Abstract

You have accessJournal of UrologyCME1 May 2022MP42-04 FINANCIAL BURDEN OF BLADDER CANCER CARE: CDC NATIONAL HEALTH SURVEY ANALYSIS Laura Bukavina, Alberto Castro Bigalli, Thomas Cwalina, Caleb Curry, Michael Callegari, Megan Prunty, Ilaha Isali, Mohit Sindhani, Adam Calaway, Lee Ponsky, Andres Correa, Alexander Kutikov, and Sarah Psutka Laura BukavinaLaura Bukavina More articles by this author , Alberto Castro BigalliAlberto Castro Bigalli More articles by this author , Thomas CwalinaThomas Cwalina More articles by this author , Caleb CurryCaleb Curry More articles by this author , Michael CallegariMichael Callegari More articles by this author , Megan PruntyMegan Prunty More articles by this author , Ilaha IsaliIlaha Isali More articles by this author , Mohit SindhaniMohit Sindhani More articles by this author , Adam CalawayAdam Calaway More articles by this author , Lee PonskyLee Ponsky More articles by this author , Andres CorreaAndres Correa More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , and Sarah PsutkaSarah Psutka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002608.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Financial toxicity (FT) has been associated with inferior clinical outcomes and is particularly relevant in bladder cancer (BCa). We aimed to analyze the impact of FT in BCa patients through measurement of the prevalence of delayed or missed clinical care secondary to FT. METHODS: We used 2008-2016 Centers for Disease Control National Health Interview Survey (CDC NHIS) to identify adults with history of BCa, stratified by age (18-64yo, >65yo) and compared them to adults without a history of cancer. We measured the following financial stressors 1) delaying or foregoing medical care 2) delay in dental care 3) worry about medical bills 4) delay in seeking mental health 5) difficulties paying for prescription medication. We used sampling and design variables to account for the complex survey design and participant nonresponse, and to make the estimates nationally representative. To estimate the association between covariates and BCa related problems, we used multivariable logistic regression (predictive margins). RESULTS: BCa survivors (18-64yo) did not report higher incidence of delay in care or foregoing care, worrying about medical bills, or inability to afford prescription medication. BCa survivors (>65yo) reported higher incidence of inability to afford mental care (17.14% vs 0.52%), delaying or foregoing care (10.26% vs 4.8%). However, BCa patients did not report an increase in worry about paying for medical bills (6.15 % vs 23.05%), and inability to afford prescriptions (0.68 vs 15.98%). On multivariable analysis, the odds ratio of individual measures reported highlighted that BCa survivors were less likely to report worrying about medical costs [OR 0.66, p=0.037] as compared to individuals without cancer (after adjusting for clinical characteristics and comorbidities), although they were more likely to report delay in medical care [OR 1.16, p=0.045] (Table 2). CONCLUSIONS: Identification of patients at risk for excess medical financial hardships is needed to move the discussion from problem acknowledgement to identifying solutions and implementing strategies. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e731 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Bukavina More articles by this author Alberto Castro Bigalli More articles by this author Thomas Cwalina More articles by this author Caleb Curry More articles by this author Michael Callegari More articles by this author Megan Prunty More articles by this author Ilaha Isali More articles by this author Mohit Sindhani More articles by this author Adam Calaway More articles by this author Lee Ponsky More articles by this author Andres Correa More articles by this author Alexander Kutikov More articles by this author Sarah Psutka More articles by this author Expand All Advertisement PDF DownloadLoading ...

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