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Erschienen in: Supportive Care in Cancer 4/2018

06.11.2017 | Original Article

Objective and subjective financial burden and its associations with health-related quality of life among lung cancer patients

verfasst von: Jieling Elaine Chen, Vivian Weiqun Lou, Hong Jian, Zhen Zhou, Meiqiong Yan, Jingfen Zhu, Guohong Li, Yaping He

Erschienen in: Supportive Care in Cancer | Ausgabe 4/2018

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Abstract

Purpose

The purpose of this study is to examine the effect of financial burden, using objective and subjective indicators, on the health-related quality of life (HRQOL) in lung cancer patients.

Method

A total of 227 patients diagnosed with lung cancer (from the inpatient unit of the department of internal medicine-chest oncology, in Shanghai Chest Hospital, China) participated in the study. Financial information was measured by direct medical costs, direct nonmedical costs, healthcare-cost-to-income ratio, and perceived financial difficulty. HRQOL was measured using the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale.

Findings

Catastrophic health spending, defined as a healthcare-cost-to-income ratio of more than 40%, was reported in 72.7% of the participants, whereas 37.0% reported that healthcare costs exceeded annual household income. Financial difficulty was perceived in 83.7% of the participants. Patients whose healthcare costs exceeded their annual household income and who perceived financial difficulty reported a clinically meaningful difference in overall HRQOL (> 6 points on the FACT-L) compared with participants without catastrophic health spending or perceived financial difficulty. Healthcare costs did not show a significant effect on HRQOL.

Conclusion

Healthcare costs exceeding total annual household income and perceived financial difficulty are associated with poorer HRQOL in lung cancer patients. Subjective indicator of financial burden has a stronger effect on quality of life than objective indicators.

