Financial Assistance Programs Research Articles

Neither gift nor loan: the strategic use of pseudo-formality at the nexus of intimacy and economy

Abstract In this paper, I introduce the concept of pseudo-formality as a novel form of relational work in economic sociology. Pseudo-formality refers to the performative use of formal aesthetics, such as contracts and repayment plans, in financial exchanges between close ties—as both parties tacitly understand that the agreement is flexible and not legally binding. I argue that pseudo-formality works by leveraging the signaling function of formal market elements in a way that contradicts their typical purpose, allowing for the compartmentalization of the economic and social aspects of the exchange. Through two complementary vignette experiments, I demonstrate that pseudo-formal framing enhances the perceived dignity of the recipient and the respect conveyed by the giver, compared to formal, informal, or gift-based arrangements. This effect partially mediates the relationship between the type of exchange and its overall acceptability. This research contributes to relational work perspectives in economic sociology by identifying a prevalent but understudied strategy for navigating the intersection of intimacy and economy, and highlights the adaptability of economic forms for relational purposes. The findings have practical implications for interpersonal exchanges as well as the design of financial assistance programs and policies, suggesting that pseudo-formal structures can provide a dignified and empowering means of support.

Understanding caregivers' needs: supporting families of autistic children

Parenting a child with autism spectrum disorder (ASD) poses significant emotional, financial, and social challenges to caregivers. This paper examines the experiences of caregivers, highlighting their increased stress, burnout, and mental health concerns. The importance of accessible information resources, respite care services, emotional support networks, and financial assistance programs is emphasized. Effective strategies for supporting caregivers include educating them about ASD symptoms, treatments, and therapies, teaching coping mechanisms for managing challenging behaviors, and promoting collaboration between healthcare providers and caregivers. Policy implications are discussed, including advocating for legislative modifications that prioritize caregiver needs, promoting inclusionary practices within educational systems, and increasing funding for early intervention programs and caregiver support services. The implementation of parent training programs, collaborative relationships between educators and caregivers, and professional development opportunities for educators are also recommended. This study aims to inform policymakers, healthcare professionals, and educators about the critical role of caregiver support in improving outcomes for children with ASD. By addressing caregiver needs and providing comprehensive support, we can enhance the well-being of both caregivers and children with ASD.

Impact of Cancer Care Financial Assistance Program on client financial toxicity and emotional distress.

204 Background: The financial impact of cancer can include high out-of-pocket costs, compensatory trade-offs (e.g., postponing treatment), and emotional distress. Cancer Care developed its Financial Assistance (FA) Program to assist with cancer-related costs and reduce client financial and emotional burden. We examined the impact of Cancer Care ’s FA Program on financial toxicity and emotional distress in clients undergoing cancer treatment. Methods: 731 patients enrolled in Cancer Care ’s FA Program (1/23-12/23) completed an evaluation survey. Clients were primarily women (71%); mean age=58 ( SD =13); 47% were non-Hispanic White, 33% non-Hispanic Black, 12% Hispanic. 84% were not employed; median household income $20K; 98% insured. Most frequent diagnoses: breast (26%), multiple myeloma (8%), and colon (5%) cancers; mean years since diagnosis=3 ( SD =6). All were on treatment (85% chemo; 38% radiation; 13% hormone; 11% immunotherapy). We used descriptive and multivariable regression analyses to examine the impact of FA and the correlates of reduced financial stress (yes/no) and emotional distress (not at all–extremely), controlling for socio-demographics. Results: The median grant award was $300 (max: $3000). FA was most often used for transportation (48%), household costs (43%), food (40%), and medical costs (30%). Only 38% of clients were aware of non-insurance financial resources during treatment. Financial compensatory trade-offs included delaying treatment (19%), choosing a less expensive treatment (7%), and stopping treatment (5%). Regarding financial toxicity, 61% reported that FA reduced their financial stress. In logistic regression, factors associated with greater likelihood of reduced financial stress after FA were larger grant amounts ( OR =1.05; p =.04), using FA for transportation ( OR =1.59; p =.00) or medical costs ( OR =1.44; p =.04), and unemployment ( OR =1.69; p =.02). Regarding emotional distress, 67% were distressed/extremely distressed before FA, vs. 25% after FA ( t =-21.72; p =.00). In linear regression, using FA for medical costs was associated with lower distress ( B =-.29; p =.00), and stopping treatment due to finances was associated with higher distress ( B =.52; p =.00), controlling for baseline distress. Using FA for other needs was not significantly associated with reduced financial/emotional distress. 50% said FA met their needs well/very well; 78% were satisfied/very satisfied with the program. Conclusions: Our results show the impact of Cancer Care ’s FA Program on reducing client financial toxicity and emotional distress, known factors in treatment adherence, quality of life, and survival. Notably, use of FA for medical and transportation costs, and grant amount, were significantly associated with improved client outcomes. Clients using funds for other basic needs may have multiple stressors requiring comprehensive multilevel support beyond FA alone.

