Experience of financial burden and distress among people with ovarian cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19400-e19400
Author(s):  
Branlyn W. DeRosa ◽  
Alexandra Katherine Zaleta ◽  
Angela J. Johnson ◽  
Kelly A. Clark ◽  
Jemeille Ackourey ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Financial Burden ◽  
Clinical History ◽  
Health Care Team ◽  
Cost Of Care ◽  
Cancer Support ◽  
Depression Risk ◽  
Cancer Experience ◽  
The Impact ◽  
Out Of Pocket Costs

e19400 Background: The impact of ovarian cancer (OC) is wide-reaching; this study explored cancer-related financial burden related to cost of care in people ever diagnosed with OC. Methods: 64 OC patients enrolled in Cancer Support Community’s Cancer Experience Registry. Participants provided demographic and clinical history, and completed 1) CancerSupportSource, a validated 25-item tool with anxiety and depression risk subscales, and 2) the 11-item COmprehensive Score for financial Toxicity (COST). Descriptive statistics were calculated for responses; Pearson/Spearman correlations and one-way ANOVA (Tukey post-hoc) were used to explore bivariate associations between financial burden, depression/anxiety risk, and demographic/clinical variables. Results: Participants were 91% non-Hispanic White, mean age = 57 years, SD= 15. 55% were currently receiving treatment (47% chemotherapy); 33% ever experienced metastatic disease. 22% reported annual income of ≤$40,000; 19% were not-employed due to disability. 13% spent $500+/month on out-of-pocket costs; 63% reported that a health care team member did not discuss cost of care with them. 36% did not know if they had enough assets to cover cancer treatment costs; 1 in 10 (11%) reported they could not meet monthly expenses. 1 in 3 reported (“quite a bit” to “very much”) worry about future financial problems resulting from illness/treatment (39%) and frustration that they cannot work or contribute as much as usual (34%). Greater financial burden was associated with lower income ( r= -.40, p= .001), greater out-of-pocket costs ( r= .24, p= .03), and not working due to disability F(5,58) = 3.84, p= .01. Among respondents, 38% were at risk for clinical depression; 44% for anxiety; greater financial burden was related to depression risk ( r = .51, p< .001) and anxiety risk ( r= .32, p= .012). Conclusions: Financial burden affects many people with ovarian cancer and is associated with poorer psychosocial outcomes. Ovarian cancer patients and survivors can benefit from access to comprehensive supportive care resources, including financial counseling. Cancer Support Community offers resources that may help, including a toll-free Helpline with a dedicated financial counselor. Future work will examine multivariate predictors of financial burden in ovarian cancer. Clinical trial information: NCT02333604 .

Multiple Myeloma Patient Experience with Financial Toxicity: Findings from the Cancer Experience Registry

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 874-874 ◽  
Author(s):  
Joanne S. Buzaglo ◽  
Melissa F. Miller ◽  
Clare Karten ◽  
Margaret Longacre ◽  
Victoria Kennedy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Financial Burden ◽  
Health Care Team ◽  
Depression Score ◽  
Cost Of Care ◽  
Financial Counseling ◽  
Cancer Experience ◽  
Out Of Pocket Costs