Implication

Health-cost-to-income ratio and perceived financial difficulty can be implied as objective and subjective indicators of financial burden to identify the patients who may need additional assistance. Communication on deciding on cost-effective treatments can be facilitated.
Literatur
1.
Zurück zum Zitat Chen WQ, Zheng RS, Baade PD et al (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66(2):115–132CrossRefPubMed Chen WQ, Zheng RS, Baade PD et al (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66(2):115–132CrossRefPubMed
2.
Zurück zum Zitat van der Linden N, Bongers ML, Coupe VMH et al (2016) Costs of non-small cell lung cancer in the Netherlands. Lung Cancer 91:79–88CrossRefPubMed van der Linden N, Bongers ML, Coupe VMH et al (2016) Costs of non-small cell lung cancer in the Netherlands. Lung Cancer 91:79–88CrossRefPubMed
3.
Zurück zum Zitat Zeng XH, Kamon J, Wang SY et al (2012) The cost of treating advanced non-small cell lung cancer: estimates from the Chinese experience. PLoS One 7(10):e48323CrossRefPubMedPubMedCentral Zeng XH, Kamon J, Wang SY et al (2012) The cost of treating advanced non-small cell lung cancer: estimates from the Chinese experience. PLoS One 7(10):e48323CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Polanski J, Jankowska-Polanska B, Rosinczuk J et al (2016) Quality of life of patients with lung cancer. Onco Targets Ther 9:1023–1028PubMedPubMedCentral Polanski J, Jankowska-Polanska B, Rosinczuk J et al (2016) Quality of life of patients with lung cancer. Onco Targets Ther 9:1023–1028PubMedPubMedCentral
5.
Zurück zum Zitat Zarogoulidou V, Panagopoulou E, Papakosta D et al (2015) Estimating the direct and indirect costs of lung cancer: a prospective analysis in a Greek University Pulmonary Department. J Thorac Dis 7:S12–S19PubMedPubMedCentral Zarogoulidou V, Panagopoulou E, Papakosta D et al (2015) Estimating the direct and indirect costs of lung cancer: a prospective analysis in a Greek University Pulmonary Department. J Thorac Dis 7:S12–S19PubMedPubMedCentral
6.
Zurück zum Zitat Gupta D, Lis CG, Grutsch JF (2007) Perceived cancer-related financial difficulty: implications for patient satisfaction with quality of life in advanced cancer. Support Care Cancer 15(9):1051–1056CrossRefPubMed Gupta D, Lis CG, Grutsch JF (2007) Perceived cancer-related financial difficulty: implications for patient satisfaction with quality of life in advanced cancer. Support Care Cancer 15(9):1051–1056CrossRefPubMed
7.
Zurück zum Zitat Delgado-Guay M, Ferrer J, Rieber AG et al (2015) Financial distress and its associations with physical and emotional symptoms and quality of life among advanced cancer patients. Oncologist 20(9):1092–1098CrossRefPubMedPubMedCentral Delgado-Guay M, Ferrer J, Rieber AG et al (2015) Financial distress and its associations with physical and emotional symptoms and quality of life among advanced cancer patients. Oncologist 20(9):1092–1098CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Lathan CS, Cronin A, Tucker-Seeley R et al (2016) Association of financial strain with symptom burden and quality of life for patients with lung or colorectal cancer. J Clin Oncol 34(15):1732–1740CrossRefPubMedPubMedCentral Lathan CS, Cronin A, Tucker-Seeley R et al (2016) Association of financial strain with symptom burden and quality of life for patients with lung or colorectal cancer. J Clin Oncol 34(15):1732–1740CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Zafar SY, McNeil RB, Thomas CM et al (2015) Population-based assessment of cancer survivors’ financial burden and quality of life: a prospective cohort study. J Oncol Pract 11(2):145–U472CrossRefPubMed Zafar SY, McNeil RB, Thomas CM et al (2015) Population-based assessment of cancer survivors’ financial burden and quality of life: a prospective cohort study. J Oncol Pract 11(2):145–U472CrossRefPubMed
10.
Zurück zum Zitat Choi JW, Park EC, Yoo KS et al (2015) The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching. BMC Health Serv Res 15:369CrossRefPubMedPubMedCentral Choi JW, Park EC, Yoo KS et al (2015) The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching. BMC Health Serv Res 15:369CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Kim Y, Yang B (2011) Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea. Health Policy 100(2–3):239–246CrossRefPubMed Kim Y, Yang B (2011) Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea. Health Policy 100(2–3):239–246CrossRefPubMed
12.
Zurück zum Zitat Xu K, Evans DB, Kawabata K et al (2003) Household catastrophic health expenditure: a multicountry analysis. Lancet 362(9378):111–117CrossRefPubMed Xu K, Evans DB, Kawabata K et al (2003) Household catastrophic health expenditure: a multicountry analysis. Lancet 362(9378):111–117CrossRefPubMed
13.
Zurück zum Zitat Sharp L, Carsin AE, Timmons A (2013) Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer. Psycho-Oncology 22(4):745–755CrossRefPubMed Sharp L, Carsin AE, Timmons A (2013) Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer. Psycho-Oncology 22(4):745–755CrossRefPubMed
14.
Zurück zum Zitat Perrone F, Jommi C, Di Maio M et al (2016) The association of financial difficulties with clinical outcomes in cancer patients: secondary analysis of 16 academic prospective clinical trials conducted in Italy. Ann Oncol 27(12):2224–2229CrossRefPubMed Perrone F, Jommi C, Di Maio M et al (2016) The association of financial difficulties with clinical outcomes in cancer patients: secondary analysis of 16 academic prospective clinical trials conducted in Italy. Ann Oncol 27(12):2224–2229CrossRefPubMed
