
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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    Online-Ressource
    Open Access Wunsch
    Verfügbarkeit (elektronisch / print)
  • 2
    Online-Ressource
    Online-Ressource
    Racial/Ethnic Disparities in Childhood Cancer Survival in the United States
    American Association for Cancer Research (AACR) ; 2021
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 30, No. 11 ( 2021-11-01), p. 2010-2017
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 30, No. 11 ( 2021-11-01), p. 2010-2017
    Kurzfassung: Non-white patients with childhood cancer have worse survival than Non-Hispanic (NH) White patients for many childhood cancers in the United States. We examined the contribution of socioeconomic status (SES) and health insurance on racial/ethnic disparities in childhood cancer survival. Methods: We used the National Cancer Database to identify NH White, NH Black, Hispanic, and children of other race/ethnicities ( & lt;18 years) diagnosed with cancer between 2004 and 2015. SES was measured by the area-level social deprivation index (SDI) at patient residence and categorized into tertiles. Health insurance coverage at diagnosis was categorized as private, Medicaid, and uninsured. Cox proportional hazard models were used to compare survival by race/ethnicity. We examined the contribution of health insurance and SES by sequentially adjusting for demographic and clinical characteristics (age group, sex, region, metropolitan statistical area, year of diagnosis, and number of conditions other than cancer), health insurance, and SDI. Results: Compared with NH Whites, NH Blacks and Hispanics had worse survival for all cancers combined, leukemias and lymphomas, brain tumors, and solid tumors (all P & lt; 0.05). Survival differences were attenuated after adjusting for health insurance and SDI separately; and further attenuated after adjusting for insurance and SDI together. Conclusions: Both SES and health insurance contributed to racial/ethnic disparities in childhood cancer survival. Impact: Improving health insurance coverage and access to care for children, especially those with low SES, may mitigate racial/ethnic survival disparities.
    Materialart: Online-Ressource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-21-0117
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2021
    ZDB Id: 2036781-8
    ZDB Id: 1153420-5
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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    Online-Ressource
    Open Access Wunsch
    Verfügbarkeit (elektronisch / print)
  • 3
    Online-Ressource
    Online-Ressource
    Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study
    American Association for Cancer Research (AACR) ; 2023
    In:  Cancer Research Communications Vol. 3, No. 9 ( 2023-09-12), p. 1830-1839
    Details
    In: Cancer Research Communications, American Association for Cancer Research (AACR), Vol. 3, No. 9 ( 2023-09-12), p. 1830-1839
    Kurzfassung: Financial hardship (FH), defined as adverse patient effects due to cancer costs, is experienced by approximately half of individuals diagnosed with cancer. Many individuals diagnosed with cancer also experience disruptions with their employment. This study examines associations of employment disruptions and FH among a nationally representative sample of individuals diagnosed with cancer in the United States. We utilized 2016/2017 Medical Expenditure Panel Survey Experiences with Cancer data from individuals who worked for pay following cancer diagnosis. Employment disruption included taking extended paid time off work; switching to part-time/less demanding jobs; and/or retiring early due to cancer diagnosis/treatment. FH domains included: material (e.g., borrowing money/financial sacrifices); psychologic (e.g., worrying about medical bills/income); and behavioral (delaying/forgoing healthcare services because of cost). Multivariable logistic regression analyses determined associations of employment disruption and FH. Among 732 individuals with a cancer history, 47.4% experienced employment disruptions; 55.9% experienced any FH. Any FH was significantly more common among individuals with versus without employment disruptions across multiple measures and domains (68.7% vs. 44.5%; P value of difference & lt;0.0001). Individuals with employment disruptions were more likely to have any FH [OR, 2.38; 95% confidence interval (CI), 1.62–3.52] and more FHs (OR, 2.76; 95% CI, 1.96–3.89] . This study highlights that employment disruptions are common and significantly associated with multiple domains of FH among individuals with a cancer history. Employer workplace accommodation, physician discussions regarding potential impacts of cancer care on employment, and other policies to minimize employment disruptions among individuals diagnosed with cancer may reduce FH in this vulnerable population. Significance: Individuals diagnosed with cancer may have employment disruptions; they may also develop FHs. People with cancer who have employment changes are more likely to also have FHs. Physicians and employers can help individuals with cancer through advancing planning, workplace assistance, and improved medical leave and insurance policies.
