Financial Hardship in Cancer Care—The Need to Define and Intervene on Actionable Metrics
Menée aux Etats-Unis par enquête auprès de 404 patients atteints d'un cancer (âge médian : 63 ans), cette étude transversale analyse l'association entre leurs difficultés financières et leurs capacités à trouver et à comprendre l'information sur l'assurance médicale
Financial hardship associated with cancer care in the US is complex in its definition and quantification and is even more complex in its mitigation. Elements of financial hardship include (1) material consequences of treatment, such as out-of-pocket expenses, debt, and decreased income; (2) psychological distress because of costs; and (3) deleterious coping mechanisms, such as delaying or skipping medications or care. Despite evolving definitions and imperfect measurement tools, we know that financial hardship from cancer treatment is a common adverse event for patients; the prevalence of financial hardship varies across sociodemographic groups, but adverse implications can be seen in at least half of patients. Financial burdens associated with cancer are associated with increased financial strain, decreased willingness to pay for care, and increased mortality. We have a growing understanding of populations who are most at risk for financial hardship: those who are underinsured or uninsured; those who are minoritized and/or made vulnerable by structural racism, geographic barriers to care, language differences, ageism, sexism, undocumented immigration status, and health literacy, among other means; and those who lack financial reserves. We ought to be beyond simply describing the problem; future research can and must be geared toward designing and testing interventions. (...)
JAMA Network Open , commentaire en libre accès, 2021