scholarly journals Household Financial Burden and Poverty Impacts of Cancer Treatment in Vietnam

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Van Minh Hoang ◽  
Cam Phuong Pham ◽  
Quynh Mai Vu ◽  
Thuy Trang Ngo ◽  
Dinh Ha Tran ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Older Patients ◽  
Financial Burden ◽  
National Income ◽  
Indirect Costs ◽  
Vulnerable Groups ◽  
Catastrophic Expenditure ◽  
Direct And Indirect Costs ◽  
Individual Interviews ◽  
Multiple Treatments

Purpose. This paper aims to analyze the household financial burden and poverty impacts of cancer treatment in Vietnam. Methods. Under the “ASEAN CosTs in ONcology” study design, three major specialized cancer hospitals were employed to assemble the Vietnamese data. Factors of socioeconomic, direct, and indirect costs of healthcare were collected prospectively through both individual interviews and hospital financial records. Results. The rates of catastrophic expenditure based on the cut-off points of 20%, 30%, 40%, and 50% of household’s income were 82.6%, 73.7%, 64.7%, and 56.9%, respectively. 37.4% of the households with patient were impoverished by the treatment costs for cancer. The statistically significant correlates of the impoverishment problem were higher among older patients (40–60 years: 1.77, 95% CI 1.14–2.73; above 60 years: 1.75, 95% CI 1.03–2.98); poorer patients (less than 100% national income: 29, 95% CI 18.6–45.24; less than 200% national income: 2.89, 95% CI 1.69–4.93); patients who underwent surgery alone (receiving nonsurgery treatment: 2.46, 95% CI 1.32–4.59; receiving multiple treatments: 2.4, 95% CI 1.38–4.17). Conclusions. Lots of households were pushed into poverty due to their expenditure on cancer care; more actions are urgently needed to improve financial protection to the vulnerable groups.

Financial Toxicity in Cancer Treatment

2021 ◽  
pp. 616-620
Author(s):  
Victoria Blinder ◽  
Francesca M. Gany
Keyword(s):  
Cancer Treatment ◽  
Emotional Distress ◽  
Low Income ◽  
Financial Distress ◽  
Financial Burden ◽  
Symptom Burden ◽  
Indirect Costs ◽  
Young Female ◽  
Vulnerable Groups ◽  
Financial Toxicity

Financial toxicity is a preventable cancer treatment side effect, encompassing the subjective financial distress and objective financial burden that result from increased spending and decreased earning after diagnosis. The prevalence of financial toxicity has increased with new expensive cancer treatments and insurers gradually shifting costs to patients. Patients with financial toxicity experience increased symptom burden, treatment nonadherence, and cancer-related death. The patients at highest risk are young, female, and nonwhite. For low-income patients, the indirect costs of cancer care can be especially burdensome and include child/elder care, transportation, unpaid work absences or job loss, cancer-related comorbidity treatment costs, and fulfilling dietary requirements. Psychosocial impacts include depression, emotional distress, and reduced quality of life. Patients in palliative care have rated financial distress as more severe than physical, familial, and emotional distress. Interventions and policy changes are needed to ameliorate the effects of financial toxicity, especially for the most vulnerable groups.

Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs

Lupus ◽  
2016 ◽  
Vol 26 (7) ◽  
pp. 756-761 ◽  
Author(s):  
A P Anandarajah ◽  
M Luc ◽  
C T Ritchlin
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Erythematosus ◽  
Annual Cost ◽  
Financial Analysis ◽  
Financial Burden ◽  
Indirect Costs ◽  
Memorial Hospital ◽  
Systemic Lupus ◽  
Direct And Indirect Costs

Objectives The objective of this study was to calculate the direct and indirect costs of admission for systemic lupus erythematosus (SLE) patients, identify the population at risk and investigate potential reasons for admission. Methods We conducted a financial analysis of all admissions for SLE to Strong Memorial Hospital between 1 July 2013 and 30 June 2015. Patient and financial records for admissions with a SLE diagnosis for the above period were retrieved. The total cost of admissions was used as a measure of direct costs and the length of stay used to assess indirect costs. Additionally, we analyzed the demographics of the hospitalized population. Results The average, annual cost of confirmed admissions to Strong Memorial Hospital for SLE was US$3.9–6.4 m. The mean annual cost per patient for hospitalization was US$51,808.41. The length of stay for all SLE patients was 1564–2507 days with an average of 8.5 days per admission. The majority of patients admitted were young women from the city of Rochester. Infections were the most common reason for admissions. Conclusion We demonstrated that admissions are a source of high direct and indirect costs to the hospital and a significant financial burden to the patient. Implementing measures to improve the quality of care for SLE patients will help decrease the morbidity and lower the economic costs to hospitals.

