Association of Health Insurance Literacy With Financial Hardship in Patients With Cancer

Khera, Nandita; Zhang, Nan; Hilal, Talal; Durani, Urshila; Lee, Minji; Padman, Rema; Voleti, Sandeep S.; Warsame, Rahma; Borah, Bijan J.; Yabroff, K. Robin; Griffin, Joan M.

doi:10.1001/jamanetworkopen.2022.23141

Cited by 33 publications

(32 citation statements)

References 28 publications

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“…Studies assessing financial hardship have focused on White patients, with insufficient representation of racial and ethnic minority individuals. Khera et al 5 recognized this gap and designed their study to include patients from a second cancer center in an attempt to enroll a more racially and ethnically diverse sample. Minoritized groups may be more likely to have unmeasured or underappreciated cost-related barriers to care and disparities that stem from systemic and structural racism.…”

Section: + Related Articlementioning

confidence: 99%

“…Given the reality of the US health care system and clinicians' ongoing responsibility to mitigate the financial hardship in patients, the work by Khera et al 5 is important because the team evaluated targets that were potentially amenable to interventions. The study supports education-based interventions to improve financial literacy and empower patients.…”

Section: + Related Articlementioning

confidence: 99%

“…Given the reality of the US health care system and clinicians' ongoing responsibility to mitigate the financial hardship in patients, the work by Khera et al 5…”

mentioning

confidence: 99%

“…Work is under way (eg, SWOG CREDIT [A Randomized Trial Addressing Cancer-Related Financial Hardship Through Delivery of a Proactive Financial Navigation Intervention] study) to prospectively evaluate how financial navigation programs may reduce material financial hardship for households.As clinicians, we should not underestimate our ability to advocate for patients by supporting systems that mitigate financial toxicity, which decreases access to care and undermines outcomes for economically vulnerable people. The study by Khera et al5 highlighted several targets for decreasing financial hardship. It should now be our goal to start the hard work of translating clinical research into real patient benefits.…”

mentioning

confidence: 99%

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Financial Hardship in Cancer Care—The Need to Define and Intervene on Actionable Metrics

Dee

Chino

2022

JAMA Netw Open

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Section: + Related Articlementioning

confidence: 99%

Section: + Related Articlementioning

confidence: 99%

“…Given the reality of the US health care system and clinicians' ongoing responsibility to mitigate the financial hardship in patients, the work by Khera et al 5…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Financial Hardship in Cancer Care—The Need to Define and Intervene on Actionable Metrics

Dee

Chino

2022

JAMA Netw Open

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“…Therefore, it is important to improve patients' health insurance literacy as well as their financial literacy. 41 We can also inform patients about access to health care policies and financial assistance when follow-up. 3 The Connotation of Self-Management About Adjuvant Therapy in Breast Cancer Survivors…”

Section: Role Managementmentioning

confidence: 99%

Self-Management About Adjuvant Therapy in Breast Cancer Survivors: A Qualitative Study

Jia¹,

Hu²

2022

PPA

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Objective This study aims to describe the experience and connotations of self-management about adjuvant therapy (AT) in Chinese breast cancer survivors (BCS) and explore possible factors that affect their self-management level. Methods Semi-structured interviews were conducted in postoperative BCS undergoing AT using a qualitative description method. The conceptual structure and connotations were extracted after researchers collected and coded interview transcripts. Results After interviewing 29 patients, the conceptual framework of self-management in BCS during AT was optimized with three major themes: medical-related, emotion, and role management. Medical-related management includes AT-related adverse reactions; medical cooperation and knowledge acquisition; recovery and protection of affected limb; medical compliance; body image; sexual function and fertility; healthy lifestyle; catheter daily protection; and AT-related financial burdens. Emotion management includes recognition, prevention, and regulation of negative emotions. Role management consists of three aspects: family role, social role, and work role. Conclusion The conceptual structure and connotations formed in this study can help researchers to evaluate and intervene in the self-management ability of BCS during AT, so as to formulate the best model of care to improve their quality of life and clinical outcomes.

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Patient-Reported Financial Burden of Treatment for Colon or Rectal Cancer

Kircher,

Duan,

et al. 2024

JAMA Netw Open

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ImportanceThe longitudinal experience of patients is critical to the development of interventions to identify and reduce financial hardship.ObjectiveTo evaluate financial hardship over 12 months in patients with newly diagnosed colorectal cancer (CRC) undergoing curative-intent therapy.Design, Setting, and ParticipantsThis prospective, longitudinal cohort study was conducted between May 2018 and July 2020, with time points over 12 months. Participants included patients at National Cance Institute Community Oncology Research Program sites. Eligibility criteria included age at least 18 years, newly diagnosed stage I to III CRC, not started chemotherapy and/or radiation, treated with curative intent, and able to speak English. Data were analyzed from December 2022 through April 2023.Main Outcomes and MeasuresThe primary end point was financial hardship, measured using the Comprehensive Score for Financial Toxicity (COST), which assesses the psychological domain of financial hardship (range, 0-44; higher score indicates better financial well-being). Participants completed 30-minute surveys (online or paper) at baseline and 3, 6, and 12 months.ResultsA total of 450 participants (mean [SD] age, 61.0 [12.0] years; 240 [53.3%] male) completed the baseline survey; 33 participants (7.3%) were Black and 379 participants (84.2%) were White, and 14 participants (3.1%) identified as Hispanic or Latino and 424 participants (94.2%) identified as neither Hispanic nor Latino. There were 192 participants (42.7%) with an annual household income of $60 000 or greater. There was an improvement in financial hardship from diagnosis to 12 months of 0.3 (95% CI, 0.2 to 0.3) points per month (P &lt; .001). Patients with better quality of life and greater self-efficacy had less financial toxicity. Each 1-unit increase in Functional Assessment of Cancer Therapy–General (rapid version) score was associated with an increase of 0.7 (95% CI, 0.5 to 0.9) points in COST score (P &lt; .001); each 1-unit increase in self-efficacy associated with an increase of 0.6 (95% CI, 0.2 to 1.0) points in COST score (P = .006). Patients who lived in areas with lower neighborhood socioeconomic status had greater financial toxicity. Neighborhood deprivation index was associated with a decrease of 0.3 (95% CI, −0.5 to −0.1) points in COST score (P = .009).Conclusions and RelevanceThese findings suggest that interventions for financial toxicity in cancer care should focus on counseling to improve self-efficacy and mitigate financial worry and screening for these interventions should include patients at higher risk of financial burden.

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Association of Health Insurance Literacy With Financial Hardship in Patients With Cancer

Cited by 33 publications

References 28 publications

Financial Hardship in Cancer Care—The Need to Define and Intervene on Actionable Metrics

Financial Hardship in Cancer Care—The Need to Define and Intervene on Actionable Metrics

Self-Management About Adjuvant Therapy in Breast Cancer Survivors: A Qualitative Study

Patient-Reported Financial Burden of Treatment for Colon or Rectal Cancer

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