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Financial Toxicity in Patients with Brain and Spine Metastases.
Koenig, Julie L; Sandhu, Navjot; Sborov, Katherine; Sabolch, Aaron; Usoz, Melissa; Li, Gordon; Gephart, Melanie Hayden; Chang, Steven; Hiniker, Susan; Soltys, Scott G; Pollom, Erqi L.
Afiliación
  • Koenig JL; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA.
  • Sandhu N; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA.
  • Sborov K; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA; Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
  • Sabolch A; Department of Radiation Oncology, Kaiser Permanente Northwest, Portland, Oregon, USA.
  • Usoz M; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA.
  • Li G; Department of Neurosurgery, Stanford Cancer Institute, Stanford, California, USA.
  • Gephart MH; Department of Neurosurgery, Stanford Cancer Institute, Stanford, California, USA.
  • Chang S; Department of Neurosurgery, Stanford Cancer Institute, Stanford, California, USA.
  • Hiniker S; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA.
  • Soltys SG; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA.
  • Pollom EL; Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California, USA. Electronic address: erqiliu@stanford.edu.
World Neurosurg ; 151: e630-e651, 2021 07.
Article en En | MEDLINE | ID: mdl-33940276
OBJECTIVE: Financial toxicity associated with cancer treatment has a deleterious impact on patient outcomes but has not been well characterized among patients with metastatic cancers. We characterize the extent of financial toxicity among this population and identify factors associated with financial toxicity. METHODS: We prospectively surveyed adult patients with brain and spine metastases who received radiosurgery at a large academic medical center between January 2018 and December 2019. Financial toxicity was measured with the Personal Financial Wellness (PFW) scale. RESULTS: In total, 93 patients were included, with a median survival of 17.7 months. Most patients had private insurance (47%) or Medicare with supplementary insurance (42%), whereas 11% of patients were uninsured or insured by Medicaid/Medicare/Veterans Affairs. Of patients, 60% were primary income earners, of whom 52% had dependents. The median PFW score was 7.0 (interquartile range, 5.1-9.1), with financial toxicity reported in 23 patients (25%). After adjusting for age and education level, private insurance (odds ratio [OR], 0.28; P = 0.080) was associated with a lower likelihood of financial toxicity. Having ≥1 emergency department visit (OR, 3.87; P = 0.024) and a cancer-related change in employment status (OR, 3.63; P = 0.036) were associated with greater likelihood of reporting financial toxicity. CONCLUSIONS: Most patients with cancer with brain and spine metastases with a poor prognosis treated at a tertiary center are primary income earners and experience financial toxicity. Further studies are warranted to assess the longitudinal impact of financial toxicity in patients with metastatic cancer, particularly those with ≥1 emergency department visit and a cancer-related change in employment status.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Columna Vertebral / Neoplasias Encefálicas / Estrés Financiero Tipo de estudio: Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Columna Vertebral / Neoplasias Encefálicas / Estrés Financiero Tipo de estudio: Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos