Association between patient-reported financial burden and catastrophic health expenditures in cancer survivors

Abstract

Purpose: To measure rates of patient-reported financial burden, compare them across cancer types, and determine whether they are predictive of catastrophic health expenditures (CHE). Methods: We extracted data from the Medical Expenditures Panel Survey from 2011 to 2017 to conduct a retrospective population-based cohort study and multivariable logistic regression to assess the financial burden of cancer across 16 cancer types and compare patient-reported metrics to CHE rates. Results: Patients with ovarian cancer were most likely to report inability paying bills (34.5 %) and filing for bankruptcy (9.4 %), while patients with thyroid cancer were most likely to incur debt (22.4 %). Patients with kidney cancer had the highest mean debt ($46,915). CHEs were independently predicted by inability to pay medical bills (OR [95 % CI], 1.96 [1.14–3.35]) and bankruptcy filing (OR [95 % CI], 3.90 [1.21–12.60]. Conclusions and implications: We report important variations in the financial burden across cancer types and underscore the importance of assessing how patient-reported measures are related to CHEs. Policy implications. The financial burden of cancer care could explain the lack of improved outcomes with increased national health spending.