Abstract Background: The US prevalence of multiple myeloma (MM) is estimated at 83,118 as of January 1, 2011 (SEER, 2014), and about 24,050 new MM cases will be diagnosed in 2014 (ACS, 2014). With advances in treatment, MM patients are living longer and are confronted with increasingly complex therapeutic decisions. Many people living with MM may have to manage a significant financial burden related to care, including medication copays and coinsurance, and other out of pocket costs. Financial toxicity can reduce quality of life and impede delivery of quality care. With the movement towards value-based cancer care, oncologists are encouraged to discuss costs with patients when considering treatment choices. We aimed to describe financial distress among MM patients and patient-provider communication about cost. Methods: From July 2013-2014, the Cancer Support Community (CSC) registered 495 MM patients to the "Cancer Experience Registry: MM," an online initiative to study and raise awareness about MM's psychosocial impact. Registrants were recruited through an outreach program including the CSC and The Leukemia & Lymphoma Society networks of communities and resources. 266 US-based registrants completed surveys including questions about the financial cost of MM and cancer-related distress. Stress-related intrusive ideation about managing the financial impact of MM was measured using the validated 7-item Impact of Event Scale (IES); levels >13 were used to indicate clinically significant symptoms associated with anxiety. Twenty-seven items from a validated distress screener (α=0.94) (CancerSupportSource, Miller 2014) were summed to create a score for overall distress (mean=33, SD=21, range 0-103), and 4 items were summed for a depression score (α=0.83) with a binary variable created to indicate at risk for depression (score≥5). Results: The sample (n=266) was 52% female, 91% Caucasian, median age 64. Median time since MM diagnosis was 4.5 years. Total annual income: 35% <$40K; 35% $40-79K; 30% at least $80K. 73% reported spending at least $100/mo on all out of pocket costs related to MM; nearly half (48%) spent $250 or more; and 22% spent $500 or more. Because of the medical costs of MM, 32% reported depleting their savings; 22% borrowed against or used money from retirement; and 35% reported cutting their grocery expenses. About one-third used pharmaceutical assistance programs (35%). In order to reduce health care costs, only 5% reported skipping dosages of medicine at least sometimes, and 6% postponed filling prescriptions. Seventeen percent reported they postponed seeking psychological counseling or support. Just over half (56%) reported a member of their health care team talked to them about resources related to getting financial help or financial counseling, and only 28% reported their health care team ever discussed the impact of MM on personal finances. Yet, 82% reported financial counseling would be 'quite a bit' or 'very much' helpful to someone with MM. A large proportion of participants reported they would be 'quite a bit' or 'very much' willing to receive financial assistance for medications (81%) and cost of treatment (77%), and, to a lesser extent, for transportation costs (55%) and living expenses (46%). There was a significant linear increase in overall distress (p=0.009) and risk for depression (p=0.010) with greater monthly increment in out of pocket costs, adjusting for income, until monthly out of pocket costs exceeded $1000. Nearly one-third (32%) reported currently experiencing clinically high levels of intrusive ideation (IES>13) about the financial cost of care. Similarly, 33% reported they were often or always upset about money and the cost of care, and 47% were moderately, seriously or very seriously concerned about health insurance or money worries. Conclusion: MM places a financial burden on patients that can significantly impact quality of life and may negatively affect treatment outcomes. Implications for future research and practice include the development and evaluation of interventions to enhance doctor-patient communication and support (e.g., financial counseling and assistance) to help ensure that the financial burden of MM does not negatively impact the patient's quality of life, course of cancer care, and health outcomes. Disclosures LeBlanc: Epi-Q: Consultancy; Helsinn Therapeutics: Honoraria, Research Funding; Boehringer Ingelheim: Membership on an entity's Board of Directors or advisory committees; Flatiron: Consultancy.

The Financial Costs of Chronic Myeloid Leukemia and Implications for Quality of Life and Adherence: Findings from the Cancer Experience Registry

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2602-2602 ◽  
Author(s):  
Joanne S. Buzaglo ◽  
Clare Karten ◽  
Elisa Weiss ◽  
Melissa F. Miller ◽  
Anne Morris
Keyword(s):  
Quality Of Life ◽  
Financial Burden ◽  
Depression Score ◽  
Cost Of Care ◽  
Outreach Program ◽  
Financial Cost ◽  
Assistance Programs ◽  
Cancer Experience ◽  
Out Of Pocket Costs

