Background Cancer patients incur high care costs; however, there is a paucity of literature characterizing unmet financial obligations for patients with urologic cancers. Kidney cancer patients are particularly burdened by costs associated with novel systemic treatments. This study aimed to ascertain the characteristics of GoFundMe® crowdfunding campaigns for patients with kidney cancer, in order to better understand the financial needs of this population. Methods We performed a cross‐sectional, quantitative, and qualitative analysis of all kidney cancer GoFundMe® campaigns since 2010. Fundraising metrics such as goal funds and amount raised, were extracted. Eight independent investigators collected patient, disease and campaign‐level variables from campaign stories (κ = 0.72). In addition, we performed a content analysis of campaign narratives spotlighting the primary appeal of the patient's life story. Results A total of 486 GoFundMe® kidney cancer campaigns were reviewed. The median goal funds were 10,000USD [IQR = 5000, 20,000] and the median amount raised was 1450USD [IQR = 578, 4050]. Most campaigns were for adult males (53%) and 62% of adults had children. A minority were for pediatric patients (17%). Thirty‐seven percent of adult patients were primary wage earners and 43% reported losing their job or substantially reducing hours due to illness. Twenty‐nine percent reported no insurance or insufficient coverage. Campaigns most frequently sought funds for medical bills (60%), nonmedical bills (27%), and medical travel (23%). Qualitative campaign narratives mostly emphasized patients’ hardship (46.3%) or high moral character (35.2%). Only 8% of campaigns achieved their target funds. Conclusions Despite fundraising efforts, patients with kidney cancer face persistent financial barriers, incurring both medical and nonmedical cost burdens. This may be compounded by limited or no insurance. Cancer care providers should be aware of financial constraints placed on kidney cancer patients, and consider how these may impact treatment regimens.
Key Points Question What are the contemporary rates of serious surgical errors, and what are best practice changes to prevent further errors? Findings This cross-sectional study identified 142 serious surgical errors from 2007 to 2017 in California hospitals. Subsequent surgery was required in 96 cases (67.6%), although death was rare. Regulators suggested 18 distinct strategies to prevent repeated events. Meaning The findings suggest that surgical error remains a complex, rare issue in California driven by surgical volume; numerous strategies have evolved to prevent future events.
Introduction:We examined the characteristics and financial outcomes of online crowdfunding campaigns for patients with major urological cancers in the U.S.Methods: This cross-sectional study analyzed publicly available data from GoFundMe, the largest online medical crowdfunding service, via automated web scraping. Online campaigns from 2010 to 2018 with the following primary cancer types were included: kidney, prostate, bladder and testicular. Financial outcomes were compared using Kruskal-Wallis and Wilcoxon rank-sum tests. Multivariable analyses were utilized to identify predictors of campaign financial outcomes.Results: Kidney cancers were the most frequent online campaign type (478), followed by prostate (379), bladder (202) and testicular (175) malignancies. Urological cancer campaign recipients frequently requested funding for medical expenses (71%) during active treatment (57%). After adjustment, testicular cancer and children's cancer campaigns generated more donations than other urological and adult cancer campaigns (p <0.05). Family and friend-authored campaigns generated more donations and average donation amounts than self-authored campaigns (p <0.05). Campaign narratives focused on disheartening circumstances received fewer donations than narratives focused on the recipient's high moral character or contributions to society (p <0.05), and unclear narratives received the smallest donation amounts (p <0.05).Conclusions: Urological cancer crowdfunding in the U.S. is primarily used to finance uncovered costs associated with medical care during active treatment. Crowdfunding financial outcomes are likely related to the campaign recipient's age, malignancy type, social network and primary appeal of the narrative. Urologists should be aware of trends in medical crowdfunding in order to better understand the financial burden this patient population faces.
Background: Pubic hair grooming has been correlated with a selfreported history of sexually transmitted infections (STIs). We examined this relationship further in a cross-sectional survey of patients attending an urban STI clinic in San Francisco in 2018.Methods: Pubic hair grooming practices and detailed sexual histories were obtained. Sexually transmitted infections were confirmed via laboratory diagnosis or physical examination by a licensed provider.
Aim To analyse the most recent trends and characteristics of playground equipment‐related injuries in children. Methods We used the National Electronic Injury Surveillance System database to acquire cases of playground equipment‐related injuries in children ≤17 years old between 1995 and 2019. A total of 184 580 unweighted cases met our study inclusion criteria. Results A total of 5 356 703 (95% confidence interval 4 235 530–6 477 876) emergency department visits for playground‐related injuries in the USA were estimated during the study period which was equal to an average of 29.4 annual injuries per 10 000 US population ≤17 years. The mean age was 6.5 (standard error 0.049) years. School‐aged (42.7%) and pre‐school children (35.3%) accounted for most playground injuries. More than half of the injuries were reported in males (53.6%). Most injuries occurred with climbing apparatuses (36%), followed by swings (25.9%) and slides (20.9%). Overall number of injuries (∆ − 22.3%, P = 0.01) and incidence (∆ − 21.6%, P = 0.01) had a declining trend after 2012. However, reported concussion injuries showed an increasing trend during the study (∆ + 28.3%, P < 0.001). A marked seasonal variation in number of injuries existed with most injuries in May and September. Conclusions Although injuries arising from playground equipment have decreased during the past 8 years, there was an increase in number of reported concussions. The outcomes of this study suggested that further efforts should be directed towards such serious injuries.
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