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Financial burden among US households affected by cancer at the end of life
Author(s) -
Cagle John G.,
Carr Dawn C.,
Hong Seokho,
Zimmerman Sheryl
Publication year - 2016
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.3933
Subject(s) - finance , business , economics
Objective Economic burden on families coping with end‐stage cancer remains poorly understood. Advanced malignancy threatens financial stability of families, and interventions are needed to buffer them from impoverishment. This study examined the relationship between subjective and objective assessments of financial burden on families (financial strain and stress, respectively) and identified potentially modifiable factors to inform intervention efforts. Methods Using national survey data, we analyzed responses from households that had recently experienced a cancer death; 176 of households provided information on financial strain, and 158 provided data on financial stress. In addition to self‐reported appraisals of financial burden, measures assessed elements of the cancer care experience, treatment, symptom burden, work impact, insurance coverage, and demographics. Results Despite being well insured, approximately a quarter of respondents reported that the cost of care was a major financial burden, and a third used all or most of their savings. Financial strain and stress were moderately positively correlated ( r = 0.46, p < 0.01). Higher financial stress scores were negatively correlated with decedent's age at death ( r = −0.34, p < 0.01), and minority respondents (‘other’ race) reported much higher financial stress ( M = 4.7; SD = 3.2) than White ( M = 0.8; SD = 1.4) or Black ( M = 1.6; SD = 2.2) respondents ( p < 0.001). Financial burden was also associated with no or limited insurance coverage, changes in employment, severe pain and nausea, and provider interactions during the cancer care experience (e.g., whether the MD paid attention to non‐medical factors or having unanswered questions about medications) ( p < 0.05 for all). Conclusions The cancer care experience, symptoms, and work impact were associated with financial burden and have important implications for research and practice. Copyright © 2015 John Wiley & Sons, Ltd.