Abstract Background: US prevalence of CML is estimated at 33,990 of January 1, 2011 (SEER, 2014). In 2014, about 5,980 new CML cases will be diagnosed (ACS, 2014). The era of tyrosine kinase inhibitors has transformed CML from an often fatal disease to one with an excellent prognosis, with ongoing treatment. Many people living with CML may have to manage a significant financial burden related to care, including medication copays and coinsurance, and other out of pocket costs. Several studies have reported that the financial burden of CML care is associated with decreased adherence (Dusetzina, 2014; Abraham, 2012; Noens, 2009). Poor adherence is associated with statistically significant decreases in 5-year event-free survival and may occur more frequently than either patients or physicians recognize (Oehler, 2013). Methods: From October 2013 to June 2014, the Cancer Support Community (CSC) and The Leukemia & Lymphoma Society (LLS) registered 484 people living with CML to the Cancer Experience Registry: CML, an online initiative designed to learn and raise awareness about the psychosocial impact of CML. Registrants were recruited through an outreach program that leveraged CSC’s and LLS’s networks of community-based affiliates and chapters, online communities, CSC’s helpline and LLS’s information resource center, other advocacy organizations, social and other media channels. 393 registrants (81%) responded to a survey, including questions about the financial cost of CML and cancer-related distress. Stress-related intrusive ideation about managing the financial impact of CML was measured using the Impact of Event Scale (IES, 7 items, Horowitz, 1979); levels >13 were used to indicate clinically significant symptoms associated with anxiety. Fifteen items from a validated distress screener (α=0.93) (CancerSupportSource, Miller 2014) were summed to create a score for overall distress (mean=23, SD=14, range 0-60), and 4 items were summed for a depression score (α=0.88) with a binary variable created to indicate at risk for depression (score≥5). For these analyses, we excluded survey participants living outside the US (n=54) and bone marrow transplant patients not taking oral CML medications (n=11). The sample (n=327) was 68% female, 98% Caucasian, median age 59. Median time since CML diagnosis was 4 years. Total annual income: 32% <$40K; 30% $40-79K; 37% at least $80K. Results: Nearly half (48%) reported spending at least $100 per month on all out of pocket costs related to CML; 27% spent $250 or more; 15% spent $500 or more; 5% spent $1,000 or more. Greater out of pocket costs were associated with higher overall distress (p<0.001) and increased risk of depression (p<0.001), adjusting for income. One-third (34%) reported that CML-related out of pocket costs affect their household “quite a bit” or “very much”; 21% responded “a little bit”; 27% responded “not at all.” More than one-third (37%) reported currently experiencing clinically high levels of intrusive ideation (IES>13) about the financial cost of care. Oral CML medicine was the greatest cost burden to participants. Because of the medical costs of CML, 33% reported depleting their savings; 20% borrowed against or used money from retirement; and 35% reported cutting their grocery expenses. Nine percent enrolled in a clinical trial that paid for most of their treatment expenses. About one-third used pharmaceutical assistance programs (30%) and co-pay assistance programs (38%). In order to reduce health care costs, 10% reported skipping dosages of medicine at least sometimes, and 14% postponed filling prescriptions. Twelve percent reported they postponed seeking psychological counseling or support. Half (51%) of participants did not know if they were eligible for Social Security Disability Insurance or Supplemental Security Income; 44% wished they had received more help with financial advice and assistance. Conclusion: CML places a financial burden on patients that is associated with patients taking measures that may significantly impact quality of life and may negatively affect treatment outcomes. Implications for future research and practice include the development and evaluation of interventions to enhance oncology team-patient communication and support (e.g., financial counseling and assistance) to help ensure that the financial burden of CML does not negatively impact the patient’s quality of life, course of cancer care, and health outcomes. Disclosures No relevant conflicts of interest to declare.

Financial toxicity and cancer-related distress among melanoma survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9588-9588
Author(s):  
Joanne S Buzaglo ◽  
Melissa F Miller ◽  
Alexandra K Zaleta ◽  
Jamese Johnson ◽  
Niraj K. Gupta
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cancer Care ◽  
Financial Burden ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Financial Impact ◽  
Out Of Pocket Costs