The tipping point: Financial and emotional costs of care for Medicare patients with cancer.

260 Background: As cancer-related health care expenses are increasing, a greater proportion of treatment costs are shifting directly to the patient, resulting in an increased financial burden for many patients. In addition to growing healthcare costs, the inflationary environment in the US has also increased the costs of daily living expenses. Although the Inflation Reduction Act (IRA) encompasses measures for negotiating prices of specific high-cost medications within Medicare Parts B and D, given the expenses associated with cancer treatment IRA negotiation provisions will likely have limited impact on patients’ financial burden. We sought to capture the financial and emotional experiences of Medicare cancer patients about their costs of care prior to the implementation of the IRA. Methods: This cross-sectional analysis used data from a nationwide survey distributed in February 2024 by Patient Advocate Foundation (PAF). Inclusion criteria included a valid email address, age >19, self-reported cancer diagnosis and Medicare coverage. Frequencies were calculated for categorical variables. Additional information about financial challenges will be collected on a subset of cancer survey respondents in May 2024. Results: A total of 331 survey respondents with cancer completed the survey. Most respondents were female (61%), age≥56 (86%), white (73%), retired (59%), married (47%), household income <$48,000 (69%), and rural location (24%). The most common cancer types were multiple myeloma (47%) and breast (26%); 25% were diagnosed < 2 years prior, 87% were receiving cancer treatment and 52% experienced financial challenges prior to diagnosis. Almost half (45%) reported a negative change in their financial situation in the past 12 months; caused by increased living (63%), food (60%), medical care (47%) and medication (39%) costs. Overwhelming/above average financial stress (40%) was reported on the day of the survey; 30% reported spending at least 25% of their monthly income on medical costs; 69% reported financial burden due to their illness. Fifty-nine percent reported that finances impacted their emotional wellbeing. Common coping strategies to alleviate financial distress included positive attitudes, family/friend support and spiritual beliefs. Conclusions: To mitigate the impact of inflation on low-income cancer patients, it is essential for policymakers, healthcare providers, and community organizations to work together to ensure access to affordable healthcare, support services, and financial assistance programs. Additionally, raising awareness about the challenges faced by this vulnerable population and advocating for policies that address their needs can help alleviate some of the burdens imposed by inflation. While the IRA is a step in the right direction, its financial impact on patients appears limited.

Improving the Cardamom Marketing: Assessing the Marketing Efficiency of Cardamom in Theni District, Tamil Nadu

