Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina
Background Little research exists on delayed and forgone health and mental health care due to cost among rural cancer survivors.Methods We surveyed survivors in 7 primarily rural, Appalachian counties February to May 2020. Univariable analyses examined the distribution and prevalence of delayed/forg...
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Taylor & Francis Group
2023-01-01
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| Series: | Cancer Survivorship Research & Care |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/28352610.2023.2270401 |
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| author | Derek S. Falk Janet A. Tooze Karen M. Winkfield Ronny A. Bell Sarah A. Birken Bonny B. Morris Carla Strom Emily Copus Kelsey Shore Kathryn E. Weaver |
| author_facet | Derek S. Falk Janet A. Tooze Karen M. Winkfield Ronny A. Bell Sarah A. Birken Bonny B. Morris Carla Strom Emily Copus Kelsey Shore Kathryn E. Weaver |
| author_sort | Derek S. Falk |
| collection | DOAJ |
| description | Background Little research exists on delayed and forgone health and mental health care due to cost among rural cancer survivors.Methods We surveyed survivors in 7 primarily rural, Appalachian counties February to May 2020. Univariable analyses examined the distribution and prevalence of delayed/forgone care due to cost in the past year by independent variables. Chi-square or Fisher’s tests examined bivariable differences. Logistic regressions assessed the odds of delayed/forgone care due to cost.Results Respondents (n = 428), aged 68.6 years on average (SD: 12.0), were 96.3% non-Hispanic white and 49.8% female; 25.0% reported delayed/forgone care due to cost. The response rate was 18.5%. The proportion of delayed/forgone care for those aged 18–64 years was 46.7% and 15.0% for those aged 65 + years (P < 0.0001). Females aged 65 + years (OR: 2.00; CI: 1.02-3.93) had double the odds of delayed/forgone care due to cost compared to males aged 65 + years.Conclusion About one in four rural cancer survivors reported delayed/forgone care due to cost, with rates approaching 50% in survivors aged <65 years.Impact Clinical implications indicate the need to: 1) ask about the impact of care costs, and 2) provide supportive services to mitigate effects of treatment costs, particularly for younger and female survivors. |
| format | Article |
| id | doaj-art-baa074655f7443d1a669a4b7a4a39834 |
| institution | Kabale University |
| issn | 2835-2610 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Cancer Survivorship Research & Care |
| spelling | doaj-art-baa074655f7443d1a669a4b7a4a398342024-12-02T05:20:10ZengTaylor & Francis GroupCancer Survivorship Research & Care2835-26102023-01-011110.1080/28352610.2023.2270401Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North CarolinaDerek S. Falk0Janet A. Tooze1Karen M. Winkfield2Ronny A. Bell3Sarah A. Birken4Bonny B. Morris5Carla Strom6Emily Copus7Kelsey Shore8Kathryn E. Weaver9Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA (Sponsor)Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USAMeharry-Vanderbilt Alliance, Nashville, TN, USAPharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USAAtrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, North Carolina, USADepartment of Social Sciences & Health Policy, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA (Sponsor)Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, North Carolina, USAAtrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, North Carolina, USAAtrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, North Carolina, USADepartment of Social Sciences & Health Policy, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA (Sponsor)Background Little research exists on delayed and forgone health and mental health care due to cost among rural cancer survivors.Methods We surveyed survivors in 7 primarily rural, Appalachian counties February to May 2020. Univariable analyses examined the distribution and prevalence of delayed/forgone care due to cost in the past year by independent variables. Chi-square or Fisher’s tests examined bivariable differences. Logistic regressions assessed the odds of delayed/forgone care due to cost.Results Respondents (n = 428), aged 68.6 years on average (SD: 12.0), were 96.3% non-Hispanic white and 49.8% female; 25.0% reported delayed/forgone care due to cost. The response rate was 18.5%. The proportion of delayed/forgone care for those aged 18–64 years was 46.7% and 15.0% for those aged 65 + years (P < 0.0001). Females aged 65 + years (OR: 2.00; CI: 1.02-3.93) had double the odds of delayed/forgone care due to cost compared to males aged 65 + years.Conclusion About one in four rural cancer survivors reported delayed/forgone care due to cost, with rates approaching 50% in survivors aged <65 years.Impact Clinical implications indicate the need to: 1) ask about the impact of care costs, and 2) provide supportive services to mitigate effects of treatment costs, particularly for younger and female survivors.https://www.tandfonline.com/doi/10.1080/28352610.2023.2270401Financial hardshipcancer survivorshipruralcost of careAppalachian region |
| spellingShingle | Derek S. Falk Janet A. Tooze Karen M. Winkfield Ronny A. Bell Sarah A. Birken Bonny B. Morris Carla Strom Emily Copus Kelsey Shore Kathryn E. Weaver Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina Cancer Survivorship Research & Care Financial hardship cancer survivorship rural cost of care Appalachian region |
| title | Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina |
| title_full | Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina |
| title_fullStr | Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina |
| title_full_unstemmed | Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina |
| title_short | Factors associated with delaying and forgoing care due to cost among long-term, Appalachian cancer survivors in rural North Carolina |
| title_sort | factors associated with delaying and forgoing care due to cost among long term appalachian cancer survivors in rural north carolina |
| topic | Financial hardship cancer survivorship rural cost of care Appalachian region |
| url | https://www.tandfonline.com/doi/10.1080/28352610.2023.2270401 |
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