Demographic Analysis of Financial Hardships Faced by Brain Tumor Survivors

Jella, Tarun K.; Cwalina, Thomas B.; Wright, Christina Huang; Wright, James

doi:10.1016/j.wneu.2021.10.124

Cited by 10 publications

(6 citation statements)

References 37 publications

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“…A Pearson χ 2 test with Rao and Scott adjustment was used to determine statistically significant differences in survey response rates. 55 All variables demonstrating a P -value of less than 0.2 in the initial bivariate analysis were selected for inclusion in a multivariable logistic regression model. The outcomes of interest were the concurrence of either moderate-to-severe mental illness or severe mental illness with self-reported financial barriers to any form of mental health services.…”

Section: Methodsmentioning

confidence: 99%

Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors

Jella

Cwalina

Vallier

2022

Journal of Orthopaedic Trauma

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Interview-based survey was conducted across representative sample of 30,000 US households.Patients/Participants: The study included 2,309 survey respondents reporting a fracture over the past 3 months, between 2004 and 2017.Intervention: Screening for financial barriers to mental health care.Main Outcome Measurements: Prevalence and factors associated with concurrent mental illness and financial barriers to mental health care based on sociodemographic and injury characteristics were the main outcome measurements. Results:Of the 2309 orthopaedic trauma survivors included in our analysis, 203 patients [7.8%, 95% confidence interval (CI): 6.4%-9.2%] were determined to experience severe mental illness, of whom 54 (25.3%, 95% CI: 18.0%-32.6%) and 86 (40.9%, 95% CI: 31.5%-50.2%) reported financial barriers to counseling and pharmacotherapy, respectively. Factors associated with concurrent severe mental illness and cost barriers to care were 45 to 64 years of age [adjusted odds ratios (AOR) 5.1, 95% CI: 1.7-15, P = 0.004], income below 200% of the Federal Poverty Threshold (AOR 2.5, 95% CI: 1.2-5.3, P = 0.012), and unemployment at the time of injury (AOR 3.9, 95% CI: 1.4-11, P = 0.009). Conclusions:Approximately one half of orthopaedic trauma survivors with severe mental illness face financial barriers to some form of mental health services. Younger, minority, and low socioeconomic status patients are most affected. These data suggest the presence of postdiagnosis disparities in mental health access that may be improved through direct provision and subsidization of integrated mental health support services for high-risk populations.

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Section: Methodsmentioning

confidence: 99%

Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors

Jella

Cwalina

Vallier

2022

Journal of Orthopaedic Trauma

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“…Using complex sampling design techniques such as stratification and clustering, the NHIS collects estimates of a wide range of health information for the civilian noninstitutionalized population of the United States. With over 600 unique questions included, the NHIS has been employed to analyze health concerns from a patient's perspective [12][13][14][15]. Since, 2013 the NHIS included financial stress questions about the following topics: "problems paying or unable to pay medical bills, past 12 months"; "worried about the medical costs of health care"; "worried about paying rent/mortgage/housing costs"; "worried about money for retirement".…”

Section: Methodsmentioning

confidence: 99%

Financial stress among skin cancer patients: a cross-sectional review of the 2013–2018 National Health Interview Survey

et al. 2022

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Financial stress among skin cancer patients may limit treatment efficacy by forcing the postponement of care or decreasing adherence to dermatologist recommendations. Limited information is available quantifying the anxiety experienced by skin cancer patients from both healthcare and non-healthcare factors. Therefore, the present study sought to perform a retrospective cross-sectional review of the 2013–2018 cycles of the National Health Interview Survey (NHIS) to determine the prevalence, at-risk groups, and predictive factors of skin cancer patient financial stress. Survey responses estimated that 11.45% (95% Cl 10.02–12.88%) of skin cancer patients experience problems paying medical bills, 20.34% (95% Cl 18.97–21.71%) of patients worry about the medical costs, 13.73% (95% Cl 12.55–14.91%) of patients worry about housing costs, and 37.48% (95% Cl 35.83–39.14%) of patients worry about money for retirement. Focusing on at-risk groups, black patients, uninsured patients, and patients with low incomes (< 200% poverty level) consistently experienced high rates of financial stress for each of the four measures. Multivariable logistic regression revealed low education, lack of insurance, and low income to be predictive of financial stress. These findings suggest that a considerable proportion of skin cancer patients experience financial stress related to both healthcare and non-healthcare factors. Where possible, the additional intricacy of treating patients at risk of high financial stress may be considered to optimize patient experience and outcomes.

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“…These and similar expenses may be difficult to cover for patients, as shown in a cross-sectional study by Desai et al. ( 42 ), who investigated the financial hardship of patients with brain tumors in the USA between 1997 and 2018. Over 10% of the respondents delayed or avoided medical care in the past year because of costs.…”

Section: Burdenmentioning

confidence: 99%

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

Pöhlmann,

Weller,

Marcellusi

et al. 2024

Front. Oncol.

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Gliomas are a group of heterogeneous tumors that account for substantial morbidity, mortality, and costs to patients and healthcare systems globally. Survival varies considerably by grade, histology, biomarkers, and genetic alterations such as IDH mutations and MGMT promoter methylation, and treatment, but is poor for some grades and histologies, with many patients with glioblastoma surviving less than a year from diagnosis. The present review provides an introduction to glioma, including its classification, epidemiology, economic and humanistic burden, as well as treatment options. Another focus is on treatment recommendations for IDH-mutant astrocytoma, IDH-mutant oligodendroglioma, and glioblastoma, which were synthesized from recent guidelines. While recommendations are nuanced and reflect the complexity of the disease, maximum safe resection is typically the first step in treatment, followed by radiotherapy and/or chemotherapy using temozolomide or procarbazine, lomustine, and vincristine. Immunotherapies and targeted therapies currently have only a limited role due to disappointing clinical trial results, including in recurrent glioblastoma, for which the nitrosourea lomustine remains the de facto standard of care. The lack of treatment options is compounded by frequently suboptimal clinical practice, in which patients do not receive adequate therapy after resection, including delayed, shortened, or discontinued radiotherapy and chemotherapy courses due to treatment side effects. These unmet needs will require significant efforts to address, including a continued search for novel treatment options, increased awareness of clinical guidelines, improved toxicity management for chemotherapy, and the generation of additional and more robust clinical and health economic evidence.

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Demographic Analysis of Financial Hardships Faced by Brain Tumor Survivors

Cited by 10 publications

References 37 publications

Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors

Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors

Financial stress among skin cancer patients: a cross-sectional review of the 2013–2018 National Health Interview Survey

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

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