9588 Background: Melanoma survivors are at risk for significant financial burden due to cancer care and out of pocket costs. We explored 1) the financial impact of melanoma and its relationship to cancer-related distress, and 2) survivors’ experiences discussing financial burden with their health care team. Methods: Of 110 melanoma survivors enrolled in the Cancer Support Community’s online Cancer Experience Registry, 56 completed questions about financial impact of cancer and cost of care communication. Participants rated concern (0 = not at all; 4 = very seriously) about 27 items encompassing psychological, emotional, physical and practical concerns; items were summed into a total distress score (mean = 33, SD = 21, range 0-88). Financial impact and overall distress were examined via regression analysis. Results: Participants were 71% female, 89% Caucasian, median age 54, and median time since diagnosis 2.5 years. Total annual income: 34% < $60K; 46% $60K+; 20% not reported. 24% spent $101-250/month on melanoma out of pocket costs; 20% spent $251-500; and 24% spent ≥$500. The top concern was health insurance/money worries (69% moderately to very seriously concerned). Due to medical costs, 57% depleted their savings, 20% borrowed against or used retirement money, 20% used pharmaceutical assistance programs, 13% skipped medicine dosages at least sometimes, and 17% postponed filling prescriptions. Only 28% reported that their health care team spoke to them about cost of care, and 28% were asked about financial distress; 42% desired financial assistance. Financial impact was associated with an increase in overall distress for those with income < $60K (p < .05; interaction p < 0.05). Conclusions: Substantial proportions of melanoma survivors experience financial burden that can impact quality of life, particularly lower income individuals. Although oncologists are encouraged to discuss treatment costs, most patients report they have not had these discussions with providers. These results support the development/evaluation of interventions to enhance doctor-patient communication, and financial counseling to minimize financial burden of melanoma and the risks it can confer for quality of life, course of cancer care, and health outcomes.

Provider-patient communication about cost of care: Results from a national patient education program.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9578-9578 ◽  
Author(s):  
Ivy A. Ahmed ◽  
Allison Harvey ◽  
Marni Amsellem ◽  
Thomas J. Smith
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Cancer Support ◽  
Support Organizations ◽  
National Patient ◽  
The Cost

9578 Background: A 2010 NIH study indicates direct cancer care expenditures will reach $158 billion in the U.S. by 2020, impacting millions of Americans. The cost of insurance for a family of 4 has increased from $6000 (2000) to over $16,000 (2011). Medical debt is a significant cause of personal bankruptcy, even if insured. The financial realities posed by costs associated with cancer care greatly complicate a cancer diagnosis. The most recent American College of Physicians Ethics Manual recommends all parties must interact honestly, openly, and fairly. (Snyder L, et al. Ann Int Med 2012, p86) This analysis explores the occurrence and value of patient-provider communication surrounding costs associated with care in a national survey of those affected by cancer. Methods: From 2011-12, 505 individuals attending Frankly Speaking About Cancer: Coping with the Cost of Care workshops completed a survey assessing experiences about the costs of cancer care. This is a Cancer Support Community national evidence-based educational program. All attendees (n=708) were eligible to complete survey. Results: Most attendees (71.3%) responded. The majority (62.4%) were people with cancer/survivors; the remainder included spouses/partners, family members, and 8.7% were health care professionals. Most (80.8%) were Caucasian, and averaged 57.2 years. Of those with cancer, 89.9% were insured at diagnosis. 59.4% reported no one on their health care team initiated a discussion about the financial aspects of their care. Included in this figure, 22.7% actively sought information from health care team, and 36.7% received no information about cost. When topic was initiated, it was by social workers (16.2%), physicians (12.3%), nurses (6.3%) or financial specialists (8.2%). When information was provided, 72.1% found it somewhat or very useful. Also, regardless of provider discussion, respondents independently sought resources for managing costs, such as other patients (44.2%), the Internet (41.5%), and patient support organizations (38.1%). Conclusions: Patients want financial information but do not receive it. These data highlight the need and value of providers initiating a dialogue about the cost of cancer care with patients.

