Perspectives on Conversations About Costs of Cancer Care of Breast Cancer Survivors and Cancer Center Staff

Pisu, Maria; Schoenberger, Yu-Mei; Herbey, Ivan; Brown-Galvan, Aquila; Liang, Margaret; Riggs, Kevin R.; Meneses, Karen

doi:10.7326/m18-2117

Cited by 23 publications

(36 citation statements)

References 30 publications

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“…Cost-saving strategies were rarely addressed with patients in any study arm (8.1% of encounters), despite evidence that patients want both reassurance as well as resources to help offset costs. 34 It is possible that patients met with social workers or were provided resources before some surgeon consultations, although this is unlikely since many patients did not have a diagnosis prior to the recorded consultation. We did not systematically ask about whether social workers or navigators are routine members of the care team.…”

Section: Discussionmentioning

confidence: 99%

Encounter Decision Aids Can Prompt Breast Cancer Surgery Cost Discussions: Analysis of Recorded Consultations

et al. 2019

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Background. Patients frequently worry about care costs, but clinicians seldom address the topic. Cost information is not typically included in patient decision aids (DAs). We examined whether including cost information in an encounter DA, with clinician training, influenced cost conversations. Method. As part of a larger trial, 14 surgeons from 4 cancer centers were randomized to 1 of 3 interventions: (1) Picture Option Grid DA that included a prompt to discuss relative treatment costs, hereafter called “cost prompt group”; (2) a text-only Option Grid DA that did not include cost information; (3) usual care. Groups 2 and 3 hereafter are referred to as “non-cost prompt groups.” Adult (18+) female patients, with stages I-IIIA breast cancer, eligible for both breast-conserving surgery and mastectomy were included. We gave surgeons feedback about adherence to the study protocol at 3, 6, and 12-months. We adapted a checklist to code the content of the audio-recorded clinical encounters. Results. 424/622 (68%) patients consented; 311 (73%) were eligible and successfully recorded (143 in the cost prompt group, 168 in the non-cost prompt groups). Costs were discussed in 132/311 (42.4%) encounters, and occurred more often in the cost prompt versus non-cost prompt groups (66.7% versus 33.3%; p<.001). Surgeons initiated the cost discussion in 86.4% of encounters in the cost prompt group vs. 34.1% in the non-cost prompt groups (p<0.001). In the non-cost prompt groups, insurance or employment questions led patients to ask about costs. Cost discussions lasted about 34 seconds when present and had sparse comparative details. Conclusions. Encounter DAs containing cost information trigger cost discussions. Additional support should help clinicians improve the quality of cost discussions and address financial distress.

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Section: Discussionmentioning

confidence: 99%

Encounter Decision Aids Can Prompt Breast Cancer Surgery Cost Discussions: Analysis of Recorded Consultations

et al. 2019

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“…79 Common cost concerns raised by patients with cancer across studies include clinician's lack of time to attend to insurance eligibility/coverage, worries that costs may affect a clinician's decisionmaking and the patient-clinician relationship, and the cost of specific tests and visits. [80][81][82] Many of these are concerns common to AYA patients with cancer, who can feel lost in an unfamiliar health care system, and are complicated by AYA patients' insurance coverage.…”

Section: Financial Toxicity: An Unaddressed Side Effect For Ayas Withmentioning

confidence: 99%

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Perez

Salsman

Fladeboe

et al. 2020

American Society of Clinical Oncology Educational Book

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Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Greater attention is needed to address AYA-specific concerns on reproductive and sexual health, financial security and independence, emotional well-being, social support, and end-of-life care. If these unique needs are unaddressed, this can adversely affect AYAs’ health care engagement and overall quality of life, increasing their risk for cancer-related morbidity and early mortality. In particular, health care decisions made during treatment have important implications for AYA patients’ future health. Oncology clinicians are well positioned to address AYA patients’ concerns by anticipating and addressing the challenges this age group is likely to face. In this paper, we explore several core topics that affect AYAs’ quality of life and that can be challenging to address. Starting from the moment of diagnosis, through cancer treatment and post-treatment survivorship, and into end of life, each section highlights critical developmental-centric life domains that are affected by the cancer experience. Specifically, we discuss resources, tools, and strategies to navigate these challenging conversations. Taking a risk-reduction approach that invites two-way communication and facilitates referral to age-appropriate resources would help destigmatize these experiences and, in turn, would support the provision of compassionate and effective age-concordant care to this vulnerable group.

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“…Dari 945 perempuan menghawatirkan tentang keuangan, 679 (72,8%) menunjukan bahwa dokter dan staf tidak membantu, dari 523 perempuan membicarakan dampak kanker payudara pada pekerjaan atau keuangan, 283 (55,4%) melaporkan tidak ada diskusi yang relevan antar tenaga kesehatan. 10,11 Submited:30/07/20 Pada pasien yang tidak memiliki asuransi kesehatan dapat membuat pasien memgeluarkan banyak biaya selama perawatan medis yang dijalani, sehingga menimbulkan masalah keuangan dan menyebabkan pasien berhutang dan mengalami kebangkrutan, hal ini terjadi sebagai akibat dari beban keuangan yang dialami. Sehingga membuat pasien kanker menunda perawatan atau pergi tanpa perawatan kanker.…”

Section: Metodeunclassified

“…Hasil dari penelitian tersebut menyebutkan sebesar 22% melaporkan mengalami dampak keuangan, orang-orang yang tidak bekerja memiliki resiko finansial toksisitas yang lebih besar (27% vs 16%, P,0,001). 9,[11][12][13][14][15][16] Perawatan dan pengobatan kanker mengalami perubahan dengan cepat dalam kurun waktu dua dekade terakhir. Hasil menyebutkan diperkirakan mengalami peningkatan dari $96.899 pada tahun 2004 menjadi $ 104.688 pada tahun 2011 ($ 1197 peningkatan per tahun [$47,$2348]).…”

unclassified

Dampak Financial Toxicity Pada penyintas Kanker

Susilowat

Afiyanti

2020

JIIKI

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Pendahuluan : Kanker merupakan salah satu penyakit yang memerlukan biaya medis yang cukup tinggi dalam perawatan dan pengobatannya sehingga dapat menyebabkan peningkatan tekanan psikososial, menurunnya kualitas dan kuantitas hidup bagi pasien kanker dan keluarga. Tujuan: systematic review untuk mengidentifikasi dampak dari diagnosis kanker pada penyintas kanker yang berkaitan dengan financial toxicity. Metode : Pencarian database yang digunakan yaitu ScienceDirect, EBSCO host, ProQuest, dan SpringerLink yang diidentifikasi dan dipublikasi dari tahun 2015-2020. Hasil : pencarian didapatkan 1.665 artikel, tetapi hanya sepuluh artikel yang memenuhi kriteria inklusi. Hasil analisis sepuluh artikel didapatkan bahwa pengobatan kanker berdampak pa-da situasi keuangan penderita kanker Kesimpulan : Penerapan intervensi pada multidisiplin dapat bekerja secara efektif , sebagai bagian dari perawatan kanker standar, sehingga dapat mengurangi dampak dari financial toxicity di antara penyintas kanker.

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Perspectives on Conversations About Costs of Cancer Care of Breast Cancer Survivors and Cancer Center Staff

Cited by 23 publications

References 30 publications

Encounter Decision Aids Can Prompt Breast Cancer Surgery Cost Discussions: Analysis of Recorded Consultations

Encounter Decision Aids Can Prompt Breast Cancer Surgery Cost Discussions: Analysis of Recorded Consultations

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Dampak Financial Toxicity Pada penyintas Kanker

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