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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Financial hardship among rural cancer survivors: An analysis of the Medical Expenditure Panel Survey
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Financial hardship among rural cancer survivors: An analysis of the Medical Expenditure Panel Survey

机译：农村癌症幸存者的财务困难：医疗支出小组调查分析

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摘要

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.
机译：一些癌症幸存者报告了他们在医疗保健的年度收入上支出了20％。与护理费用相关的患者的过度财务负担被称为金融困难，这些困难可能在农村癌症幸存者中更为普遍。本研究通过2011年医疗支出小组调查补充剂研究了1419名农村和城市癌症幸存者之间的金融困难对比 - 癌症的影响及其对财务处理的影响。我们合并了四个问题，创造了衡量材料的财务困难，并审查了一个关于财政担忧的一个问题。我们进行了多变量的逻辑回归分析，它产生了与金融困难和担忧相关的因素的差距（或），然后产生平均调整后的预测概率。我们专注于大都市统计区（MSA）指定归类的农村和城市差异，控制年龄，教育，种族，婚姻状况，健康保险，家庭收入和自上次癌症治疗以来的时间。更多农村癌症幸存者报告的经济困难比城市幸存者（23.9％对17.1％）。但是，我们调整的模型显示幸存者MSA指定对金融困难或担忧没有重大影响。城市幸存者的平均调整预测金融困难的概率为18.6％（置信区间[CI]：11.9％-27.5％）和24.2％的农村幸存者（CI：15.0％-36.2％）。对于财务担忧，城市幸存者的平均调整后预测概率为19.9％（CI：12.0％-31.0％）和农村幸存者的18.8％（CI：12.1％-28.0％）。通过决策助剂和/或患者导航员提高患者提供​​者的沟通可能有助于减少金融困境，无论农村城市地位如何。

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