Abstract
Simple SummaryFinancial burdens result from the growing out-of-pocket costs associated with cancer care to help patients regain physical and psychological health-related quality of life (HRQoL) are dramatically intensified. The aim of our study was to assess the association of HRQoL with financial burden using both subjective and objective methods among patients with non-Hodgkin’s lymphoma (NHL) in China. A majority of the patients reported suffering moderate to high financial burdens. A significant relationship between increased financial burden and reduced HRQoL was identified. Patients tended to report a poorer HRQoL when using objective method than using subjective method to estimate financial burden. Medical professionals should involve patients and their families into the clinical decision making and provide them cost-effective plans.Objective: This study aimed to assess the association of health-related quality of life (HRQoL) with financial burden among patients with non-Hodgkin’s lymphoma (NHL) in China. Methods: The data used for the analyses came from a nationwide survey to investigate the health status of patients with lymphomas in China. The EQ-5D and EORTC QLQ-C30 were used to assess the patients’ HRQoL. The financial burden was calculated using both subjective and objective methods. The chi-squared test, Kruskal–Wallis one-way analysis of variance, ordinal least squared model, and Tobit regression model were used to estimate the relationship between financial burden and HRQoL. Results: Data from 1549 patients who reported living with 11 subtypes of NHL were elicited for our analysis. Approximately 60% of respondents reported suffering moderate to high financial burdens. A significant relationship between increased financial burden and reduced HRQoL scores, including the EQ-Index, physical, emotional, and social functioning, was identified. Compared with using an objective method to measure financial burden, patients with NHL indicated a poorer HRQoL when using a subjective method to measure financial burden. Conclusion: Medical professionals should select highly cost-effective treatments and ensure that patients understand the potential financial consequences of those treatments.
Highlights
Non-Hodgkin’s lymphoma (NHL), which includes more than 60 subtypes, is a cancer that originates in the lymphatic system and spreads through the system in a non-orderly manner [1]
Compared with patients with NHL who reported living with low financial burden, those with high burden were more likely to be less educated, to be uninsured, living in rural areas, and to have low income
The link between financial burden for NHL patients and negative mental health-related quality of life (HRQoL) was identified by our study. This is in line with the findings reported by previous studies; for example, Park & Look found that higher levels of financial burden were more strongly associated with lower mental HRQOL
Summary
NHL accounts for nearly 90% of lymphomas and is listed as the ninth and tenth most common types of cancer for males and females worldwide [2]. In Asian countries, the incidence rate of NHL was listed as eighth, ninth and thirteen most common types of cancer in Singapore, South Korea and Japan, respectively [3]. In China, NHL is the tenth most common cause of cancer-related deaths and has an incident rate of 6.43/100,000 [4]. HRQoL is an important outcome of cancer care, which can reflect an individual’s perceived physical and mental health over time. HRQoL synthesizes the patients’ preferences and needs with the medical professionals expertise, which are necessary parts of evidence-based decision making in both clinical medicine and public health [5]. The increased incidence of cancer, combined with the overall decline in its mortality rate has resulted in a growing number of cancer survivors
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