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The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public–private healthcare system

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Abstract

Purpose

Although awareness is increasing that cancer can have an adverse financial and economic impact for patients, the overall burden remains poorly understood. To elucidate these issues, we used qualitative methods to explore the financial impact of a cancer diagnosis in Ireland, which has a mixed public–private healthcare system and where sick leave and sick pay are at employers’ discretion.

Methods

Face-to-face semi-structured interviews were conducted with hospital-based oncology social workers (OSWs; 21 OSWs from 11 hospitals) and patients (20 from eight hospitals; 11 breast, 5 prostate and 4 lung cancer). Participants were asked about the (1) extra expenses incurred, (2) cancer’s impact on work and income, and (3) accessing financial assistance/social welfare benefits. The two interview sets were analysed separately using thematic analysis.

Results

Broad themes that emerged included the wide range of additional cancer-related medical and non-medical expenses incurred by all patients, including those with medical cards (which entitle the bearer to receive health services free of charge) and those with private health insurance; the major impact of cancer and its treatment on work and patient/household income (all patients who were working at diagnosis experienced a drop in income); and difficulties in accessing medical cards and benefits.

Conclusions

This study reveals the complex, multidimensional nature of the financial and economic burden cancer imposes on patients and the whole family unit. Changes in income post-cancer exacerbate the effects of cancer-related out-of-pocket expenses. These findings have implications for healthcare professionals, service providers and policy makers.

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Acknowledgments

This study was funded by the Irish Cancer Society. We thank the study participants and the health professionals who helped recruit patients. We are grateful to the members of the project Steering Committee (Harry Comber, Noeleen Donnelly, Joan Kelly, John McCormack, Niamh Ni Chonghaile, Eileen O’Donnell, Olwyn Ryan) for their input, to Frances Drummond and Judith Murphy for double coding some of the interviews, and to Claire O’Callaghan and Grace Buckley for transcription.

Disclosures

A project grant was awarded to the National Cancer Registry from Sanofi-aventis, 2010–2012, for research on comorbidity in prostate cancer (PI: L Sharp). A. Timmons and R. Gooberman-Hill have no relevant disclosures to make.

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Authors and Affiliations

  1. National Cancer Registry, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland

    Aileen Timmons & Linda Sharp

  2. School of Clinical Sciences, University of Bristol, Bristol, UK

    Rachael Gooberman-Hill

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  1. Aileen Timmons
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  2. Rachael Gooberman-Hill
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  3. Linda Sharp
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Correspondence to Aileen Timmons.

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Timmons, A., Gooberman-Hill, R. & Sharp, L. The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public–private healthcare system. Support Care Cancer 21, 107–117 (2013). https://doi.org/10.1007/s00520-012-1498-4

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  • DOI: https://doi.org/10.1007/s00520-012-1498-4

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