15.
Zurück zum Zitat Azzani M, Roslani AC, Su TT (2016) Financial burden of colorectal cancer treatment among patients and their families in a middle-income country. Support Care Cancer 24(10):4423–4432CrossRefPubMed Azzani M, Roslani AC, Su TT (2016) Financial burden of colorectal cancer treatment among patients and their families in a middle-income country. Support Care Cancer 24(10):4423–4432CrossRefPubMed
16.
Zurück zum Zitat Kodama Y, Morozumi R, Matsumura T et al (2012) Increased financial burden among patients with chronic myelogenous leukaemia receiving imatinib in Japan: a retrospective survey. BMC Cancer 12:152CrossRefPubMedPubMedCentral Kodama Y, Morozumi R, Matsumura T et al (2012) Increased financial burden among patients with chronic myelogenous leukaemia receiving imatinib in Japan: a retrospective survey. BMC Cancer 12:152CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Zaidi AA, Ansari TZ, Khan A (2012) The financial burden of cancer: estimates from patients undergoing cancer care in a tertiary care hospital. Int J Equity Health 11(1):60CrossRefPubMedPubMedCentral Zaidi AA, Ansari TZ, Khan A (2012) The financial burden of cancer: estimates from patients undergoing cancer care in a tertiary care hospital. Int J Equity Health 11(1):60CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Choi Y, Kim JH, Park EC (2015) The effect of subjective and objective social class on health-related quality of life: new paradigm using longitudinal analysis. Health Qual Life Outcomes 13:121CrossRefPubMedPubMedCentral Choi Y, Kim JH, Park EC (2015) The effect of subjective and objective social class on health-related quality of life: new paradigm using longitudinal analysis. Health Qual Life Outcomes 13:121CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Singh-Manoux A, Marmot MG, Adler NE (2005) Does subjective social status predict health and change in health status better than objective status? Psychosom Med 67(6):855–861CrossRefPubMed Singh-Manoux A, Marmot MG, Adler NE (2005) Does subjective social status predict health and change in health status better than objective status? Psychosom Med 67(6):855–861CrossRefPubMed
20.
Zurück zum Zitat Honjo K, Kawakami N, Tsuchiya M et al (2014) Association of subjective and objective socioeconomic status with subjective mental health and mental disorders among Japanese men and women. Int J Behav Med 21(3):421–429CrossRefPubMed Honjo K, Kawakami N, Tsuchiya M et al (2014) Association of subjective and objective socioeconomic status with subjective mental health and mental disorders among Japanese men and women. Int J Behav Med 21(3):421–429CrossRefPubMed
21.
Zurück zum Zitat Cella DF, Bonomi AE, Lloyd SR et al (1995) Reliability and validity of the functional assessment of cancer therapy-lung (FACT-L) quality-of-life instrument. Lung Cancer 12(3):199–220CrossRefPubMed Cella DF, Bonomi AE, Lloyd SR et al (1995) Reliability and validity of the functional assessment of cancer therapy-lung (FACT-L) quality-of-life instrument. Lung Cancer 12(3):199–220CrossRefPubMed
22.
Zurück zum Zitat Huang HY, Shi JF, Guo LW et al (2016) Expenditure and financial burden for common cancers in China: a hospital-based multicentre cross-sectional study. Lancet 388:S10CrossRef Huang HY, Shi JF, Guo LW et al (2016) Expenditure and financial burden for common cancers in China: a hospital-based multicentre cross-sectional study. Lancet 388:S10CrossRef
24.
Zurück zum Zitat Sun YL, Gregersen H, Yuan W (2016) Chinese health care system and clinical epidemiology. Clin Epidemiol 9:167–178CrossRef Sun YL, Gregersen H, Yuan W (2016) Chinese health care system and clinical epidemiology. Clin Epidemiol 9:167–178CrossRef
27.
Zurück zum Zitat Cella D, Eton DT, Fairclough DL et al (2002) What is a clinically meaningful change on the Functional Assessment of Cancer Therapy–Lung (FACT-L) questionnaire?: results from Eastern Cooperative Oncology Group (ECOG) Study 5592. J Clin Epidemiol 55(3):285–295CrossRefPubMed Cella D, Eton DT, Fairclough DL et al (2002) What is a clinically meaningful change on the Functional Assessment of Cancer Therapy–Lung (FACT-L) questionnaire?: results from Eastern Cooperative Oncology Group (ECOG) Study 5592. J Clin Epidemiol 55(3):285–295CrossRefPubMed
28.
Zurück zum Zitat Fiteni F, Anota A, Westeel V et al (2016) Methodology of health-related quality of life analysis in phase III advanced non-small-cell lung cancer clinical trials: a critical review. BMC Cancer 16(1):122CrossRefPubMedPubMedCentral Fiteni F, Anota A, Westeel V et al (2016) Methodology of health-related quality of life analysis in phase III advanced non-small-cell lung cancer clinical trials: a critical review. BMC Cancer 16(1):122CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Singh-Manoux A, Adler NE, Marmot MG (2003) Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 56(6):1321–1333CrossRefPubMed Singh-Manoux A, Adler NE, Marmot MG (2003) Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 56(6):1321–1333CrossRefPubMed
Metadaten
Titel
Objective and subjective financial burden and its associations with health-related quality of life among lung cancer patients
verfasst von
Jieling Elaine Chen
Vivian Weiqun Lou
Hong Jian
Zhen Zhou
Meiqiong Yan
Jingfen Zhu
Guohong Li
Yaping He
Publikationsdatum
06.11.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 4/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3949-4

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