Lihua Li, Donglan Zhang, Yan Li, Mayuri Jain, Xingyu Lin, Rebecca Hu, Junxiu Liu, Janani Thapa, Lan Mu, Zhuo Chen, Bian Liu, José A Pagán
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We used conditional logistic regression to examine the association between cancer history and medical financial hardship and to assess whether this association varied by age, sex, race and ethnicity, and region of residence.</p><p><strong>Results: </strong>Compared with those who did not have a history of cancer, young adult cancer survivors were more likely to report material financial hardship (22.8% vs 15.2%; odds ratio = 1.65, 95% confidence interval = 1.50 to 1.81) and behavior-related financial hardship (34.3% vs 24.4%; odds ratio = 1.62, 95% confidence interval = 1.49 to 1.76) but not psychological financial hardship (52.6% vs 50.9%; odds ratio = 1.07, 95% confidence interval = 0.99 to 1.16). Young adult cancer survivors who were Hispanic or lived in the Midwest and South were more likely to report psychological financial hardship than their counterparts.</p><p><strong>Conclusions: </strong>We found that young adult cancer survivors were more likely to experience material and behavior-related financial hardship than young adults without a history of cancer. We also identified specific subgroups of young adult cancer survivors that may benefit from targeted policies and interventions to alleviate medical financial hardship.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903972/pdf/","citationCount":"0","resultStr":"{\"title\":\"Medical financial hardship between young adult cancer survivors and matched individuals without cancer in the United States.\",\"authors\":\"Lihua Li, Donglan Zhang, Yan Li, Mayuri Jain, Xingyu Lin, Rebecca Hu, Junxiu Liu, Janani Thapa, Lan Mu, Zhuo Chen, Bian Liu, José A Pagán\",\"doi\":\"10.1093/jncics/pkae007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Young adult cancer survivors face medical financial hardships that may lead to delaying or forgoing medical care. This study describes the medical financial difficulties young adult cancer survivors in the United States experience in the post-Patient Protection and Affordable Care Act period.</p><p><strong>Method: </strong>We identified 1009 cancer survivors aged 18 to 39 years from the National Health Interview Survey (2015-2022) and matched 963 (95%) cancer survivors to 2733 control individuals using nearest-neighbor matching. We used conditional logistic regression to examine the association between cancer history and medical financial hardship and to assess whether this association varied by age, sex, race and ethnicity, and region of residence.</p><p><strong>Results: </strong>Compared with those who did not have a history of cancer, young adult cancer survivors were more likely to report material financial hardship (22.8% vs 15.2%; odds ratio = 1.65, 95% confidence interval = 1.50 to 1.81) and behavior-related financial hardship (34.3% vs 24.4%; odds ratio = 1.62, 95% confidence interval = 1.49 to 1.76) but not psychological financial hardship (52.6% vs 50.9%; odds ratio = 1.07, 95% confidence interval = 0.99 to 1.16). Young adult cancer survivors who were Hispanic or lived in the Midwest and South were more likely to report psychological financial hardship than their counterparts.</p><p><strong>Conclusions: </strong>We found that young adult cancer survivors were more likely to experience material and behavior-related financial hardship than young adults without a history of cancer. We also identified specific subgroups of young adult cancer survivors that may benefit from targeted policies and interventions to alleviate medical financial hardship.</p>\",\"PeriodicalId\":14681,\"journal\":{\"name\":\"JNCI Cancer Spectrum\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-02-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903972/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JNCI Cancer Spectrum\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/jncics/pkae007\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JNCI Cancer Spectrum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jncics/pkae007","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:年轻的成年癌症幸存者面临着医疗经济困难,这可能会导致他们推迟或放弃医疗护理。本研究描述了平价医疗法案(ACA)颁布后,美国年轻的成年癌症幸存者所经历的医疗经济困难:我们从 2015-2022 年全国健康访谈调查中确定了 1009 名 18-39 岁的癌症幸存者,并使用近邻匹配法将 963 名(95%)癌症幸存者与 2733 名对照者进行了匹配。我们使用条件逻辑回归法研究了癌症病史与医疗经济困难之间的关联,并评估了这种关联是否因年龄、性别、种族/民族和居住地区而异:与没有癌症病史的人相比,年轻的成年癌症幸存者更有可能报告物质上的经济困难(22.8% vs 15.2%;几率比(OR)1.65,95% 置信区间(CI):1.50-1.81)和行为上的医疗经济困难(34.3% vs 24.4%;OR 1.62,95% CI:1.49-1.76),但不包括心理上的经济困难(526% vs 50.9%;OR 1.07,95% CI:0.99-1.16)。拉美裔或居住在中西部和南部的年轻癌症幸存者比同类人更有可能报告心理经济困难:我们发现,与没有癌症病史的年轻人相比,年轻的成年癌症幸存者更有可能经历物质和行为上的医疗经济困难。我们还发现了一些特定的年轻癌症幸存者亚群,他们可能会受益于有针对性的政策和干预措施,以缓解医疗经济困难。
Medical financial hardship between young adult cancer survivors and matched individuals without cancer in the United States.
Background: Young adult cancer survivors face medical financial hardships that may lead to delaying or forgoing medical care. This study describes the medical financial difficulties young adult cancer survivors in the United States experience in the post-Patient Protection and Affordable Care Act period.
Method: We identified 1009 cancer survivors aged 18 to 39 years from the National Health Interview Survey (2015-2022) and matched 963 (95%) cancer survivors to 2733 control individuals using nearest-neighbor matching. We used conditional logistic regression to examine the association between cancer history and medical financial hardship and to assess whether this association varied by age, sex, race and ethnicity, and region of residence.
Results: Compared with those who did not have a history of cancer, young adult cancer survivors were more likely to report material financial hardship (22.8% vs 15.2%; odds ratio = 1.65, 95% confidence interval = 1.50 to 1.81) and behavior-related financial hardship (34.3% vs 24.4%; odds ratio = 1.62, 95% confidence interval = 1.49 to 1.76) but not psychological financial hardship (52.6% vs 50.9%; odds ratio = 1.07, 95% confidence interval = 0.99 to 1.16). Young adult cancer survivors who were Hispanic or lived in the Midwest and South were more likely to report psychological financial hardship than their counterparts.
Conclusions: We found that young adult cancer survivors were more likely to experience material and behavior-related financial hardship than young adults without a history of cancer. We also identified specific subgroups of young adult cancer survivors that may benefit from targeted policies and interventions to alleviate medical financial hardship.