Perceived cancer-related financial difficulty: implications for patient satisfaction with quality of life in advanced cancer
- 23 January 2007
- journal article
- Published by Springer Science and Business Media LLC in Supportive Care in Cancer
- Vol. 15 (9), 1051-1056
- https://doi.org/10.1007/s00520-007-0214-2
Abstract
Cancer and its treatment often lead to financial difficulty in patients with advanced cancer. The goal of this study was to investigate the relationship between perceived cancer-related financial difficulty and patient satisfaction with quality of life (QoL) in advanced cancer. A case series of 954 cancer patients treated at Cancer Treatment Centers of America, a private tertiary care oncology facility in the USA, was investigated. Perceived financial difficulty was measured using the QLQ-C30 financial difficulty subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between perceived financial difficulty and QLI was evaluated using multivariate analysis of variance and multiple regression analysis. Of 954 patients, 579 were women and 375 were men, with the median age at presentation of 56 years (range 20-90 years). Sixty-six percent did not respond to prior treatment. Most common cancers were breast (26%), colorectal (19%), and lung (16%). Two hundred ninety-six (31%) patients perceived their financial condition as poor. Every 10-year increase in current age was significantly associated with a decline in all QLI subscales except for family subscale. Newly diagnosed patients had significantly better QLI scores for all subscales as compared to those who did not respond to definitive treatment elsewhere before coming to our hospital. After controlling for the effects of age and treatment history, every 10-unit increase in perceived financial difficulty score was statistically significantly associated with 0.52, 0.36, 0.32, 0.24, and 0.40 unit decline in QLI health/physical, social/economic, psychological/spiritual, family, and overall function score, respectively. We found that perceived financial difficulty is strongly correlated with patient satisfaction with QoL in advanced cancer. These findings indicate a need for the providers of cancer care to be aware that nonclinical factors such as perceived financial difficulty can have an important bearing on QoL of cancer patients.Keywords
This publication has 17 references indexed in Scilit:
- Financial and family burden associated with cancer treatment in Ontario, CanadaSupportive Care in Cancer, 2006
- Estimating Costs of Care for Patients with Newly Diagnosed Metastatic Colorectal CancerClinical Colorectal Cancer, 2006
- Economic Burdens and Quality of Life of Family Caregivers of Cancer PatientsOncology, 2005
- The financial burden of cancer: estimates from a study of insured women with breast cancer.2004
- Out-of-Pocket Health-Care Expenditures among Older Americans with CancerValue in Health, 2004
- Estimating the Cost of Informal Caregiving for Elderly Patients With CancerJournal of Clinical Oncology, 2001
- Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire.Journal of Clinical Oncology, 1995
- Psychometric assessment of the quality of life indexResearch in Nursing & Health, 1992
- Development of a quality of life index for patients with cancer.1990
- Nonmedical costs to patients and their families associated with outpatient chemotherapyCancer, 1984