Cancer-related distress and cost of care concerns among gastric cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15583-e15583 ◽  
Author(s):  
Linda S. House ◽  
Melissa F Miller ◽  
Alexandra K Zaleta ◽  
Jamese Johnson ◽  
Crystal Shereen Denlinger ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Health Care ◽  
At Risk ◽  
Emotional Distress ◽  
Financial Burden ◽  
Health Care Team ◽  
Physical Symptoms ◽  
Cost Of Care ◽  
Care Team ◽  
Clinically Significant

e15583 Background: Individuals with gastric cancer (GC) are at risk for significant physical, psychological, and financial burden related to their illness and cost of care. This study characterizes cancer-related distress and concerns among survivors of GC and related cancers and the support survivors receive from their health care team for these concerns. Methods: Of 110 GC survivors enrolled in the Cancer Support Community’s online Cancer Experience Registry, 30 (43% stomach, 37% esophageal, 20% GIST) rated their level of concern (0 = not at all; 4 = very seriously) about psychological, emotional, physical and practical concerns (27 items). Risk for clinically significant distress was identified via a 4-item subscale (α = 0.86, cutoff score = 6.) Participants also completed the Impact of Events (IES) intrusion subscale and questions about their healthcare team’s involvement in addressing concerns. Results: Participant median age was 61 years; median time since diagnosis was 3 years. 23% experienced recurrence; 37% had metastatic disease.The highest ranked concerns (rated moderately to very seriously) included: eating and nutrition (62%); fatigue (62%); health insurance or money worries (59%); worry about the future (59%); feeling sad or depressed (50%); changes or disruptions to work, school, or home life (48%); sleep problems (48%); and worry about family (48%). Half of respondents (50%) were at risk for clinically significant emotional distress; 39% reported intrusive thoughts about the cost of cancer care. Fewer than half indicated their health care team asked about emotional distress (43%), lifestyle (43%), work (40%), finances (37%), or family (33%). Participants wished for more help with emotions related to cancer (57%), long-term side effects (55%), and financial advice/assistance (52%). Conclusions: Substantial proportions of gastric cancer survivors express concern about physical symptoms, emotional distress, and financial burden, yet many report they are not counseled about these concerns. Efforts are needed to reduce distress and the financial burden associated with gastric cancer to reduce their potential impact on quality of life, treatment adherence, and other illness outcomes.

Predictors of anxiety and depression risk among individuals with lung cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23136-e23136
Author(s):  
Kevin Stein ◽  
Shauna McManus ◽  
Pierre M. Gardan ◽  
Julie S. Olson ◽  
Melissa F. Miller ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Symptom Burden ◽  
Health Care Team ◽  
Care Team ◽  
Anxiety And Depression ◽  
Team Communication ◽  
Cancer Support ◽  
Depression Risk ◽  
Clinically Significant

e23136 Background: Lung cancer (LC) patients can face long-term symptom burden, quality of life concerns, and enduring distress. This study explored predictors of psychosocial distress among a community-based sample of LC survivors. Methods: 208 individuals with LC enrolled in Cancer Support Community’s Cancer Experience Registry, provided demographic/clinical background, and reported cancer-related distress using CancerSupportSource, a 25-item tool measuring level of concern ( 0-4) over 5 domains: emotional well-being (including 2-item depression and 2-item anxiety risk screening subscales), symptom burden and impact, body image and healthy lifestyle, health care team communication (HCTC), and relationships and intimacy. Using logistic regression, we estimate which domains influence anxiety and depression risk, controlling for significant demographic/clinical variables. Results: Participants were 68% female, 83% non-Hispanic White; mean ( SD) age = 61 (11) years; mean ( SD) years since diagnosis = 3.1 (4.5); 86% non-small cell lung cancer (NSCLC); 43% ever diagnosed as metastatic. 52% underwent surgery; 76% received chemotherapy, 65% radiation. 53% were at risk for clinically significant anxiety; 42% for clinically significant depression. Concerns about relationships and intimacy were associated with greater odds of anxiety risk ( OR= 1.70; p< .01); a positive interaction suggested that anxiety risk among individuals with NSCLC varied by HCTC concerns, with greater concerns being associated with higher risk ( p< .05). Concerns about symptom burden and impact ( OR= 1.21; p< .01) and HCTC ( OR= 1.57; p< .05) were significantly associated with greater odds of depression risk; these associations did not vary by LC type. Conclusions: Concerns around health care team communication, relationships and intimacy, and symptom burden and impact are important considerations in understanding risk for anxiety and depression among lung cancer patients and survivors. Additionally, type of lung cancer (NSCLC) can moderate the degree to which concerns about HCTC are associated with risk. Findings highlight the need for constructive patient-provider communication, particularly around relationships and intimacy and symptom burden. Clinical trial information: NCT02333604.

