Financial and family burden associated with cancer treatment in Ontario, Canada
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Goals of work
To determine the financial and family resources burden associated with the treatment of cancer. A questionnaire was developed to determine the direct monthly “out-of-pocket costs” (OOPC), the indirect costs, and the associated perceived family burden.
Materials and methods
A self-administered questionnaire using a quota sample from five cancer clinics in Ontario, Canada was given to 282 cancer patients (74 breast, 70 colorectal, 68 lung, and 70 prostate). Monthly OOPC were obtained for: drugs, home care, homemaking, complementary and alternative medicines, vitamins and supplements, family care, travel, parking, accommodations, devices, and others. The questionnaire asked if OOPC for treatment were a burden, and if others took time from work to provide caregiving.
The mean monthly OOPC was $213, with an additional $372 related to imputed travel costs. For those patients who responded that the burden was “significant” (16.5%), their OOPC was $452. In the case of patients responding that their burden was “unmanageable” (3.9%), their OOPC was $544. The survey showed that 35.6% of patients required others to take time from work and this was higher in the under-65 category. The mean number of days lost from work in the previous 30 days for these caregivers was 7 days.
These results suggest the financial burden is problematic for 20% of this sample. The caregivers’ lost time from work influence this burden, and for 36% of this sample, it amounts to one third of their working days in any given month. Policies and programs to address these gaps are needed.
KeywordsCancer Self-administered questionnaire Out-of-pocket costs Financial burden
Funding was provided through the Opportunities Fund in the CIHR-funded research group “Medicare to home and community” (M-THAC) and covered most of the shipping and printing costs, the logistics of which were managed by M-THAC research coordinator Cathy Bezic. There were a number of individuals who assisted at the five participating regional cancer centers including: Allen Edwardson (NWORCC), Scott Sellick (NWORCC), Elenor Dilullo (LRCP), Susan Wolnick (LRCP), Dr. David D’Souza (LRCP), Diane Manii (OHRCC), Diane Dilnot (SWRCC), Susan Dimitry (JCC), Adrieanne Hasler (JCC), Mary O’Brien (JCC), Dr. Richard Tozer (JCC), and Dr. Tim Whelan (JCC). Annual cancer incidence data were provided from Carole Herbert at the Ontario Cancer Registry and by Darlene Dale at Princess Margaret Hospital.
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