Kelsey M. Owsley, PhD MPH


Curriculum vitae



Department of Health Systems, Management, and Policy

University of Colorado - Anschutz Medical Campus



Cancer’s Lasting Financial Burden: Evidence from a Longitudinal Assessment


Journal article


Ya-Chen Tina Shih, Kelsey M. Owsley, Lauren Hersch Nicholas, K. Robin Yabroff, Cathy Bradley

Cite

Cite

APA   Click to copy
Shih, Y.-C. T., Owsley, K. M., Nicholas, L. H., Yabroff, K. R., & Bradley, C. Cancer’s Lasting Financial Burden: Evidence from a Longitudinal Assessment.


Chicago/Turabian   Click to copy
Shih, Ya-Chen Tina, Kelsey M. Owsley, Lauren Hersch Nicholas, K. Robin Yabroff, and Cathy Bradley. “Cancer’s Lasting Financial Burden: Evidence from a Longitudinal Assessment” (n.d.).


MLA   Click to copy
Shih, Ya-Chen Tina, et al. Cancer’s Lasting Financial Burden: Evidence from a Longitudinal Assessment.


BibTeX   Click to copy

@article{ya-chen-a,
  title = {Cancer’s Lasting Financial Burden: Evidence from a Longitudinal Assessment},
  author = {Shih, Ya-Chen Tina and Owsley, Kelsey M. and Nicholas, Lauren Hersch and Yabroff, K. Robin and Bradley, Cathy}
}

 PURPOSE: To conduct a longitudinal analysis of out-of-pocket expenditure (OOPE) trajectories for the assessment of cancer’s lasting financial impact.  METHODS: We identified newly diagnosed patients with cancer from the 2002-2018 Health and Retirement Study and constructed a matched non-cancer control group. Outcomes included monthly OOPE for prescription drugs (RX-OOPE) and OOPE for all medical services other than drugs (non-RX OOPE) in the past 2 years, consumer debt and new individual retirement account (IRA) withdrawals. Generalized linear models were used to compare RX-OOPE and non-RX OOPE between the cancer and matched control group before, during, and after diagnosis. Logistic regression models were used to compare household-level consumer debt or early IRA withdrawal. Subgroup analysis stratified patients by age (< 65 vs. ≥ 65), health status, and median household income, with the low-income group stratified by Medicaid coverage. RESULTS: The study cohort included 2,022 patients with cancer and 10,110 matched non-cancer controls. Mean non-RX OOPE of patients with cancer was similar to the mean of matched controls before diagnosis, but statistically significantly higher at diagnosis ($1,157, P<0.001), and 2 ($511, P<0.001), 4 ($360, P=0.006), and 6 years ($430, P=0.010) after diagnosis. A similar pattern was observed in RX-OOPE. A significantly higher proportion of cancer patients incurred consumer debt at diagnosis (34.5% vs. 29.9%, P<0.001) and 2 years after (32.5% vs. 28.2%, P=0.002). There was no statistically significant difference in new IRA withdrawals. CONCLUSIONS: Patients experienced lasting financial consequences following cancer diagnosis and were most pronounced among patients ≥65, in good-to-excellent health at baseline, and with low income, but without Medicaid coverage. Remedies include policies to reduce cancer care costs and expand patient insurance coverage options while reducing cost-sharing. 



 


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