Step forward: how health insurance mitigates financial toxicity in cancer care in Pakistan.

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-10-16 DOI:10.1007/s00520-025-10004-y

Wajiha Ahmad Qazi, Shahid Muhammad Iqbal, QurratulAin Jamil

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引用次数: 0

Abstract

Aim: Cancer imposes a significant financial burden on patients. This study evaluates the role of health cards in reducing financial toxicity (FT) and improving health-related quality of life (HRQOL) and psychological distress among cancer patients in Pakistan.

Methods: This cross-sectional study was conducted in Bahawalpur, Pakistan, between March and June 2024. A total of 672 cancer patients (336 with and 336 without health cards) were recruited using non-probability purposive sampling. FT was assessed using the Comprehensive Score for Financial Toxicity (COST), while HRQOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G). The Depression, Anxiety, and Stress Scale-21 (DASS-21) evaluated psychological distress.

Results: Independent t-tests showed significant differences between patients with and without health card coverage: FT significantly decrease from 7.21 to 13.24, HRQOL improve from 28.60 to 47.56, and psychological distress declined, all p < 0.001. FT correlated positively with HRQOL (r = 0.814) and negatively with depression (r = -0.222), anxiety (r = -0.475), and stress (r = -0.675), indicating strong links between financial relief and well-being (p < 0.001). MANOVA results indicated that health cards had a strong multivariate effect across all outcomes (Wilks' Lambda = 0.060, F(5,666) = 2071.97, p < 0.001, η² = 0.940).

Conclusion: Health cards play a crucial role in reducing FT while improving HRQOL and psychological well-being among cancer patients in Pakistan. The findings underscore the need to expand health coverage to ensure financial protection and enhance successful treatment outcomes for vulnerable populations.

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向前迈进：医疗保险如何减轻巴基斯坦癌症治疗的财务毒性。

目的：癌症给患者带来了巨大的经济负担。本研究评估了健康卡在巴基斯坦癌症患者中减少财务毒性（FT）和改善健康相关生活质量（HRQOL）和心理困扰方面的作用。方法：本横断面研究于2024年3月至6月在巴基斯坦巴哈瓦尔布尔进行。采用非概率目的抽样方法，共招募了672名癌症患者（336名有健康卡，336名没有健康卡）。FT使用财务毒性综合评分（COST）进行评估，而HRQOL使用癌症治疗功能评估（FACT-G）进行测量。抑郁、焦虑和压力量表21 （DASS-21）评估心理困扰。结果：独立t检验显示，有无健康卡覆盖的患者之间存在显著差异：FT从7.21降至13.24，HRQOL从28.60降至47.56，心理困扰下降，p值均为0.940)。结论：健康卡在巴基斯坦癌症患者减少FT、改善HRQOL和心理健康方面起着至关重要的作用。调查结果强调需要扩大健康覆盖范围，以确保经济保障并提高弱势群体的成功治疗结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.