Introduction: The cardamom is the oldest spices and belongs to Zingiberaceae family. It is cultivated in the thick shady, rainy forests of the Western Ghats of the South India. The major growing states are Kerala, Karnataka and Tamil Nadu in reference to green cardamom (Small) and its botanical name Elettaria cardamomum. The part of Theni district is constituted by thick vegetations of hills of Western Ghats and Cumbum Valley at Bodi and Uthamapalayam taluk. In these areas, the farmers are cultivating the Cardamom. This study aims to find out the socio-economic characters, marketing behavior, assess the marketing efficiency of different supply channels and ranking the major problems faced by farmers to market their agricultural product. Methodology: The author used both primary and secondary data. The maximum area covered by cardamom was used as criteria for selecting the blocks. Purposive random sampling method was used to select the villages and the data was collected from the 60 farmers and other stakeholders using well-structured questionnaire. The descriptive statistics and percentage analysis were used for interpreting the results. For marketing analysis, marketing costs, marketing margin and price spread were estimated. For marketing efficiency, Acharya’s method (2003) was used. Results: The 34 respondents with 56.67 percent were found to be 21-35 years of age group. It was found that 7 respondents only with 11.67 percent and 26 respondents with 43.33 percent were found to be illiterate and the annual turnover of 1-5 lakh respectively. Using Acharya’s method (2003), the marketing efficiency of the channel I, II, III were 5.92, 9.97, 7.27 respectively. The price spread in the marketing channel I, II, and III are Rs. 295.94 per Kg, Rs. 163.54 per Kg and 229.48 per Kg respectively. It was shown that channel II is efficient due to high efficiency value and less price spread. Producer in the marketing channel II had highest share (90.88) in consumer rupee. The result showed that the Lack of timely adequate funds were major problem faced by the cardamom farmers with garret mean score of 65.23. The financial problems were common in the respondents. Conclusion: Marketing channel II was efficient because the spice auction center plays a vital role in protecting the farmer as well as consumer from the malpractices and exploitation of Intermediaries and to provide the transparency in trading operations of cardamom. The government may increase the financial assistance or technical support program to support the cardamom growers of the Tamil Nadu. The board should educate the farmers to grade or sort the cardamom before entering the e-Auction center to get better price for better quality of the commodity and to expand the pilot project of separate e-auctions for lab tested cardamom for artificial colours and pesticidal residues to potential markets of Tamil Nadu.

Impact of Financial Stress on Academic Performance of University Students in South East Nigeria

Abstract The purpose of this study is to examine how financial stress affects academic performance among university students in South East Nigeria. By using descriptive statistics and the Chi-Square model, we examined the relationship between financial stress and academic outcomes among 250 participants from five South Eastern universities. Several key factors contributing to financial stress were examined such as students’ monthly income, medical bills cost, ability to save, academic materials cost, student borrowing levels, and cost of feeding. The findings indicate that students’ monthly income and the cost of medical bills are the key determinants of financial stress among students. Based on the second objective, the study revealed that inability to pay bills as student, the inability to purchase required academic materials (books, course packs, supplies) due to their high costs, difficulties in paying school fees, and work schedules are the most significant factors that contribute to financial stress which negatively affect academic performance for students. Therefore, we recommend that government should enhance its financial assistance programs to alleviate financial stress among university students as this will improve their academic performance. Also, Collaboration with external stakeholders, can further enhance the resources available to students in need. Finally, this study illustrates the detrimental effects of financial stress on academic performance among university students in southeast Nigeria and should be interpreted with caution as its limited to South-East Nigeria.

Cohort Survival of the K to 12 Student Entrants Towards the Development of Strategic Interventions Supportive to Cbea-mmsu Programs

The study was undertaken to determine the cohort survival rate of the pioneer batch of the K to 12 student entrants of the eight (8) degree programs at the College of Business, Economics and Accountancy (CBEA), identify the underlying factors triggering the student dropout and institutionalize an intervention program to support the successful retention and graduation of all students. The Reconstructed Cohort Method was used and places less demand on the availability of detailed data over time. This method makes three assumptions: dropouts never return to school; the promotion, repetition and drop-out rates observed in the last two years remain constant over the entire period in which the cohort is enrolled in school and the same rates apply to all students enrolled in a given year level, regardless of whether they previously repeated a subject. A comprehensive analysis on the data gathered was done to process the underlying factors which will serve as valuable inputs in the design of programs and policies to reduce the dropout rate and support the successful retention and graduation of students. Findings showed that the survival rate of the pioneer batch of the K to 12 student entrants of the different programs range from 55.5% (BS Accountancy) to 97.5% (BSBA HRM) or an average of 81.62%. Overall, the survival rate among the males is 84.14% and the females is 80.86%. Majority (81.03%) of the respondents who were not able to finish their schooling on time indicated academic-related as their reason. Others mentioned about personal/family concern (17.24) and one indicated career concern. Some of the suggested interventions supportive to CBEA programs include: the implementation of an institutionalized Academic Advising Program, conduct of series of Academic Advising workshop, Academic Counseling, referral, group counselling, a more aggressive admission interview, parent/guardian conference, peer tutorial, financial assistance program and documentation of academic advising and counseling sessions. In addition, Guidance counselors must be one of the signatories in the dropping out and shifting forms. A replication research study involving different programs in the university is recommended.

