Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy

作者：Jeremy Phillip Harris, Eric Ku, Garrett K. Harada, Sophie Hsu, Elaine Jiayuee Chiao, P. Syamasundar Rao, Erin H. Healy, Misako Nagasaka, Jessi Humphreys, Michael A. Hoyt · 发表于：American Journal of Hospice and Palliative Medicine® · 年份：2023 · DOI：10.1177/10499091231187999 · 被引用次数：11 · 研究领域：Economic and Financial Impacts of Cancer、Health Systems, Economic Evaluations, Quality of Life、Palliative Care and End-of-Life Issues

Introduction: Financial toxicity has negative implications for patient well-being and health outcomes. There is a gap in understanding financial toxicity for patients undergoing palliative radiotherapy (RT). Methods: A review of patients treated with palliative RT was conducted from January 2021 to December 2022. The FACIT-COST (COST) was measured (higher scores implying better financial well-being). Financial toxicity was graded according to previously suggested cutoffs: Grade 0 (score ≥26), Grade 1 (14-25), Grade 2 (1-13), and Grade 3 (0). FACIT-TS-G was used for treatment satisfaction, and EORTC QLQ-C30 was assessed for global health status and functional scales. Results: 53 patients were identified. Median COST was 25 (range 0-44), 49% had Grade 0 financial toxicity, 32% Grade 1, 15% Grade 2, and 4% Grade 3. Overall, cancer caused financial hardship among 45%. Higher COST was weakly associated with higher global health status/Quality of Life (QoL), physical functioning, role functioning, and cognitive functioning; moderately associated with higher social functioning; and strongly associated with improved emotional functioning. Higher income or Medicare or private coverage (rather than Medicaid) was associated with less financial toxicity, whereas an underrepresented minority background or a non-English language preference was associated with greater financial toxicity. A multivariate model found that higher area income (HR .80, P = .007) and higher cognitive functioning (...