scholarly journals What is the financial burden to patients of accessing surgical care in Sierra Leone? A cross-sectional survey of catastrophic and impoverishing expenditure

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e039049
Author(s):  
Manraj Phull ◽  
Caris E Grimes ◽  
Thaim B Kamara ◽  
Haja Wurie ◽  
Andy J M Leather ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Financial Burden ◽  
Surgical Care ◽  
Indirect Costs ◽  
Poverty Line ◽  
Household Expenditure ◽  
Tertiary Level ◽  
Catastrophic Expenditure ◽  
Cross Sectional Survey ◽  
Cross Sectional

ObjectivesTo measure the financial burden associated with accessing surgical care in Sierra Leone.DesignA cross-sectional survey conducted with patients at the time of discharge from tertiary-level care. This captured demographics, yearly household expenditure, direct medical, direct non-medical and indirect costs for surgical care, and summary household assets. Missing data were imputed.SettingThe main tertiary-level hospital in Freetown, Sierra Leone.Participants335 surgical patients under the care of the hospital surgical team receiving operative or non-operative surgical care on the surgical wards.Outcome measuresRates of catastrophic expenditure (a cost >10% of annual expenditure), impoverishment (being pushed into, or further into, poverty as a result of surgical care costs), amount of out-of-pocket (OOP) costs and means used to meet these costs were derived.ResultsOf 335 patients interviewed, 39% were female and 80% were urban dwellers. Median yearly household expenditure was US$3569. Mean OOP costs were US$243, of which a mean of US$24 (10%) was spent prehospital. Of costs incurred during the hospital admission, direct medical costs were US$138 (63%) and US$34 (16%) were direct non-medical costs. US$46 (21%) were indirect costs. Catastrophic expenditure affected 18% of those interviewed. Concerning impoverishment, 45% of patients were already below the national poverty line prior to admission, and 9% of those who were not were pushed below the poverty line following payment for surgical care. 84% of patients used household savings to meet OOP costs. Only 2% (six patients) had health insurance.ConclusionObtaining surgical care has substantial economic impacts on households that pushes them into poverty or further into poverty. The much-needed scaling up of surgical care needs to be accompanied by financial risk protection.

scholarly journals Economic burden of migraine in Latvia and Lithuania: direct and indirect costs

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ágnes Lublóy
Keyword(s):  
Health Care ◽  
Resource Utilization ◽  
Financial Burden ◽  
Productivity Loss ◽  
Indirect Costs ◽  
Direct Costs ◽  
Health Care Resource ◽  
Total Cost ◽  
Direct And Indirect Costs ◽  
Health Care Resource Utilization

Abstract Background Migraine is a primary headache disorder which affects all aspects of life. The financial burden of migraine imposed on the society might be substantial. This study aims at estimating the economic cost of migraine in Latvia and Lithuania, including both direct and indirect costs. Direct costs encompass the costs of migraine-related health care resource utilization. Indirect costs are related to productivity loss, the potential or expected earnings lost due to migraine. Methods Direct cost is assessed by using the prevalence method, a widely used cost-of-illness approach. The prevalence rate of migraine and the migraine-related health care resource utilization are proxied from the literature, whereas unit cost of medical services and procedures are retrieved from national databases and providers. For estimating the indirect cost of migraine, we follow the human capital approach. We quantify three components of indirect costs: reduced labour force participation, absence from work and reduced productivity while at work. The number of unemployed migraineurs, days missed from work and days lost due to impairment while at work are drawn from the literature. Unemployment rate and average income in Latvia and Lithuania are then inserted to assess indirect costs. Results We find that the mean per-person total cost of migraine is €801 annually in Latvia, and €721 in Lithuania. In both countries around 30% of total cost is direct cost; cost related to a wide array of migraine-related medical services and interventions. The total cost of migraine is €112.26 million in Latvia, corresponding to 0.42% of Latvia’s GDP. The total cost of migraine is €149.62 million in Lithuania, corresponding to 0.35% of Lithuania’s GDP. In both countries two thirds of total cost is related to lost workdays due to absenteeism and presenteeism. Conclusions The financial burden of migraine imposed on the society is substantial in Latvia and Lithuania. Improvements in care for patients with migraine, such as easier access to structured headache assessment services, wider availability of various procedures and preventive medications would significantly increase direct costs. Nevertheless, this cost increase might be far outweighed by lower migraine-related productivity loss, especially as the prevalence of migraine is the highest in the most productive years of life.

