Ayesha P Ng, Yas Sanaiha, Joseph E Hadaya, Arjun Verma, Jane Yanagawa, Peyman Benharash
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引用次数: 0
Abstract
Background: Although financial toxicity, defined as the harmful financial burden experienced by patients undergoing cancer treatment, has been of growing interest, data in thoracic oncology are lacking. We aimed to examine the risk of financial toxicity among patients undergoing surgical resection of thoracic malignancies.
Methods: Adults undergoing lobectomy, pneumonectomy, or esophagectomy for cancer were identified in the 2012-2021 National Inpatient Sample (NIS). Risk of financial toxicity was defined as health expenditure (total hospitalization costs for the uninsured and maximum out-of-pocket costs for the insured) exceeding 40% of post-subsistence income. Multivariable logistic regressions were used to identify factors associated with financial toxicity risk.
Results: Of 384,340 patients, 69.5% had government-funded insurance, 27.2% private insurance, and 1.0% were uninsured. Compared to those with insurance, uninsured patients were more commonly Black and Hispanic and less commonly electively admitted. Mortality, complications, LOS, and costs were comparable regardless of insurance status. Approximately 68.9% of uninsured and 17.3% of insured patients were at risk of financial toxicity, and incidence of financial toxicity remained stable over time. After risk adjustment, complications were associated with over 2-fold increased risk of financial toxicity among uninsured (AOR 2.21, 95% CI 1.38-3.55). Among the insured, Black, Hispanic, and publicly insured patients demonstrated greater risk of financial toxicity, while minimally invasive operations and metropolitan hospitals exhibited lower risk of financial toxicity.
Conclusions: Concordant with prior work examining financial toxicity in abdominal oncologic surgery, thoracic surgery demonstrates a comparable burden of financial toxicity. Referral policies and care subsidization may be considered in patients undergoing thoracic malignancy resections at risk for financial toxicity.
期刊介绍：
The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards.
The Annals of Thoracic Surgery features:
• Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques
• New Technology articles
• Case reports
• "How-to-do-it" features
• Reviews of current literature
• Supplements on symposia
• Commentary pieces and correspondence
• CME
• Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery.
An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.
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