    Materialart: Online-Ressource
    ISSN: 2767-9764
    URL: Article
    DOI: 10.1158/2767-9764.CRC-23-0157
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2023
    ZDB Id: 3098144-X
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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    Online-Ressource
    Open Access Wunsch
    Verfügbarkeit (elektronisch / print)
  • 4
    Online-Ressource
    Online-Ressource
    Health Insurance Coverage Disruptions and Access to Care and Affordability among Cancer Survivors in the United States
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 11 ( 2020-11-01), p. 2134-2140
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 11 ( 2020-11-01), p. 2134-2140
    Kurzfassung: Lack of health insurance is associated with having problems with access to high-quality care. We estimated prevalence and evaluated associations of insurance coverage disruptions and access to health care and affordability among cancer survivors in the United States. Methods: Adult cancer survivors ages 18 to 64 years with current private or public health insurance were identified from the 2011 to 2018 National Health Interview Survey (n = 7,186). Health insurance coverage disruption was measured as self-reports of any time in the prior year without coverage. Outcomes included preventive services use, problems with care affordability, and cost-related medication nonadherence in the prior year. We used separate multivariable logistic models to evaluate associations between coverage disruptions and study outcomes by current insurance coverage. Results: Among currently insured survivors, 3.7% [95% confidence interval (95% CI), 3.0%–4.4%] with private, and 7.8% (95% CI, 6.5%–9.4%) with public insurance reported coverage disruptions in 2011 to 2018. We estimated that approximately 260,000 survivors ages 18 to 64 years had coverage disruptions in 2018. Among privately and publicly insured survivors, those with coverage disruptions were less likely to report all preventive services use (16.9% vs. 36.2%; 14.6% vs. 25.3%, respectively) and more likely to report any problems with care affordability (55.0% vs. 17.7%; 71.1% vs. 38.4%, respectively) and any cost-related medication nonadherence (39.4% vs. 10.1%; 36.5% vs. 16.3%, respectively) compared with those continuously insured (all P & lt; 0.05). Conclusions: Coverage disruptions in the prior year were associated with problems with health care access and affordability among currently insured survivors. Impact: Reducing coverage disruptions may help improve access and affordability for survivors.
    Materialart: Online-Ressource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-20-0518
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2020
    ZDB Id: 2036781-8
    ZDB Id: 1153420-5
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
    Open Access Wunsch
    Verfügbarkeit (elektronisch / print)
  • 5
    Online-Ressource
    Online-Ressource
    Medical Financial Hardship among Cancer Survivors in the United States: What Do We Know? What Do We Need to Know?
    American Association for Cancer Research (AACR) ; 2018
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 27, No. 12 ( 2018-12-01), p. 1389-1397
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 27, No. 12 ( 2018-12-01), p. 1389-1397
    Kurzfassung: Rising costs of cancer care have led to increased concerns about medical financial hardship for cancer survivors and their families in the United States. In this commentary, we provide an overview of research describing medical financial hardship and introduce a conceptual framework for identifying risk factors and research gaps at the patient and family, provider and care team, health care system, employer, and state and national policy levels. We then use this framework to highlight measurement and data infrastructure gaps related to hardship, summarize existing interventions to minimize hardship, and identify opportunities for future intervention efforts.
    Materialart: Online-Ressource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-18-0617
    Sprache: Englisch
    Verlag: American Association for Cancer Research (AACR)
    Publikationsdatum: 2018
    ZDB Id: 2036781-8
    ZDB Id: 1153420-5
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
    Open Access Wunsch
    Verfügbarkeit (elektronisch / print)
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