Impact of the COVID-19 pandemic on Canadian performing and creative artists: An interpretive descriptive study using the social-ecological model.

Public health restrictions during the Coronavirus-2019 (COVID-19) pandemic in Canada have substantially reduced the work and income of performing and creative artists. We aimed to understand how factors at the public policy, community, organizational, interpersonal and individual levels affected Canadian performing and creative artists' health and livelihood during the pandemic. We interviewed 14 creative and performing artists from an academic hospital-based healthcare center in Toronto, Canada. In addition, we conducted secondary data analysis on an existing set of 17 transcribed interviews from a quality improvement study that included relevant information to answer the present study's research question. We applied an interpretive descriptive approach to our qualitative inquiry and used the social-ecological model (SEM) as our analytic framework. We identified factors at all levels of the SEM that tended to synergistically affect the health and livelihood of artists during the COVID-19 pandemic. Public health restrictions and government financial assistance programs have downstream effects on other levels. During the pandemic, many artists sensed an overwhelming loss of community, financial instability, and limited access to healthcare; which in turn affected their health. For those who accessed financial assistance programs, the stability of income afforded time for rest without the stress of food insecurity or housing instability. Use of the SEM as an analytic framework reflects the multidirectional intricacy and dynamic interplay among factors operating within and across all five levels, bringing to light potential areas of improvement at various levels to strengthen resilience and reduce risk factors associated with artists' health and healthcare access. Findings also accentuated the fragility of precarious work that inundates the performing arts industry, which emphasizes the need for interventions and policies to address this issue. Such interventions might include financial support programs for artists, access to affordable healthcare services, and efforts to strengthen social support networks within the arts community.

Making Financial Assistance Programs Equitable and Accessible

This Viewpoint discusses the lack of oversight and uniformity in hospitals’ financial assistance programs and the impact on patient access.

The Impact of Socio-Economic Factors on Maternal Health in Rural Africa

Maternal health was a critical indicator of societal well-being, reflecting the quality of healthcare systems and socio-economic conditions. In rural Africa, maternal health outcomes were alarmingly poor, with high maternal mortality rates persisting despite global efforts. This review explored the impact of socio-economic factors on maternal health in rural Africa, focusing on economic barriers, educational attainment, gender inequality, access to healthcare services, and social support networks. Economic barriers such as poverty and healthcare costs significantly limit access to essential maternal care. Educational attainment influences health literacy and the utilization of maternal healthcare services, with higher education levels correlating with better health outcomes. Gender inequality and entrenched cultural norms restrict women’s autonomy and decision-making power, negatively affecting maternal health. Access to healthcare services in rural areas is severely constrained by geographic isolation, inadequate infrastructure, and resource limitations. Social support networks, including family, friends, community members, and traditional birth attendants, play a crucial role in maternal health by providing emotional, informational, and practical support. This review used a comprehensive analysis of existing literature to discuss these factors and propose solutions to improve maternal health outcomes in rural Africa. Strategies such as financial assistance programs, expanding educational opportunities, empowering women, improving healthcare infrastructure, and strengthening social support networks are essential for addressing these challenges. By implementing these targeted interventions, significant improvements in maternal health can be achieved, leading to healthier mothers and stronger communities in rural Africa. Keywords: Maternal Health, Socio-Economic Factors, Rural Africa, Gender Inequality, Healthcare Access.

