Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.
Abstract
Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients.Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking.Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT.Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.
참고문헌 (35)
- Hoang VM, "Household financial burden and poverty impacts of cancer treatment in Vietnam", Biomed Res Int, 2017, pp.9350147~ (2017)[DOI]
- ACTION Study Group, "Policy and priorities for national cancer control planning in low-and middle-income countries : lessons from the Association of Southeast Asian Nations(ASEAN)Costs in Oncology prospective cohort study", Eur J Cancer, 74, pp.26~37 (2017)[DOI]
- Ngan TT, "Financial toxicity due to breast cancer treatment in low-and middle-income countries : evidence from Vietnam", Support Care Cancer, 29(11), pp.6325~6333 (2021)[DOI]
- de Moor JS, "Cancer-related care costs and employment disruption : recommendations to reduce patient economic burden as part of cancer care delivery", J Natl Cancer Inst Monogr, 2022(59), pp.79~84 (2022)[DOI]
- Carrera PM, "The financial burden and distress of patients with cancer : understanding and stepping-up action on the financial toxicity of cancer treatment", CA Cancer J Clin, 68(2), pp.153~165 (2018)[DOI]
- Boby JM, "Financial toxicity in cancer care in India : a systematic review", Lancet Oncol, 22(12), pp.e541~e549 (2021)[DOI]
- Witte J, "Methods for measuring financial toxicity after cancer diagnosis and treatment : a systematic review and its implications", Ann Oncol, 30(7), pp.1061~1070 (2019)[DOI]
- Donkor A, "Financial toxicity of cancer care in low-and middle-income countries : a systematic review and meta-analysis", Support Care Cancer, 30(9), pp.7159~7190 (2022)[DOI]
- Xu B, "A systematic review of financial toxicity among cancer patients in China", Asia Pac J Oncol Nurs, 9(8), pp.100071~ (2022)[DOI]
- Liu M, "Financial toxicity of patients with lung cancer in China : results from a National Survey Study", Cancer Med, 12(4), pp.4751~4760 (2023)[DOI]
- Qiu Z, "Financial toxicity assessment and associated factors analysis of patients with cancer in China", Support Care Cancer, 31(5), pp.264~ (2023)[DOI]
- Eala MA, "Financial toxicities of cancer in low-and middle-income countries : perspectives from Southeast Asia", Cancer, 128(16), pp.3013~3015 (2022)[DOI]
- Chen J, "The health effects of cost-related treatment delays", Am J Med Qual, 26(4), pp.261~271 (2011)[DOI]
- Hueniken K, "Measuring financial toxicity incurred after treatment of head and neck cancer : development and validation of the Financial Index of Toxicity questionnaire", Cancer, 126(17), pp.4042~4050 (2020)[DOI]
- "Oncology centre introduction"[URL]
- "Introduction on Da Nang Oncology Hospital"[URL]
- de Souza JA, "The development of a financial toxicity patient-reported outcome in cancer : the COST measure", Cancer, 120(20), pp.3245~3253 (2014)[DOI]
- de Souza JA, "Measuring financial toxicity as a clinically relevant patient-reported outcome : the validation of the COmprehensive Score for financial Toxicity(COST)", Cancer, 123(3), pp.476~484 (2017)[DOI]
- Cronbach LJ, "Coefficient alpha and the internal structure of tests", Psychometrika, 16(3), pp.297~334 (1951)[DOI]
- Smith GL, "Financial burdens of cancer treatment : a systematic review of risk factors and outcomes", J Natl Compr Canc Netw, 17(10), pp.1184~1192 (2019)[DOI]
- Wang S, "Assessment of the prevalence and related factors of financial toxicity in cancer patients based on the COST scale : a systematic review and meta-analysis", Eur J Oncol Nurs, 68, pp.102489~ (2024)[DOI]
- Xu B, "Financial toxicity and its risk factors among patients with cancer in China : a nationwide multisite study", Asia Pac J Oncol Nurs, 11(5), pp.100443~ (2024)[DOI]
- Nikte V, "Financial toxicity and its implication on quality of life in patients attending the palliative care department in a regional cancer centre : an observational study", J Cancer Policy, 39, pp.100460~ (2024)[DOI]
- Ng MS, "Identifying a cut-off score for the COST measure to indicate high financial toxicity and low quality of life among cancer patients", Support Care Cancer, 29(10), pp.6109~6117 (2021)[DOI]
- ACTION Study Group, "Financial catastrophe, treatment discontinuation and death associated with surgically operable cancer in South-East Asia : results from the ACTION Study", Surgery, 157(6), pp.971~982 (2015)[DOI]
- Susilowati M, "The socio-demographic factors correlated with financial toxicity among patients with breast cancer in Indonesia", J Public Health Res, 10(s1) (2021)[DOI]
- Lee HY, "Use of high-level health facilities and catastrophic expenditure in Vietnam : can health insurance moderate this relationship?", BMC Health Serv Res, 19(1), pp.318~ (2019)[DOI]
- Kong YC, "Out-of-pocket payments for complementary medicine following cancer and the effect on financial outcomes in middle-income countries in southeast Asia : a prospective cohort study", Lancet Glob Health, 10(3), pp.e416~e428 (2022)[DOI]
- Tran BT, "Measurement of health-related quality of life among colorectal cancer patients using the Vietnamese value set of the EQ-5D-5L", Patient Prefer Adherence, 14, pp.2427~2437 (2020)[DOI]
- Tran BT, "The direct and indirect costs of colorectal cancer in Vietnam : an economic analysis from a social perspective", Int J Environ Res Public Health, 18(1), pp.12~ (2020)[DOI]
- Joyce DD, "Coping mechanisms for financial toxicity among patients with metastatic prostate cancer : a survey-based assessment", J Urol, 210(2), pp.290~298 (2023)[DOI]
- Zheng Z, "Do cancer survivors change their prescription drug use for financial reasons? Findings from a nationally representative sample in the United States", Cancer, 123(8), pp.1453~1463 (2017)[DOI]
- Itani Y, "Cancer treatment-related financial toxicity in Japan : a scoping review", Front Psychol, 14, pp.1205016~ (2023)[DOI]
- Giang NH, "Is health insurance associated with health service utilization and economic burden of non-communicable diseases on households in Vietnam?", Health Syst Reform, 6(1), pp.1~15 (2020)[DOI]
- Shah K, "Role of financial toxicity in perpetuating health disparities", Trends Cancer, 8(4), pp.266~268 (2022)[DOI]