Identifying Patients in Financial Need

Abstract

Some eligible patients with financial hardship may not be referred to assistance programs because cancer care providers do not know the full extent of patients' needs. This article describes barriers cancer care providers face in identifying patients who have financial concerns by using qualitative data from 21 interviews with providers from one Canadian province. Interviews were audio recorded, transcribed verbatim, and analyzed with a thematic approach. Four major themes emerged: no standardized approach existed for assessing needs, family members rather than patients may have better awareness of financial concerns, patients may not be forthcoming about financial concerns, and financial concerns may change over time. Adopting a standardized assessment protocol that routinely screens patients at multiple times during their care, educating patients about out-of-pocket costs, and educating providers to identify and assess financial need may enable more patients to access available financial resources. Although the Canadian and U.S. healthcare systems are different, concerns about out-of-pocket costs may be similar.

A Telephone Helpline Assessment of Psychosocial Needs of Adults with Cancer Post Institute of Medicine (IOM) Recommendations

“…The reason for the increase in calls during Period 2 for "helpline services information" in those ≥65 may be related to the focus on outreach to older adults with cancer as part of the larger study. The findings about the ongoing need for financial assistance, help with coping issues, and a need for additional information reflect those in other research reports published after the IOM report in 2007 and suggest that the IOM recommendations have not been fully implemented into cancer care [28]- [35]. When call categories were separated by the age of the person with cancer (i.e., patient) (<65 vs. ≥65) the percent of those seeking information about financial assistance was lower in the ≥65 group (Table 3).…”

“…Therefore, it was often not possible to match callers seeking financial assistance with stage of disease and age for this study. Mathews and Park suggested that people with cancer in financial need were not adequately screened by healthcare providers [35]. They cited a lack of a standardized approach to assessing the financial needs of people with cancer and reluctance of them to disclose financial concerns as barriers in indentifying patients with financial need.…”

Are survivors who report cancer‐related financial problems more likely to forgo or delay medical care?

“…Key challenges to identifying survivors in financial distress include a lack of standardized methods to assess need and the necessity of accounting for changing needs over time. 37 A recently proposed model of cancer rehabilitation that recognizes the need for comprehensive care, including attention to social and vocational needs, suggests that expanding survivorship care to include services that both promote self-management and encourage survivors to remain or return to the workforce has the potential to reduce overall cancer costs as well as costs to individual survivors 38 and should be considered as a way to reduce financial burden.…”

Cancer Support and Resource Needs Among African American Older Adults

“…Healthcare financing and delivery changes, particularly cost-cutting efforts on the part of insurers, may widen existing gaps in access to services for racial and ethnic minorities, greatly affecting those in rural areas with diminished access to health care (DiIorio et al, 2011; Mathews & Park, 2009). Patients have identified cancer costs as contributing to treatment barriers, increasing stress, and decreasing quality of life (Klimmek, Snow, & Wenzel, 2010; Wagner & Lacey, 2004).…”

“…Patients have identified cancer costs as contributing to treatment barriers, increasing stress, and decreasing quality of life (Klimmek, Snow, & Wenzel, 2010; Wagner & Lacey, 2004). The high cost of cancer treatment is borne by patients and caregivers (Chang et al, 2004; Mathews & Park, 2009) and may be a greater barrier to treatment for African Americans (Chu, Miller, & Springfield, 2007; Mosavel & Sanders, 2011) with significant societal consequences (Adler & Page, 2008). …”