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Racial variation in willingness to trade financial resources for life‐prolonging cancer treatment
Author(s) -
Martin Michelle Y.,
Pisu Maria,
Oster Robert A.,
Urmie Julie M.,
Schrag Deborah,
Huskamp Haiden A.,
Lee Jeannette,
Kiefe Catarina I.,
Fouad Mo.
Publication year - 2011
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25839
Subject(s) - medicine , psychosocial , cancer , odds ratio , quality of life (healthcare) , confidence interval , logistic regression , ethnic group , observational study , willingness to pay , gerontology , demography , nursing , psychiatry , sociology , anthropology , economics , microeconomics
BACKGROUND: Minority patients receive more aggressive care at the end of life, but it is unclear whether this trend is consistent with their preferences. We compared the willingness to use personal financial resources to extend life among white, black, Hispanic, and Asian cancer patients. METHODS: Patients with newly diagnosed lung or colorectal cancer participating in the Cancer Care Outcomes Research and Surveillance observational study were interviewed about myriad aspects of their care, including their willingness to expend personal financial resources to prolong life. We evaluated the association of race/ethnicity with preference for life‐extending treatment controlling for clinical, sociodemographic, and psychosocial factors using logistic regression. RESULTS: Among patients (N = 4214), 80% of blacks reported a willingness to spend all resources to extend life, versus 54% of whites, 69% of Hispanics, and 72% of Asians ( P <.001). In multivariate analyses, blacks were more likely to opt for expending all financial resources to extend life than whites (odds ratio, 2.41; 95% confidence interval, 1.84‐3.17; P < .001). CONCLUSIONS: Black cancer patients are more willing to exhaust personal financial resources to extend life. Delivering quality cancer care requires an understanding of how these preferences impact cancer care and outcomes. Cancer 2011;. © 2011 American Cancer Society.