Characteristics of cancer patients' out-of-pocket costs in Ontario.
Published: 2005
Language: eng
Number of pages: 283
Description: Methods. A self-administered questionnaire was used to capture demographic data and patients' OOPC over 30-days. It was completed by patients with breast (n = 74), colorectal (n = 70), lung (n = 68) and prostate (n = 70) cancer at five cancer centres in Ontario, Canada between October 2001 and April 2003 (n = 282).Introduction. Government funding for health care is often justified as enhancing "social solidarity" by distributing the financial burdens of illness across society. Although Canadian Medicare ensures that no financial barriers exist for patients receiving medically necessary physician or hospital care, when services are provided outside of hospitals or by non-physicians even medically necessary care may not be fully covered.Results. Monthly OOPC (mean, range) were: imputed travel mileage ($372, $0--$6180), parking and fares ($47, $0--$450), devices ($46, $0--$2350), prescription drugs ($45, $0--$1400), accommodations ($43, $0--$1500), complementary and alternative medicine ($29, $0--$5000), vitamins ($25, $0--$400), homemaking ($14, $0--$1000), family care ($12, $0--$1200), homecare ($2, $0--$330), other ($8, $0--$250), and total excluding travel costs ($213, $0--$5230). In addition, 20% of patients that were still working lost an average of 12.7 workdays, and 36% reported that family/friends had taken time off work (mean 7 days) to assist in caregiving during the month under investigation. Variables influencing OOPC included: tumour type, treatment modality, insurance coverage, and clinic distance, although these explained little of the variance.Because of technological changes and health system restructuring, more care is now being delivered outside of hospitals. Potentially, cancer patients may incur both direct (e.g. drugs, devices, transportation) and indirect (e.g. lost income) out-of-pocket costs (OOPC). This thesis examines the extent to which such costs now fall upon cancer patients and their families. This thesis hypothesizes that, for some proportion of patients, costs will be significant or unmanageable.Conclusions. Although overall OOPC were relatively modest, they were highly skewed, and 20.4% found them "significant" or "unmanageable." Patients' perceived burden appears to be influenced by both their incurred healthcare expenses and their cancer related lost income. However, many of the healthcare costs were for items not traditionally covered; policy makers will need to discuss the boundaries of public responsibilities for healthcare.
Notes: Thesis (Ph.D.)--University of Toronto, 2005.

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Source: Dissertation Abstracts International, Volume: 66-06, Section: B, page: 3036.