Cancer survivors face hardships related to medical bills

A new study now finds that cancer survivors carry a higher burden related to medical debt payments and bills compared with individuals without a cancer history. The greatest hardships are found in younger survivors.

The research, published in CANCER, a peer-reviewed journal of the American Cancer Society, the study also found that among privately insured survivors, those who enrolled in high deductible health plans and did not have health savings accounts were particularly vulnerable to medical financial hardship.

Medical financial hardship can encompass three domains: material (such as problems paying medical bills); psychological (for example, worrying about paying medical bills); and behavioural (which might include forgoing or delaying care because of cost).Zhiyuan Zheng, PhD, of the American Cancer Society, and his colleagues analysed information from the 2013 to 2016 National Health Interview Survey.

The study included nationally representative samples of 10,354 cancer survivors and 124,436 individuals without a cancer history.Compared with those without a cancer history, cancer survivors were more likely to report any material hardship (ages 18 to 49: 43.4% versus 30.1%; ages 50 to 64: 32.8% versus 27.8%; ages 65 and older: 17.3% versus 14.7%), psychological hardship (ages 18 to 49: 53.5% versus 47.1%, with similar rates for older groups), and behavioural hardship (ages 18 to 49: 30.6% versus 21.8%; ages 50 to 64: 27.2% versus 23.4%, with similar rates for ages 65 and older).

Among privately insured survivors, having a high deductible health plan without a health savings account was also associated with greater hardship compared with low-deductible insurance.

Speaking about the study, Dr. Zheng said, “Identifying patients with medical financial hardship will be important for primary care and oncology care providers.” He further added, “Developing and evaluating interventions to minimize medical financial hardship will be important for the research community. It may also require attention from health policy makers.”According to Dr Zheng, younger cancer survivors, aged between 18 to 49 years, experience greater financial hardship than their older counterparts.

He said, “It may be that they do not have the opportunity to accumulate financial assets to pay for medical expenses. In addition, a cancer diagnosis might interrupt employment, and consequently limit access to employer-sponsored health insurance coverage.””Although we could not identify the underlying reasons for greater hardship intensity in the younger group in this study, we believe it will be an important area for additional research,” he concluded.

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First Published: Jan 22, 2019 10:45 IST