scholarly journals Patient and family financial burden associated with cancer treatment in Canada: a national study

2021 ◽  
Author(s):  
Christopher J. Longo ◽  
Margaret I. Fitch ◽  
Jonathan M. Loree ◽  
Linda E. Carlson ◽  
Donna Turner ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Financial Burden ◽  
Family Care ◽  
Indirect Costs ◽  
National Study ◽  
Patients With Cancer ◽  
Alternative Medicines ◽  
Patient Reported ◽  
Household Incomes ◽  
Self Administered Questionnaire

Abstract Goal To determine patient-reported financial and family burden associated with treatment of cancer in the previous 28 days across Canada. Methods A self-administered questionnaire (P-SAFE v7.2.4) was completed by 901 patients with cancer from twenty cancer centres nationally (344 breast, 183 colorectal, 158 lung, 216 prostate) measuring direct and indirect costs related to cancer treatment and foregone care. Monthly self-reported out-of-pocket-costs (OOPCs) included drugs, homecare, homemaking, complementary/ alternative medicines, vitamins/supplements, family care, accommodations, devices, and “other” costs. Travel and parking costs were captured separately. Patients indicated if OOPC, travel, parking, and lost income were a financial burden. Results Mean 28-day OOPCs were CA$518 (US Purchase Price Parity [PPP] $416), plus CA$179 (US PPP $144) for travel and CA$84 (US PPP $67) for parking. Patients self-reporting high financial burden had total OOPCs (33%), of CA$961 (US PPP $772), while low-burden participants (66%) had OOPCs of CA$300 (US PPP $241). “Worst burden” respondents spent a mean of 50.7% of their monthly income on OOPCs (median 20.8%). Among the 29.4% who took time off work, patients averaged 18.0 days off. Among the 26.0% of patients whose caregivers took time off work, caregivers averaged 11.5 days off. Lastly, 41% of all patients had to reduce spending. Fifty-two per cent of those who reduced spending were families earning < CA$50,000/year. Conclusions In our Canadian sample, high levels of financial burden exist for 33% of patients, and the severity of burden is higher for those with lower household incomes.

scholarly journals Burden of Treatment Among Elderly Patients with Cancer: A Scoping Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 612
Author(s):  
Adem Sav ◽  
Sara S. McMillan ◽  
Adeola Akosile
Keyword(s):  
Elderly Patients ◽  
Cancer Treatment ◽  
Scoping Review ◽  
Financial Burden ◽  
Significant Proportion ◽  
Indirect Costs ◽  
The United States ◽  
Treatment Burden ◽  
Cross Sectional ◽  
Patients With Cancer

Background: The objective of this scoping review is to understand how treatment burden is experienced in elderly patients with cancer and what the most prevalent dimensions of treatment burden are among this population. According to one conceptual model, there are six dimensions of treatment burden, including financial, medication, administrative, time/travel, lifestyle, and healthcare. Methods: A scoping review methodology framework was used to collected data from EMBASE CINAHL (Cumulative Index to Nursing and Allied Health Literature), Medline/PubMed, Scopus, Web of Science, Embase, and Cochrane from 2000 to March 2020. Studies which focused on treatment burden among elderly patients with cancer (+65 years) were selected. Data were extracted using a standardized proforma. Results: The results identified 3319 total papers. Of these, 24 met the inclusion criteria and were included in the scoping review. A significant proportion of these studies was conducted in the United States (n = 10) using self-reported, cross-sectional data. Financial burden was the most prevalent dimension of treatment burden, with 11 studies focusing on the direct and indirect costs associated with cancer treatment. Other but less obvious aspects of treatment burden elderly patients experienced included the length of time taken to access and administer treatment and medication-related burdens. Conclusion: Emerging findings suggest that the financial aspects of cancer treatment are a significant burden for most elderly cancer patients. Personalized healthcare interventions targeting ways to reduce and screen for treatment burden, particularly those related to cost, are urgently needed.

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