Financial Hardship and Quality of Life Among Patients With Advanced Cancer Receiving Outpatient Palliative Care: A Pilot Study.
Sarah M Belcher, Haerim Lee, Janet Nguyen and 7 others
PMID 34974507WHAT IT FOUND
Patients with advanced cancer in palliative care reported significant financial hardship, with only 36.5% able to cover care costs.
This hardship was independently associated with worse physical role limitations, pain, and emotional well-being, even after adjusting for age, race, and performance status.
Key findings
01Only 36.5% of participants had been able to cover their share of cancer care costs, and more than 70% had some or extreme difficulty paying for basic needs.
02Financial hardship was significantly associated with worse quality of life in three dimensions: role limitations due to physical health, pain, and emotional well-being.
03Nearly half of the participants (49.4%) had low health literacy, and 68.1% reported no discussion with providers about out-of-pocket cancer care costs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was a small pilot (n=73) with a cross-sectional design, so it cannot prove that financial hardship causes worse quality of life, only that they are associated. Recruitment was halted early due to the COVID-19 pandemic, and the data were collected just before the associated economic downturn, which may have exacerbated financial hardship in ways not fully captured. The sample was clinically heterogeneous in terms of cancer diagnoses and included patients from a safety-net hospital, which may limit generalizability to broader populations. Mean imputation was used for missing scale items, which may introduce bias.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not interpret the association between financial hardship and pain as evidence that reducing costs will directly alleviate pain. This is a cross-sectional study, so it shows a link but does not prove that financial hardship causes worse pain, nor that addressing finances will improve pain scores.