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This study used data from the 2018 National Financial Capability Study to investigate the association between financial hardship and retirement planning behaviors. Results from logistic regressions showed that respondents with hig...
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This study used data from the 2018 National Financial Capability Study to investigate the association between financial hardship and retirement planning behaviors. Results from logistic regressions showed that respondents with high difficulty making ends meet were more likely to calculate retirement needs and more likely to own a non-employer sponsored retirement plan. The perceived over-indebtedness was positively associated with owning an employer-sponsored account while negatively associated with owning a non-employer-sponsored account. Financial fragility was associated with a lower likelihood of calculating retirement needs and having a retirement account. The results of additional generational analyses revealed that the difficulty making ends meet and the perceived over-indebtedness showed different patterns with retirement planning behavior across three generations. In contrast, financial fragility showed consistent and negative associations with the retirement planning behaviors across generations.
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Financial toxicity is the adverse impact of a cancer diagnosis on a patient’s financial well‐being resulting from direct or indirect costs. Potential consequences of financial toxicity include material loss, psychological distre...
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Financial toxicity is the adverse impact of a cancer diagnosis on a patient’s financial well‐being resulting from direct or indirect costs. Potential consequences of financial toxicity include material loss, psychological distress, and/or maladaptive coping strategies. This review will summarize the prevalence, causes, and consequences of financial toxicity, with an emphasis on strategies to anticipate and reduce its burden. Improvement will require multilevel, coordinated efforts between stakeholders including patients, providers, health systems, payers, manufacturers, and policymakers.
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Abstract Purpose Addressing financial toxicity among cancer patients is a complex process that requires a multifaceted approach, particularly for rural patients who may face additional cost‐related barriers to care. In this study...
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Abstract Purpose Addressing financial toxicity among cancer patients is a complex process that requires a multifaceted approach, particularly for rural patients who may face additional cost‐related barriers to care. In this study, we examined interventions being implemented by financial navigation staff at various cancer centers that help address financial toxicity experienced by oncology patients. Methods We conducted semistructured interviews with a convenience sample of financial navigation staff across 29 cancer centers in both rural and urban areas in 7 states. Interviews were audio‐recorded and transcribed. Descriptive coding and thematic analysis techniques were used to analyze the data. Findings Thirty‐five participants were interviewed, the majority of whom worked in cancer centers located in rural counties. Participants identified the use of screening tools, patient education, and access to tailored financial assistance resources as best practices. Immediate resource needs included additional financial navigation staff, including lay navigators and community health workers, to promote linkages to local resources. Suggested clinical areas for intervention included proactive and early implementation of financial assessments and discussions between providers and patients, along with training and access to regularly updated resources for those in financial navigator/counselor roles. Participants also discussed the need for policy‐level interventions to reform health systems (including employment protections) and health insurance programs. Conclusions Implementing proactive methods to screen for and address financial needs of patients is essential to improving cancer‐related outcomes. Additional programs and research are needed to help establish systematic and standardized methods to enhance financial navigation services, especially for underserved rural communities.
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Purpose To identify predictors of financial hardship, operationalized as foregoing health care, making financial sacrifices, and being concerned about having inadequate financial and insurance information. Methods Cancer survivors...
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Purpose To identify predictors of financial hardship, operationalized as foregoing health care, making financial sacrifices, and being concerned about having inadequate financial and insurance information. Methods Cancer survivors (n = 346) identified through the New Jersey State Cancer Registry were surveyed from August 2018 to September 2019. Multivariable logistic regression analyses were performed. Results Cancer survivors with household incomes less than $50,000 annually were more likely than those earning $50,0000-$90,000 to report foregoing health care (15.8 percentage points, p < 0.05). Compared to retirees, survivors who were currently unemployed, disabled, or were homemakers were more likely to forego doctor's visits (11.4 percentage points, p < 0.05), more likely to report borrowing money (16.1 percentage points, p < 0.01), and more likely to report wanting health insurance information (25.7 percentage points, p < 0.01). Employed survivors were more likely than retirees to forego health care (16.8 percentage points, p < 0.05) and make financial sacrifices (20.0 percentage points, p < 0.01). Survivors who never went to college were 9.8 percentage points (p < 0.05) more likely to borrow money compared to college graduates. Black survivors were more likely to want information about dealing with financial and insurance issues (p < 0.01); men were more likely to forego health care (p < 0.05). Conclusion Findings highlight the role of employment status and suggest that education, income, race, and gender also shape cancer survivors' experience of financial hardship. There is a need to refine and extend financial navigation programs. For employed survivors, strengthening family leave policies would be desirable.
