ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021
Association of co-morbidities with financial hardship in survivors of adult cancer.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Social Needs in Cancer Survivors: A Scoping Review and Future Directions.Current oncology reports · 2025Article
- Interventions to Address Cancer-Related Financial Hardship: A Scoping Review and Call to Action.JCO oncology practice · 2025Article
- COVID-19 testing and financial toxicity in cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Types of usual sources of care and their association with healthcare outcomes among cancer survivors: a Medical Expenditure Panel Survey (MEPS) study.Journal of cancer survivorship : research and practice · 2023Article
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Authors and funding
3 authors.
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Abstract
purposeTo evaluate the impact of co-morbidities on financial hardship in adult cancer survivors and the role of health insurance and a usual source of care (i.e., a particular doctor's office/health center/other place that the person usually goes if he/she is sick or needs advice) in relieving this impact.
methodsUsing the Medical Expenditure Panel Survey, we estimated prevalence of two financial hardships, out-of-pocket (OOP) burden and financial worry, among 1196 adult cancer survivors. A modified Charlson co-morbidity index (CCI) assessed co-morbidities, which represent a medical event (e.g., a doctor's appointment) associated with co-morbid conditions within the past 1 year. Multivariable logistic regression tested the influence of health insurance and a usual source of care on associations of co-morbidities with financial hardship by middle/high vs. low-income families and by working vs. retirement-age individuals.
resultsYears since cancer diagnosis ranged from 0 to 76 years (mean: 10.3, SD: 9.8), 10 and 25% of survivors experienced OOP burden and financial worry. For OOP burden, increased CCI was a risk factor among survivors of low-income families, ORs: 1.91 (95% CI: 1.06, 3.46) for a CCI 1-2 and 3.37 (95% CI: 1.72, 6.61) for a CCI ≥ 3 vs. CCI of 0. For financial worry, increased CCI was a risk factor among working-age survivors, ORs: 1.58 (95% CI: 1.02, 2.47) for a CCI 1-2 and 2.15 (95% CI: 1.19, 3.87) for a CCI ≥ 3 vs. CCI of 0. However, having health insurance and a usual source of care did not mitigate impact of co-morbidities on financial hardship (P values > 0.05).
conclusionsImpact of co-morbidities on OOP and financial worry burden was greatest in survivors of low-income families and working-age, respectively. Health insurance and a usual source of care did not relieve the impact of co-morbidities on financial hardship. IMPLICATIONS: Effective strategies are warranted to mitigate financial hardship for survivors.
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