Fumiko Chino, MD, a widowed radiation oncologist at Durham, N.C.-based Duke University, is studying the effects of medical debt on cancer patients following her husband's death, reports NPR.
Dr. Chino, who estimated she was left with hundreds of thousands of dollars of medical debt when her husband lost his battle with cancer, recently co-authored a research letter regarding financial distress and cost expectations cancer patients face.
The research letter, published Thursday in JAMA Oncology, details the results of a cross-sectional survey study of 300 cancer patients receiving anticancer therapy at a comprehensive cancer center and at three affiliated rural oncology clinics. Researchers said the enrolled patients consented to the survey and were compensated for completing it. Researchers also reviewed the EHR for cancer diagnosis, stage, type of treatment, and duration of treatment when they enrolled patients. They also assessed patient estimates of recent, averaged monthly costs to determine patient out-of-pocket expenses.
The study found 118 insured cancer patients (39 percent) receiving treatment faced greater than anticipated out-of-pocket cost. Overall, the average out-of-pocket healthcare expenses for cancer patients, excluding insurance premiums, was 11 percent.
Researchers said they also found underinsured patients devoting almost one-third of their income to healthcare-related costs were the most distressed. Patients with lower household incomes were at higher risk for unexpected costs and had higher out-of-pocket expenses.
"Facing unexpected treatment costs was associated with lower willingness to pay for care, even when adjusting for financial burden. This suggests that unpreparedness for treatment-related expenses may impact future cost-conscious decision making," the study authors concluded. "Interventions to improve patient healthcare cost literacy might impact decision making. Indeed, the Institute of Medicine has listed cancer cost-related health literacy as a high priority for future research, and this priority has been included in the Center for Medicare and Medicaid's Oncology Care Model. Future studies should test interventions for cost mitigation through shared decision making."