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This study examines how racial/ethnic discrimination
influences financial access and material hardship, using
survey data collected from self-identified Korean immigrants
living in two counties in Alabama (N = 241). Key
variab...
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This study examines how racial/ethnic discrimination
influences financial access and material hardship, using
survey data collected from self-identified Korean immigrants
living in two counties in Alabama (N = 241). Key
variables are experiencing racial/ethnic discrimination,
two subjective measures of financial access, and four indicators
of material hardship (overall, food-related, health
insurance, and medical care). Descriptive analyses show a
high rate of experiencing racial/ethnic discrimination, limited
access to basic financial services and credit, and considerable
rates of material hardship. Regression analyses
indicate that experiencing discrimination has a significant
association with access to credit but not with access to
basic financial services. Access to credit has a significant
and negative association with all types of material hardship.
Our findings challenge the model minority myth of
socially and economically integrated Asian/Korean immigrants.
Results call for anti-discrimination policies and
public efforts to expand financial access and reduce material
hardship among Korean immigrants.
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Purpose Financial hardship can be a major cause of distress among persons with cancer, resulting in chronic stress and impacting physical and emotional health. This paper provides an analysis of the lived experience of cancer pati...
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Purpose Financial hardship can be a major cause of distress among persons with cancer, resulting in chronic stress and impacting physical and emotional health. This paper provides an analysis of the lived experience of cancer patients' financial hardship from diagnosis to post-treatment. Methods In-depth interviews were conducted with 26 cancer survivors who reported financial hardship during and/or after treatment. The interviews were analyzed using Dedoose(TM)as an organizational tool, the life course perspective as an organizing theoretical framework, and a thematic analysis tool(1)to answer our research questions. Our analysis identified that timing and sequencing of life transitions and stress proliferation furthered the process of financial stress over time. Findings Cancer survivors do not experience financial toxicity as a singular process; the experience can be quite different depending on age and life transitions. Practice/Policy Implications These findings provide psychosocial oncology providers with a framework for identifying patients at risk for financial distress and addressing the critical needs related to their life stage.
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Little information has been compiled across studies about existing interventions to mitigate issues of medical financial hardship, despite growing interest in health care delivery. The purpose of this qualitative systematic scopin...
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Little information has been compiled across studies about existing interventions to mitigate issues of medical financial hardship, despite growing interest in health care delivery. The purpose of this qualitative systematic scoping review was to examine content and outcomes of interventions to address medical financial hardship. PRISMA guidelines were applied to present results using PubMed, Scopus, and CINAHL, published between January 1980 and August 2020. Additional studies were identified through reference lists of selected papers. Included studies focused on mitigating medical financial hardship from out-of-pocket (OOP) health care expenses as an intervention strategy with at least 1 evaluation component. Screening 2412 articles identified 339 articles for full-text review, 12 of which met inclusion criteria. Variation was found regarding targets and outcome measurement of intervention. Primary outcomes were in the following categories: financial outcomes (eg, OOP expenses), behavioral outcomes, psychosocial, health care utilization, and health status. No included studies reported significant reduction in OOP expenses, perceptions of financial burden/toxicity, or health status. However, changes were observed for behavioral outcomes (adherence to treatment, patient needs addressed), some psychosocial outcomes (mental health symptoms, perceived support, patient satisfaction), and care utilization such as routine health care. No patterns were observed in the achievement of outcomes across studies based on intensity of intervention. Few rigorous studies exist in this emerging field, and studies have not shown consistent positive effects. Future research should focus on conceptual clarity of the intervention, align outcome measurement and achieve consensus around outcomes, and employ rigorous study designs, measurement, and outcome follow-up.
