Financial toxicity among patients with lung cancer in a publicly funded health care system.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 192-192
Author(s):  
Doreen Anuli Ezeife ◽  
Joshua Morganstein ◽  
Sally C Lau ◽  
Lisa Le ◽  
David Cella ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Logistic Regression ◽  
Healthcare System ◽  
Financial Distress ◽  
Public Healthcare ◽  
Financial Toxicity ◽  
Public Healthcare System ◽  
Factors Associated ◽  
Multivariable Logistic Regression

192 Background: Financial distress has been established as a clinically relevant patient-reported outcome (PRO) associated with worse mortality and quality of life, but remains under-recognized by health care providers. Our goal was to define factors associated with financial toxicity (FT) in a public healthcare system. Methods: Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FT was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0-44 with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP) and extended insurance coverage (EIC) were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FT (COST < 21). Results: Of 251 patients approached, 200 (80%) participated. Median age of the cohort was 65 years; 56% were female, 64% immigrants and 77% employed or on pension. Median total OOP while on treatment ranged between $1000-5000 CAD. Median COST score was 21 (range 0-44). FT was associated with age, with patients < 65 years reporting greater FT than older patients (COST 18.0 vs. 24.0, p < 0.0001). In multivariable logistic regression analysis, younger age was associated with greater FT, when adjusting for income, employment status, OOP and EIC (OR 3.6, [95% CI, 1.5-9.1]; p < 0.0001). Total OOP > $1000 and EIC also were associated with greater FT (adjusted OR 5.0 [95% CI, 2.0-12.1] and 3.7 [95% CI, 1.5-9.1], respectively). Conclusions: Age is significantly associated with FT in the Canadian (Ontario) public healthcare system, with younger lung cancer patients reporting greater financial distress. This study highlights priority patient populations where FT should be routinely assessed and appropriate resources for support offered.

Patients’ willingness to pay for blood-based EGFR T790M testing: Results from a Canadian validation study of circulating DNA T790M testing.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18329-e18329
Author(s):  
Tristan Alexandra Barnes ◽  
Janessa J. Laskin ◽  
Parneet Kaur Cheema ◽  
Geoffrey Liu ◽  
Mussawar Iqbal ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Willingness To Pay ◽  
Healthcare System ◽  
Validation Study ◽  
Demographic Data ◽  
Perceived Value ◽  
Public Healthcare ◽  
Tumor Biopsy ◽  
Public Healthcare System ◽  
Egfr Kinase

e18329 Background: Detection of EGFRmutations in circulating tumor DNA (ctDNA) in peripheral blood has been shown to have high concordance with definitive tumor biopsy samples. Patients’ perceived value and willingness to pay for novel technology can help inform policy and funding decisions in the public healthcare system. Methods: Canadian patients undergoing screening for the ASTRIS clinical trial (NCT02474355) were invited to participate in a national Canadian validation study of blood-based ctDNA T790M testing. All participants had metastatic EGFRmutant lung cancer with acquired resistance to EGFR kinase inhibitors. In addition to collection of blood samples and demographic data, patients completed a structured interview measuring their perceived value of blood-based ctDNA testing as an alternative to tumor biopsy and willingness to pay for testing using both open-ended and iterative bidding approaches. The study was supported by a grant from AstraZeneca. Results: 55 patients have been accrued of a planned 60. As of 01/31/2017, demographic data for 55 and willingness to pay data for 52 patients were available, the rest are pending. The median age of the cohort is 64 years (range 31-87), 68% are Asian (36/53), 56% female (31/55). Patients received a median of 1 prior line of treatment (range 1-7); all received prior EGFR kinase inhibitor therapy (66% gefitinib), and 34% also received prior cytotoxic chemotherapy (18/53). All but one patient preferred to have the blood test over repeat tumor biopsy. Patients were personally willing to pay a median of $400 CAD for the test (IQR $600, range 0-$10000). Patients estimated that a reasonable price for the test was a median of $150 (IQR $300, range 0-$2500). Conclusions: Lung cancer patients value ctDNA testing highly and prefer it to tumor biopsy. Despite the expectation that services like molecular testing should be covered through the Canadian public healthcare system, patients expressed willingness to pay out of pocket for ctDNA blood testing, reflecting perceived major value of this technology.

