Financial hardship among rural cancer survivors: An analysis of the Medical Expenditure Panel Survey

Details

• Journal Article:
  Prev Med
• Personal Author:
  Odahowski, Cassie L. ; Zahnd, Whitney E. ; Zgodic, Anja ; Edward, Jean S. ; Hill, Lauren N. ; Davis, Melinda M. ; Perry, Cynthia K. ; Shannon, Jackilen ; Wheeler, Stephanie B. ; Vanderpool, Robin C. ; Eberth, Jan M.
  More +
• Description:
  Some cancer survivors report spending 20% of their annual income on medical care. Undue financial burden that patients face related to the cost of care is referred to as financial hardship, which may be more prevalent among rural cancer survivors. This study examined contrasts in financial hardship among 1419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement - The Effects of Cancer and Its Treatment on Finances. We combined four questions, creating a measure of material financial hardship, and examined one question on financial worry. We conducted multivariable logistic regression analyses, which produced odds ratios (OR) for factors associated with financial hardship and worry, and then generated average adjusted predicted probabilities. We focused on rural and urban differences classified by metropolitan statistical area (MSA) designation, controlling for age, education, race, marital status, health insurance, family income, and time since last cancer treatment. More rural cancer survivors reported financial hardship than urban survivors (23.9% versus 17.1%). However, our adjusted models revealed no significant impact of survivors' MSA designation on financial hardship or worry. Average adjusted predicted probabilities of financial hardship were 18.6% for urban survivors (Confidence Interval CI: 11.9%-27.5%) and 24.2% for rural survivors (CI: 15.0%-36.2%). For financial worry, average adjusted predicted probabilities were 19.9% for urban survivors (CI: 12.0%-31.0%) and 18.8% for rural survivors (CI: 12.1%-28.0%). Improving patient-provider communication through decision aids and/or patient navigators may be helpful to reduce financial hardship and worry regardless of rural-urban status.
• Subjects:
  • Adult
  • Aged
  • Aged, 80 and over
  • Cancer Survivors
  • Cost of Illness
  • Female
  • Financing, Personal
  • Health Expenditures
  • Humans
  • Insurance, Health
  More +
• Keywords:
  • Health expenditures
  • Cost of illness
  • Rural health
  • Neoplasms
  • Health surveys
  • Stress
  • Psychological
  • Survivors
• Source:
  Prev Med. 129 Suppl:105881
• DOI:
  http://dx.doi.org/10.1016/j.ypmed.2019.105881
• Pubmed ID:
  31727380
• Pubmed Central ID:
  PMC7190004
• Document Type:
  Text ; Journal Article
• Funding:
  U48 DP005006/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP005017/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP005000/DP/NCCDPHP CDC HHSUnited States/ ; K07 CA211971/CA/NCI NIH HHSUnited States/ ; U48 DP005014/DP/NCCDPHP CDC HHSUnited States/
• Genre:
  Journal Article
• Download URL:
  https://stacks.cdc.gov/view/cdc/87447/cdc_87447_DS1.pdf
• File Type:
  [PDF - 338.75 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:066e840aa04a607461e0f4f0e1a45df981ee2c6254a6ab3f0dad45de9675ae1ca614e473fcc2133e2a38d9496abbf0d0547874001e59bf71f7eb087ab56f6b8b