Horizontal Inequality in Healthcare Utilisation in Rural Sabah, Malaysia

Ensuring universal access to healthcare is essential for societal equity. However, significant inequalities exist within global healthcare systems, resulting in unequal access to services and divergent health outcomes. Socioeconomic inequity, poor living conditions, and inadequate healthcare infrastructure perpetuate poor health among poor communities. Despite greater healthcare needs, economically disadvantaged populations face substantial barriers to obtaining necessary services. This research evaluates the equitable aspect of healthcare utilisation in Sabah’s rural areas to guide policy formulation. Nabawan, a rural area in Sabah with high poverty rates, was selected to assess income-related inequality and inequity in healthcare utilisation. Using the horizontal equity index and decomposition analysis, it was found that economic status significantly influences healthcare distribution, typically favouring the affluent. Central to this analysis is the concept of “equal treatment for equal need,” ensuring individuals with similar healthcare needs receive similar care regardless of economic status. Results indicate that wealthier individuals are slightly more likely to utilise healthcare services, although the difference is minimal. To address disparities, enhancing targeted financial assistance programs like PeKa B40 could reduce out-of-pocket expenses for low-income households. Additionally, increasing healthcare funding for rural infrastructure and training local healthcare workers can ensure equitable access for all households.

Impact of a first-year medical student patient navigation initiative on healthcare access and students' skills

Background: Medical schools with complex patient populations, characterized by linguistic diversity and uncertain immigration status, face challenges in imparting essential skills in patient care, particularly in understanding healthcare barriers, building rapport, and fostering empathy. A South Florida medical school with a predominantly non-English-speaking and undocumented patient population piloted a Patient Navigation (PN) program within the first-year curriculum to address these challenges. We present the student feedback from the program’s first two years to guide medical schools in simultaneously caring for this unique patient population, with the aim of enhancing medical education. Methods: This program diverged from traditional Patient Navigation approaches by leveraging specialized hospital-associated translation services and collaborating with the Health System's Financial Assistance program. We performed a crosssectional study on student feedback surveys to identify program features significantly associated with a satisfying PN experience, and to provide insights to optimize and refine the program for future implementations. Results: The program engaged 245 out of 306 first-year medical students in PN for 118 patients. Successful contact was established with 55% of patients and 70% achieved their navigation objectives. Satisfaction metrics revealed that students given patients were nearly five times more satisfied than their counterparts. This positively impacts both student experience and patient outcomes, showcasing the program's effectiveness in bridging healthcare disparities. Discussion: The PN program proved successful in linking low-risk patients to follow-up care, offering medical students first-hand exposure to the challenges of care for primarily non-English-speaking and undocumented populations. The initiative aimed to enhance healthcare access for marginalized patients while providing medical students with an immersive understanding of patient-centric care beyond conventional curricular offerings. Key lessons learned include improving communication channels between students and patients, and optimizing community resources for streamlined patient support. Future iterations will prioritize these lessons, emphasizing cultural competence and patient advocacy to enhance both student education and patient care outcomes.

Barriers and Opportunities to Improve Healthcare Access for Uninsured Patients at a Student-Run Free Clinic in New Haven, Connecticut.

Uninsured patients have limited options to pay for necessary medical services. Most United States hospitals offer financial assistance programs (FAPs) to help patients pay for care, but the challenges of accessing these programs demonstrate a need for more solutions. This study was a retrospective review of 200 randomly sampled HAVEN Free Clinic patients from September 2022 to September 2023. Patients were eligible to be seen at HAVEN if 18-65 years old, without health insurance, and living in New Haven County, Connecticut. Application histories to Medicaid and hospital FAP at a non-profit tertiary care center in Connecticut were assessed. In the 200-patient sample, average age was 43.4 ± 11.2 years old, 61.0% were female, and 86.5% were Hispanic or Latino. 68% were employed with a median household yearly income of $18,200 [$7,293-$26,741]. 80% had applied for a hospital FAP-71.1% were currently approved for Free Care or Discounted Care. 6% were approved for Medicaid; 2.5% were approved for Emergency Medicaid. Of those who applied for a hospital FAP, 28.3% received ≥ 1 application denial. Most common hospital FAP denial reasons were missing, wrong, or outdated proof of income (93.9%), and incomplete application (6.1%). Hospital FAPs and Medicaid provide important access to care for uninsured patients, but are not without barriers and should not be viewed as the only solution. Improving hospital FAP access involves assessing eligibility at presentation, extending approval duration, and advocating for more funding. Addressing these barriers can advance equitable care for all.