scholarly journals Factors associated to experienced continuity of care between primary and outpatient secondary care in the Catalan public healthcare system

2013 ◽  
Vol 27 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Marta-Beatriz Aller ◽  
Ingrid Vargas ◽  
Sina Waibel ◽  
Jordi Coderch-Lassaletta ◽  
Inma Sánchez-Pérez ◽  
...  
Keyword(s):  
Healthcare System ◽  
Continuity Of Care ◽  
Secondary Care ◽  
Public Healthcare ◽  
Public Healthcare System ◽  
Factors Associated

scholarly journals Epidemiological factors associated with Toxoplasma gondii infection in postpartum women treated in the public healthcare system of Goiânia, State of Goiás, Brazil

2018 ◽  
Vol 51 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Juliana Boaventura Avelar ◽  
Marcos Gontijo da Silva ◽  
Hanstter Hallison Alves Rezende ◽  
Heloisa Ribeiro Storchilo ◽  
Waldemar Naves do Amaral ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Healthcare System ◽  
Public Healthcare ◽  
Postpartum Women ◽  
Public Healthcare System ◽  
The Public ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Toxoplasma Gondii Infection

scholarly journals P89.03 Demonstrating VALUE of Liquid Biopsy for Lung Cancer in a Public Healthcare System

2021 ◽  
Vol 16 (3) ◽  
pp. S689
Author(s):  
D. Hao ◽  
J. Laskin ◽  
S. Laurie ◽  
J. Agulnik ◽  
R. Juergens ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Healthcare System ◽  
Liquid Biopsy ◽  
Public Healthcare ◽  
Public Healthcare System

Integrating a Pilot Newborn Screening for Spinal Muscular Atrophy Into the Australian Public Healthcare System

2021 ◽  
Author(s):  
Arlene M. D'Silva ◽  
Hugo Sampaio ◽  
Didu Sanduni Thamarasa Kariyawasam ◽  
David Mowat ◽  
Jacqui Russell ◽  
...  
Keyword(s):  
Spinal Muscular Atrophy ◽  
Newborn Screening ◽  
Healthcare System ◽  
Muscular Atrophy ◽  
Public Healthcare ◽  
Public Healthcare System

scholarly journals Investigation of some factors associated with utilization of maternal health care services by adolescent mothers in Tanzania

2021 ◽  
Vol 47 (2) ◽  
pp. 847-861
Author(s):  
Elia Magwaja ◽  
Jacqueline Minja ◽  
Majige Selemani Budeba ◽  
Rocky R.J. Akarro
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Maternal Health ◽  
Health Facility ◽  
Adolescent Mothers ◽  
Maternal Health Care ◽  
Adolescent Mother ◽  
Cross Sectional ◽  
Safe Delivery ◽  
Factors Associated

This study examined some factors associated with the utilization of maternal health care servicesby adolescent mothers (15-19 years) in Tanzania in order to provide advice accordingly. The studyused cross-sectional study of adolescent mothers aged 15-19 years using Demographic HealthSurvey and Malaria indicator Survey 2015/16 data. The dependent variables were number ofantenatal care visits, the place where an adolescent mother delivered and post-natal checkup(adolescent mother’s health checking after being discharged or after a home delivery). Theindependent variables were birth order, education level of a mother, marital status of a mother,media exposure, wealth index, distance to health facility. Multiple binary logistic regression wasused to examine an association between each dependent variable and their respective independentvariables. Data was analyzed using IBM SPSS statistics and STATA. This study used 550adolescent mothers in the analysis. Majority of the adolescent mothers had less than four AntenatalCare (ANC) visits (53.5%), while 68.5% of adolescent mothers delivered at a health facility.Adolescent mothers with two or more children had less odds of having at least four ANCscompared to those with one child, whereas adolescent mothers with at least secondary educationhad greater odds of delivering at a health facility compared to those who had no education.Adolescent mothers who had at least four antenatal care visits and those who are married hadgreater odds of checking their health after being discharged compared to adolescent mothers whohad less than 4 ANCs and single adolescent mothers. It was advised that provision of maternaleducation to young girls on the importance of safe delivery and health checking after delivery isvery important to reduce adolescent maternal morbidity and mortality in the country. Keywords: Adolescent; Maternal Health; Logistic regression; Chi-square

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