Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer

Jade C. Newton, Claire E. Johnson, Harry Hohnen, Max Bulsara, Angela Ives, Sandy McKiernan, Violet Platt, Ruth McConigley, Neli S. Slavova-Azmanova, Christobel Saunders

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Out-of-pocket expenses (OOPE) can have a significant impact on patients’ experiences of cancer treatment. This cross-sectional study sought to quantify the OOPEs experienced by rural cancer patients in Western Australia (WA), and determine factors that contributed to higher OOPE. Methods: Four hundred people diagnosed with breast, lung, colorectal or prostate cancer who resided in selected rural regions of WA were recruited through the WA Cancer Registry and contacted at least 3 months after diagnosis to report the medical OOPE (such as surgery or chemotherapy, supportive care, medication and tests) and non-medical OOPE (such as travel costs, new clothing and utilities) they had experienced as a result of accessing and receiving treatment. Bootstrapped t tests identified demographic, financial and treatment-related factors to include in multivariate analysis, performed using log-linked generalised linear models with gamma distribution. Results: After a median 21 weeks post-diagnosis, participants experienced an average OOPE of AU$2179 (bootstrapped 95% confidence interval $1873–$2518), and 45 (11%) spent more than 10% of their household income on these expenses. Participants likely to experience higher total OOPE were younger than 65 years (p = 0.008), resided outside the South West region (p = 0.007) and had private health insurance (PHI) (p < 0.001). Conclusions: Rural WA cancer patients experience significant OOPE following their diagnosis. The impact these expenses have on patient wellbeing and their treatment decisions need to be further explored.

Original languageEnglish
Pages (from-to)3543-3552
Number of pages10
JournalSupportive Care in Cancer
Volume26
Issue number10
DOIs
Publication statusPublished - 1 Oct 2018

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Health Expenditures
Western Australia
Neoplasms
Clothing
Therapeutics
Health Insurance
Registries
Colorectal Neoplasms
Linear Models
Lung Neoplasms
Prostatic Neoplasms
Multivariate Analysis
Cross-Sectional Studies
Demography
Confidence Intervals
Breast Neoplasms
Costs and Cost Analysis
Drug Therapy

Cite this

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title = "Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer",
abstract = "Purpose: Out-of-pocket expenses (OOPE) can have a significant impact on patients’ experiences of cancer treatment. This cross-sectional study sought to quantify the OOPEs experienced by rural cancer patients in Western Australia (WA), and determine factors that contributed to higher OOPE. Methods: Four hundred people diagnosed with breast, lung, colorectal or prostate cancer who resided in selected rural regions of WA were recruited through the WA Cancer Registry and contacted at least 3 months after diagnosis to report the medical OOPE (such as surgery or chemotherapy, supportive care, medication and tests) and non-medical OOPE (such as travel costs, new clothing and utilities) they had experienced as a result of accessing and receiving treatment. Bootstrapped t tests identified demographic, financial and treatment-related factors to include in multivariate analysis, performed using log-linked generalised linear models with gamma distribution. Results: After a median 21 weeks post-diagnosis, participants experienced an average OOPE of AU$2179 (bootstrapped 95{\%} confidence interval $1873–$2518), and 45 (11{\%}) spent more than 10{\%} of their household income on these expenses. Participants likely to experience higher total OOPE were younger than 65 years (p = 0.008), resided outside the South West region (p = 0.007) and had private health insurance (PHI) (p < 0.001). Conclusions: Rural WA cancer patients experience significant OOPE following their diagnosis. The impact these expenses have on patient wellbeing and their treatment decisions need to be further explored.",
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author = "Newton, {Jade C.} and Johnson, {Claire E.} and Harry Hohnen and Max Bulsara and Angela Ives and Sandy McKiernan and Violet Platt and Ruth McConigley and Slavova-Azmanova, {Neli S.} and Christobel Saunders",
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Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer. / Newton, Jade C.; Johnson, Claire E.; Hohnen, Harry; Bulsara, Max; Ives, Angela; McKiernan, Sandy; Platt, Violet; McConigley, Ruth; Slavova-Azmanova, Neli S.; Saunders, Christobel.

In: Supportive Care in Cancer, Vol. 26, No. 10, 01.10.2018, p. 3543-3552.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer

AU - Newton, Jade C.

AU - Johnson, Claire E.

AU - Hohnen, Harry

AU - Bulsara, Max

AU - Ives, Angela

AU - McKiernan, Sandy

AU - Platt, Violet

AU - McConigley, Ruth

AU - Slavova-Azmanova, Neli S.

AU - Saunders, Christobel

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Purpose: Out-of-pocket expenses (OOPE) can have a significant impact on patients’ experiences of cancer treatment. This cross-sectional study sought to quantify the OOPEs experienced by rural cancer patients in Western Australia (WA), and determine factors that contributed to higher OOPE. Methods: Four hundred people diagnosed with breast, lung, colorectal or prostate cancer who resided in selected rural regions of WA were recruited through the WA Cancer Registry and contacted at least 3 months after diagnosis to report the medical OOPE (such as surgery or chemotherapy, supportive care, medication and tests) and non-medical OOPE (such as travel costs, new clothing and utilities) they had experienced as a result of accessing and receiving treatment. Bootstrapped t tests identified demographic, financial and treatment-related factors to include in multivariate analysis, performed using log-linked generalised linear models with gamma distribution. Results: After a median 21 weeks post-diagnosis, participants experienced an average OOPE of AU$2179 (bootstrapped 95% confidence interval $1873–$2518), and 45 (11%) spent more than 10% of their household income on these expenses. Participants likely to experience higher total OOPE were younger than 65 years (p = 0.008), resided outside the South West region (p = 0.007) and had private health insurance (PHI) (p < 0.001). Conclusions: Rural WA cancer patients experience significant OOPE following their diagnosis. The impact these expenses have on patient wellbeing and their treatment decisions need to be further explored.

AB - Purpose: Out-of-pocket expenses (OOPE) can have a significant impact on patients’ experiences of cancer treatment. This cross-sectional study sought to quantify the OOPEs experienced by rural cancer patients in Western Australia (WA), and determine factors that contributed to higher OOPE. Methods: Four hundred people diagnosed with breast, lung, colorectal or prostate cancer who resided in selected rural regions of WA were recruited through the WA Cancer Registry and contacted at least 3 months after diagnosis to report the medical OOPE (such as surgery or chemotherapy, supportive care, medication and tests) and non-medical OOPE (such as travel costs, new clothing and utilities) they had experienced as a result of accessing and receiving treatment. Bootstrapped t tests identified demographic, financial and treatment-related factors to include in multivariate analysis, performed using log-linked generalised linear models with gamma distribution. Results: After a median 21 weeks post-diagnosis, participants experienced an average OOPE of AU$2179 (bootstrapped 95% confidence interval $1873–$2518), and 45 (11%) spent more than 10% of their household income on these expenses. Participants likely to experience higher total OOPE were younger than 65 years (p = 0.008), resided outside the South West region (p = 0.007) and had private health insurance (PHI) (p < 0.001). Conclusions: Rural WA cancer patients experience significant OOPE following their diagnosis. The impact these expenses have on patient wellbeing and their treatment decisions need to be further explored.

KW - Cancer

KW - Cross-sectional study

KW - Financial toxicity

KW - Health expenditure

KW - Western Australia

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U2 - 10.1007/s00520-018-4205-2

DO - 10.1007/s00520-018-4205-2

M3 - Article

VL - 26

SP - 3543

EP - 3552

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

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ER -