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Objective This study explores the impact that cancer-related financial hardship/worries can have on family life. Methods Forty patients (19 male and 21 female) and 17 carers participated in a qualitative study, which drew on certa...
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Objective This study explores the impact that cancer-related financial hardship/worries can have on family life. Methods Forty patients (19 male and 21 female) and 17 carers participated in a qualitative study, which drew on certain elements of grounded theory methods. Participants were 18 years or older and were accessed through a regional cancer centre, an acute National Health Service trust, a support group and the Macmillan Benefits Helpline. Interviews were transcribed verbatim and analysed thematically with the aid of nvivo 7 (QSR International, Cambridge, MA, USA). Results Many participants said that prior to experiencing cancer, they had never thought about its effects on finances. The early part of the cancer journey was characterised by a need to be positive about the future, limited discussion about money within families and a lack of action in relation to finances. Many participants, especially those of working age, described cancer-related financial worries and difficulties that had impacted on family lifestyle, roles and relationships. Consequences included house repossession, bankruptcy, loss of independence and relationship breakdown. Conclusions Health and social care professionals have a role in prompting people affected by cancer to take stock of their finances early in the cancer trajectory, in order to avert knock-on effects. An approach that combines hope with proactivity is needed. More work into the long-term effects of financial difficulties/worries and specific financial issues that affect people from Black and minority ethnic backgrounds is needed.
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BACKGROUND: Financial burden can affect healthcare utilization. Few studies have assessed the short-term associations between material (debt, trouble paying rent) and psychological (worry or distress about affording future healthc...
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BACKGROUND: Financial burden can affect healthcare utilization. Few studies have assessed the short-term associations between material (debt, trouble paying rent) and psychological (worry or distress about affording future healthcare) financial risks, and subsequent outpatient and emergency healthcare use. Worry was defined as concerns about affording future healthcare.
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Background Cancer costs should be discussed by patients and providers, but information is not readily available. Results from recently published studies (in the last 5 years) on direct and indirect cancer costs may help guide thes...
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Background Cancer costs should be discussed by patients and providers, but information is not readily available. Results from recently published studies (in the last 5 years) on direct and indirect cancer costs may help guide these discussions. Methods The authors reviewed studies published between 2013 and 2017 that reported direct health care costs and indirect (productivity losses) costs. The annual mean total and net costs of cancer were summarized for all payers and for survivors only by age (ages 18‐64 and ≥65 years), by phase of care (initial [ie, 12 months from diagnosis], continuing, and end‐of‐life [ie, 12 months before death]), or for recently diagnosed (within 1‐2 years of diagnosis) and longer term survivors. Results For all payers combined, costs for cancers like breast, prostate, colorectal, and lung cancers were $20,000 to $100,000 in the initial phase, $1000 to $30,000 annually in the continuing phase, and ≥$60,000 in the end‐of‐life phase. Annual out‐of‐pocket costs to recently diagnosed survivors were >$1000 for medical care and time costs, approximately $2000 for productivity losses, and from $2500 to >$4000 for employment disability, depending on age. For longer term survivors, the cost of medical care was approximately $1500 for older survivors and $747 for younger survivors, time costs were $831 to $955 for older survivors and $459 to $630 for younger survivors, and productivity losses were approximately $800. Disability among long‐term survivors was similar to that among short‐term survivors. Limitations of the reviewed studies included older data and under‐representation of higher cost cancers. Conclusions Frequently updated cost information for all cancer types is needed to guide discussions of anticipated short‐term and long‐term cancer‐related costs with survivors. Cancer 2018;000:000‐000 . ? 2018 American Cancer Society .
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