Improving oral health screening and dental referrals for patients with diabetes in a community health clinic.

Oral health screening and access to dental care in adults with diabetes lead to improved health outcomes and quality of life. Patients with barriers to accessing health services have a greater risk of poor medical and dental outcomes. People with diabetes are more likely to have periodontal disease and less likely to visit a dentist. Oral screening and dental referrals were not being done at a community health clinic in Plano, Texas. The aim of this 6-month quality-improvement project was to increase oral health screenings in adults with diabetes from 0% to 80%; subaim was to increase access to dental services by increasing referrals from 0% to 50%. Adults with diabetes without insurance or dental care in the past 12 months were eligible for the project ( n = 263). Outcome measures were tracked using a longitudinal chart. Eligible patients were screened and referred to a dental office with an income-based financial assistance program using Plan-Do-Study-Act methodology. Staff education, referral order set, and follow-up calls were additional processes implemented. Fifty-two percent of eligible patients were screened, 35.9% were referred to dental services, and 17.7% of those referred established care with dental clinic. Interventions were successful in improving access to dental care, although target goal was not met. Creating systems that facilitate interdisciplinary care improved health equity and standards of health in chronic disease.

Influence of Socioeconomic Status of Parents on the Scholastic Achievement of Mathematics Students in Selected Secondary Schools within Ado LGA of Ekiti State

The investigation explored the influence of socioeconomic status of parents regarding the academic successes of math students in chosen secondary schools located in the Ado LGAof Ekiti State. The study encompassed both public and private educational institutions, employing a straightforward random sampling technique to select five secondary schools and sixty students. Information was gathered via a self-designed questionnaire with distinct sections A and B, concentrating on demographic details and parental elements such as education level, family background, income, and occupational status in relation to students' performance in Mathematics. The instrument underwent face and content validity procedures, and the results were assessed using Pearson correlation coefficient, yielding a value of 0.85. Hypotheses were evaluated through Chi-square analysis, and data were presented using pie charts and tables. The outcomes unveiled a significant influence of parent’ educational background, family background, occupation, and income level on the academic success of mathematics students. The researcher recommends the implementation of financial assistance programs for families with lower incomes to ensure equitable access to quality mathematics resources. Moreover, schools are encouraged to establish initiatives and parental engagement programs, fostering an inclusive and equitable learning environment. The study advocates for policy changes to promote fairness in mathematics education for students from diverse socioeconomic backgrounds.

Understanding Barriers to Guideline-Concordant Treatment in Foregut Cancer: From Data to Solutions

BackgroundA large proportion of patients with foregut cancers do not receive guideline-concordant treatment (GCT). This study sought to understand underlying barriers to GCT through a root cause analysis approach.MethodsA single-institution retrospective review of 498 patients with foregut (gastric, pancreatic, and hepatobiliary) adenocarcinoma from 2018 to 2022 was performed. Guideline-concordant treatment was defined based on National Comprehensive Cancer Network guidelines. The Ishikawa cause and effect model was used to establish main contributing factors to non-GCT.ResultsOverall, 34% did not receive GCT. Root causes of non-GCT included Patient, Physician, Institutional Environment and Broader System-related factors. In decreasing order of frequency, the following contributed to non-GCT: receipt of incomplete therapy (N = 28, 16.5%), deconditioning on chemotherapy (N = 26, 15.3%), delays in care because of patient resource constraints followed by loss to follow-up (N = 19, 11.2%), physician factors (N = 19, 11.2%), no documentation of treatment plan after referral to oncologic expertise (N = 19, 11.2%), loss to follow-up before oncology referral (N = 17, 10%), nonreferral to medical oncologic expertise (N = 16, 9.4%), nonreferral to surgical oncology in patients with resectable disease (N = 15, 8.8%), and complications preventing completion of treatment (N = 11, 6.5%). Non-GCT often was a function of multiple intersecting patient, physician, and institutional factors.ConclusionsA substantial percentage of patients with foregut cancer do not receive GCT. Solutions that may improve receipt of GCT include development of automated systems to improve patient follow-up; institutional prioritization of resources to enhance staffing; financial counseling and assistance programs; and development and integration of structured prehabilitation programs into cancer treatment pathways.

