Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study
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摘要Objective: We assessed financial toxicity (FT) among Chinese patients with cancer and investigated associated risk factors guided by a multilevel conceptual framework. Methods: Applying multistage stratified sampling, we selected six tertiary and six secondary hospitals across three economically diverse provinces in China. From February to October 2022, 1208 patients with cancer participated. FT was measured using the COmprehensive Score for financial Toxicity (COST), with 28 potential risk factors identified at multilevel. Multiple regression analysis was used for risk factor identification. Results: FT prevalence was 82.6% (95% confidence interval [CI]: 80.5%, 84.8%), with high FT (COST score < 18.5) observed in 40.9% of participants (95% CI: 38.1%, 43.7%). Significant risk factors included younger age at cancer diagnosis, unmarried status, low annual household income, negative impact of cancer on participants' or family caregiver's work, advanced cancer stage, longer hospital stay for cancer treatment or treatment-related side effects, high perceived stress, poor emotional/informational support, lack of social medical insurance or having urban and rural resident basic medical insurance, lack of commercial medical insurance, tertiary hospital treatment, and inadequate cost discussions with healthcare providers (all P < 0.05). Conclusions: Cancer-related FT is prevalent in China, contributing to disparities in cancer care access and healthrelated outcomes. The risk factors associated with cancer-related FT encompasses multilevel, including patient/ family, provider/practice, and payer/policy levels. There is an urgent need for collective efforts by patients, healthcare providers, policymakers, and insurers to safeguard the financial security and well-being of individuals affected by cancer, promoting health equities in the realm of cancer care.
出版社接受日期11.03.2024
著者Xu B., So W. K. W., Choi K. C., Huang Y., Liu M., Qiu L., Tan J., Tao H., Yan K., Yang F.
期刊名稱Asia-Pacific Journal of Oncology Nursing
出版年份2024
月份5
卷號11
期次5
出版社Elsevier
文章號碼100443
國際標準期刊號2347-5625
電子國際標準期刊號2349-6673
語言英式英語