ArticleJCO oncology practice2023
Relationships Among Health Insurance Literacy, Financial Toxicity, and Sociodemographic Factors in Patients With Cancer.
Article in JCO oncology practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- A pilot randomized clinical trial of a peer support intervention for hematopoietic stem cell transplantation.Blood advances · 2026Trial
- The Association Between Insurance Type and Financial Toxicity in Older Adult Surgical Patients.The Journal of surgical research · 2026Article
- Racial and Ethnic Inequities in Managing Prescription Drug Costs Among Older Adults in Medicare.Journal of racial and ethnic health disparities · 2026Article
- The association between plant protein intake and cancer risk: a prospective cohort study.Nutrition journal · 2026Article
- Identifying the Core Functions of a Health Insurance Literacy Program for Adolescent and Young Adult Cancer Survivors.Journal of adolescent and young adult oncology · 2026Article
- Differences in patient-centered burdens and economic outcomes based on sociodemographic characteristics and social determinants of health: a scoping review.Frontiers in public health · 2026Article
- Associations of Medicare Advantage Enrollment Duration with Health Insurance Literacy and Access to and Affordability of Health Care.Journal of general internal medicine · 2026Article
- The Impact of a Pilot Oncology Summer Internship on Early Medical Students' Understanding of Oncology and Social Determinants of Health: A Mixed-Methods Study.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Financial Toxicity in ESKD.Kidney360 · 2025Article
- Patient Perspectives on Prior Authorization for Cancer Care.JAMA network open · 2025Article
- Social Needs in Cancer Survivors: A Scoping Review and Future Directions.Current oncology reports · 2025Article
- A peer support intervention in patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT): The STEPP randomized pilot trial design and methods.Contemporary clinical trials · 2025Article
- Patient-Reported Financial Burden of Treatment for Colon or Rectal Cancer.JAMA network open · 2024Article
- Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States.Cancers · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe objective of the study was to describe the prevalence of health insurance literacy (HIL) and investigate how patient-reported outcome measures assessing HIL are related to financial toxicity in patients with cancer.
methodsWe assessed HIL and financial toxicity in 404 patients enrolled between December 2019 and January 2021 at two medical centers in the United States. We conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to explore and test the relationships among the factors and items. We fit structural equation models (SEMs) to find the relationships among the factors and sociodemographic/clinical characteristics.
resultsThe EFA revealed items loaded on four factors: knowledge about health insurance, confidence related to HIL (HIL confidence), information-seeking behavior related to health insurance, and financial toxicity. The four-factor CFA model had good fit statistics (comparative fit index, 0.960; Tucker-Lewis index, 0.958; root mean square error of approximation, 0.046; and standardized root mean square residual, 0.086). In SEM, income, education level, and race positively predicted knowledge about health insurance. Knowledge about health insurance and number of total lines of cancer treatment was positively associated with HIL confidence. Higher income, older age, and HIL confidence were associated with less financial toxicity. Higher levels of financial toxicity, HIL confidence, and knowledge were associated with greater information-seeking behavior.
conclusionOur findings showed how different aspects of HIL are related to financial toxicity even after adjustment for sociodemographic and clinical characteristics. Future studies should investigate the longitudinal relationships among these factors to help develop interventions to mitigate financial toxicity.
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