Organizational and economic mechanism of financing agricultural production in conditions of market transformation

The article is devoted to the problems of financial support for agricultural sector of economy of Kazakhstan. The goal is to study organizational and economic mechanism of financing agricultural industry in conditions of market transformation in order to develop recommendations for optimizing this system to improve access to financial sources for agricultural enterprises, develop financial instruments, and promote the expansion of market relations. Methods – abstract-logical, graphic, comparative analysis, generalization. Results - available financial resources for agro-industrial complex are analyzed: budgetary funds, investments, loans based on the use of various state financial assistance programs. The relevance of the study lies in the possibility of implementing individual proposals when developing rules for financing, lending, changing the criteria for subsidizing AIC, as well as the effective use of investment funds, loans and other financial resources. The need for additional attraction of internal and external investors has been identified. Conclusions - the state has a regulatory impact on the investment process by ensuring rational pricing, increasing flexibility of lending, tax and depreciation policies, stimulating business activity by providing investors with benefits, and highlighting priority areas of investment. It is necessary to monitor current and future factors of external and internal environment at the state, regional levels and enterprises. There is a need in the near and medium term for effective measures to financially support production and processing of competitive products, increase the variety of produced goods and maintain high quality at all stages of their production. Financial decisions are the basis for effective investment projects.

IMPACT OF THE WAR ON UKRAINE'S INVESTMENT CLIMATE: RISK ASSESSMENT AND PROSPECTS FOR FOREIGN INVESTORS

The article is devoted to a comprehensive analysis of the impact of the Russian-Ukrainian war on the investment climate in Ukraine. Based on current statistical data and expert assessments, the main risks for foreign investors caused by military actions on the country's territory are identified. Among them are: large-scale destruction of critical infrastructure, disruption of established logistics chains, a rapid decline in the purchasing power of the population, as well as a high level of uncertainty regarding the further course and duration of the armed conflict. At the same time, the author considers the potential prospects for restoring the investment attractiveness of Ukraine in the conditions of post-war reconstruction. Special emphasis is placed on forecasting the likely dynamics and sectoral structure of foreign investment in the Ukrainian economy starting from 2025, based on the assumption of the completion of the active phase of hostilities. Based on the identified competitive advantages of Ukraine, a set of measures is proposed to improve the national investment environment in the medium and long term. They include ensuring macroeconomic stability, carrying out structural reforms of the regulatory and judicial systems, strengthening the institutional protection of investors' rights, as well as attracting large-scale financial and technical assistance from international partners. At the same time, the author emphasizes the critical importance of forming a holistic strategic vision for the development of Ukraine as a competitive and investment-attractive state in the long-term horizon, which requires the implementation of a targeted policy to stimulate innovation, build modern infrastructure and integrate into global value chains. The article also analyzes the experience of other countries that have suffered significant economic losses due to military conflicts, and highlights the most effective strategies for restoring investment attractiveness in post-war reconstruction. In particular, successful examples of attracting foreign investment in the countries of the Balkan region and Southeast Asia, which managed to quickly overcome the consequences of armed confrontations and ensure sustainable economic growth, are considered. Based on this experience, the author proposes to adapt best practices to Ukrainian realities, taking into account the specifics of the national institutional environment and geopolitical context. Special attention is paid to the role of international financial institutions, in particular the International Monetary Fund, the World Bank, and the European Bank for Reconstruction and Development, in supporting investment processes in Ukraine in the context of post-war recovery. The importance of aligning their financial and technical assistance programs with national development priorities and ensuring effective coordination of efforts of all stakeholders is emphasized. In summary, the author concludes that restoring the investment attractiveness of Ukraine in the conditions of post-war reconstruction will require a comprehensive approach that combines urgent measures to overcome the devastating consequences of the war with strategic initiatives aimed at ensuring the long-term competitiveness of the national economy. Only under such conditions will Ukraine be able to fully realize its investment potential and become an attractive destination for international capital in the post-war world.