Perspectives and practices of oncology providers in addressing financial toxicity.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18342-e18342
Author(s):  
Meera Vimala Ragavan ◽  
Divya Ahuja Parikh ◽  
Manali I. Patel
Keyword(s):  
Cost Effectiveness ◽  
Financial Burden ◽  
Cost Of Care ◽  
Extensive Literature ◽  
Financial Toxicity ◽  
Clinical Practices ◽  
Oncology Providers ◽  
Attending Physicians ◽  
Out Of Pocket Costs ◽  
Available Resources

e18342 Background: Few studies have evaluated the perspectives and clinical practices of oncology providers in regards to assisting patients with financial toxicity. Our study sought to assess providers’ attitudes regarding their role in addressing patients’ financial concerns, understand practice patterns in discussing cost of care, and obtain feedback on potential interventions to help address existing barriers. Methods: We developed an 18-question electronic, anonymous survey informed by an extensive literature search and piloted with three physicians with health services research experience. We emailed the survey to 75 attending physicians in Medical Oncology, Hematology, and Radiation Oncology, 117 advance practice practitioners (APPs) and 46 trainees. Responses during the study period 12/12/2018-1/31/2019 were analyzed. Results: A total of 71 (response rate of 30%) participants completed the survey, including 31 attending physicians, 28 APPs, and 12 trainees. Sixty-two percent of participants agreed that oncology providers should openly discuss cost of care with patients. There was wide variation in opinion around whether providers should offer the same treatment recommendations to all patients regardless of cost, with one third stating they agreed, one third stating they disagreed, and one third stating they were neutral. Sixty-one percent of participants did not use any cost-effectiveness tools in decision making. Sixty-three percent of respondents stated that a gap in knowledge of out of pocket costs was the number one barrier to helping patients avoid financial toxicity. The highest ranked intervention of those listed was a guide on available resources for patients with financial needs, voted for by 70% of respondents. Conclusions: Providers identified many barriers at our institution to discussing cost of care, including lack of transparency of out of pocket costs and lack of awareness of available resources. Providers were overwhelmingly interested in incorporating institutional resources and cost-effectiveness tools into their clinical practices. These findings can inform provider-level interventions to better address the financial burden patients face with their cancer care.

Evaluating the early impact of adding a financial counselor to an Oncology Care Model pilot program.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 67-67
Author(s):  
Margaret Liang ◽  
Sarah S. Summerlin ◽  
Gabrielle Betty Rocque ◽  
Terri Salter ◽  
Mark Wiersma ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Financial Burden ◽  
Health Care Team ◽  
Care Team ◽  
Care Model ◽  
Annual Household Income ◽  
Financial Counseling ◽  
Insurance Benefit ◽  
Oncology Care ◽  
The Impact

67 Background: The Oncology Care Model (OCM) emphasizes the importance of patient costs. Our practice identified a need for patient financial counseling (Plan) and added a financial counselor to the care team (Do). Our objective is to describe the financial counseling process and evaluate (Study) the impact of adding a financial counselor to address financial burden among cancer patients. Methods: New treatment orders trigger a task to the financial counselor who mails a letter including personalized insurance benefit information (i.e., deductible, out of pocket maximum, amount met to date), estimated out of pocket cost for prescribed chemotherapy regimen, and additional financial resources. The health care team can also place referrals for identified needs. Data on patient characteristics, referral patterns, and services delivered was abstracted from the electronic medical record. Results: The financial counselor contacted 157 cancer patients from 4/2018-4/2019, including 134 (85%) OCM patients. The average age was 68 years old (range 22-91); 93 (59%) patients were female; 39 (25%) patients identified as black. Out of 32 patients with documented income, the average annual household income was $25,000. Most patients had Medicare Part D coverage (67/73, 92%) and secondary insurance (59/77, 77%). The financial counselor contacted patients by mail (52/77, 68%), phone (13/77, 17%), in-person at clinic (7/77, 9%), e-mail (1/77, 1%), or using multiple methods (4/77, 5%). Actions taken included mailing insurance benefit and estimated out of pocket cost letters (60/72, 83%), referring to social workers or lay navigators (5/72, 7%), or reviewing insurance benefits (4/72, 6%). Co-pay applications through foundation grants were submitted by the financial counselor for 27 patients of which most (23/27, 85%) were approved. Conclusions: Financial counselors provide diverse services to cancer patients to reduce financial burden, including to patients without secondary insurance who were noted to have additional financial needs. Patient satisfaction surveys and accounting for the dollar amount returned to patients and the health system represent next steps for our new program (Act).