QOL-47. FINANCIAL TOXICITY IN PEDIATRIC NEUROSURGICAL ONCOLOGY

Abstract BACKGROUND Financial toxicity encompasses the negative impact of medical costs on patients. To our knowledge, financial toxicity in pediatric neurosurgical oncology remains unstudied. METHODS All pediatric neurosurgical cases from 2016 to 2020 performed at Memorial Sloan Kettering Cancer Center were included. Financial toxicity (FT) was defined as patients experiencing: bankruptcy, bills sent to collections, settlement, or timed payment plan, expression of financial concern to social work, or utilization of copay, financial, or social work philanthropy assistance programs. FT was assessed in the 2 years pre- and post- surgical intervention for all patients. RESULTS Two hundred and ninety-five surgical procedures across 203 patients were analyzed. The rate of FT in the two years prior to the first neurosurgical procedure was 17% (34/203). The most common toxicities were financial assistance program (47%), social work philanthropy (29%), and bills sent to collections (24%). The rate of FT for the subset of patients surviving at least 2 years after surgery was 34% (30/87) with the most common toxicities being financial assistance program (33%), collections (33%) and social work philanthropy (27%). The majority of patients who experienced FT had at least one commercial insurance policy (56% for the pre-surgical cohort, 70% for the post-surgical cohort). For all 203 patients, the 2-year cumulative incidence of FT following first neurosurgical procedure was 19% (CI:14%,25%) with those experiencing pre-operative toxicity having a significantly higher two-year cumulative incidence of FT at 62% (95%CI: [43%,76%], p<0.001) following first neurosurgical procedure. Patients without FT prior to first procedure had a two-year cumulative incidence of FT of 11% (95%CI: [7%,16%], p<0.001). CONCLUSIONS FT rates are substantial in the pediatric neurosurgical oncology population. Pre-operative FT influenced post-surgical FT. The most common toxicity was financial assistance program utilization. The majority of patients and families who experienced FT had at least one commercial insurance plan.

Impact of a proactive patient assistance program for diverse ambulatory oncology patients: A retrospective cohort study.

e13513 Background: Significant differences persist in cancer incidence, survival, morbidity, and mortality among populations in the U.S. Individuals of lower socioeconomic status (SES) suffer disproportionately from cancer and other disease burdens compared to individuals with higher SES. Financial hardship is increasingly common, with many cancer survivors reporting difficulty paying medical bills, high financial distress, and delaying or forgoing care because of cost. Cancer patients reporting financial hardship are more likely to have psychosocial distress. Financial distress has been linked with several clinically relevant patient outcomes including quality of life, symptom burden, compliance, and survival. An NCI-designated comprehensive cancer center (CCC) with a diverse racial, ethnic, and linguistic patient population utilizes My Wellness Check (MWC) program to identify patients experiencing emotional, physical, practical, and social concerns. Among 4,117 MWC patient responders representing 43.1% of eligible patients during October 2019 - February 2022, 801 patients (19.5%) with 976 supportive or practical needs alerts were triggered to social workers where only 68.4% of the alerts were acted upon within a 72-hour window. For patients identified by MWC as having financial toxicity, Social Workers identified available resources to assist with patients’ out-of-pocket costs. Methods: In July 2022, the CCC launched a patient financial assistance program which included screening of all patients receiving systemic therapy administered at infusion centers. A third-party partner was contracted to provide patient advocates and technology augmenting the EHR. Patient Advocates identified eligible patients and enrolled them into financial assistance programs. Results: A retrospective analysis was performed for the period of May 2022 - December 2023, comparing patients receiving philanthropic medical financial assistance consisting of copay assistance and grants sponsored by drug manufacturers and diagnosis based non-profit foundations with infusion center patient population demographic data. The cohort participating in patient assistance programs included a higher percentage of female, Hispanic, age 27-64, commercially insured, and patients that reside in high and medium-high Social Vulnerability Index (SVI) counties. Conclusions: A proactive patient financial assistance program can help reduce financial distress for patients with cancer, especially those residing in high and medium high SVI counties. Leveraging the expertise of a third party helps mitigate financial toxicity in the short term and can help drive more equitable cancer outcomes.