scholarly journals Australian Experiences of Out-of-Pocket Costs and Financial Burden Following a Cancer Diagnosis: A Systematic Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2422
Author(s):  
Annie Bygrave ◽  
Kate Whittaker ◽  
Christine Paul ◽  
Elizabeth A. Fradgley ◽  
Megan Varlow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Low Income ◽  
Cancer Care ◽  
Financial Burden ◽  
Secondary Outcome ◽  
Cancer Type ◽  
Increased Risk ◽  
The Impact ◽  
Out Of Pocket Costs

(1) Background: This systematic review was conducted to identify cancer patient experiences, and the impact of out-of-pocket costs and financial burden in Australia. (2) Methods: A systematic review, following the Preferring Reporting Items for Systematic Reviews and Meta-Analyses, was conducted. Cumulative Index of Nursing and Allied Health Literature and PubMed were searched. The primary outcome was financial burden among cancer patients and their families in Australia. The secondary outcome was out-of-pocket costs associated with cancer care and treatment within the population sample, and the impact of financial burden. (3) Results: Nineteen studies were included, covering more than 70,000 Australians affected by cancer. Out-of-pocket costs varied by cancer type and ranged from an average of AUD 977 for breast cancer and lymphoedema patients to AUD 11,077 for prostate cancer patients. Younger aged patients (≤65 years), Aboriginal and Torres Strait Islander people, people in rural and/or remote areas, households with low income, those who were unemployed and people with private health insurance were at increased risk of experiencing out-of-pocket costs, financial burden or a combination of both. (4) Conclusions: Australians diagnosed with cancer frequently experience financial burden, and the health and financial consequences are significant. Focusing efforts on the costs of care and options about where to have care within the context of informed decisions about cancer care is necessary.

scholarly journals Integrated Clinical Pathways: Communication and Participation in a Multidisciplinary Team

2021 ◽  
Vol 9 (B) ◽  
pp. 1549-1555
Author(s):  
Mateja Šimec ◽  
Sabina Krsnik ◽  
Karmen Erjavec
Keyword(s):  
Health Care ◽  
Clinical Pathway ◽  
Multidisciplinary Team ◽  
Care Delivery ◽  
Clinical Pathways ◽  
Health Care Team ◽  
Cross Sectional Study ◽  
Cost Of Care ◽  
Cross Sectional ◽  
The Impact

BACKGROUND: An integrated clinical pathway (ICP) is a key method for structuring or planning processes of care, enabling the modernization of health-care delivery and coordination of multiple roles, forming a complete, patient-centered multidisciplinary health-care team and establishing the sequence of activities, promoting individual and team communication, collaboration, networking, and transparency, and reducing the cost of care. AIM: As there is a research gap in the area of communication among members of a multidisciplinary team for the treatment of patients through an ICP, the aim of this study was to determine the impact of communication of a member of a multidisciplinary team on the active participation of an individual in this multidisciplinary team. METHODS: A cross-sectional study of three ICPs, forchronic kidney disease, stroke, and total hip arthroplasty was conducted in a typical Slovenian general hospital. RESULTS: The results show that in the analyzed hospital, two of the three clinical pathways are not yet fully integrated. CONCLUSION: There is a weak influence of staff communication within a multidisciplinary team on an individual’s participation in this multidisciplinary team, indicating the need for various activities to actually implement clinical pathway “integration,” and promote better communication within teams to strengthen participation in multidisciplinary patient care pathways.

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