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Cancer cost communication: experiences and preferences of patients, caregivers, and oncologists—a nationwide triad study

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Abstract

Purpose

We assessed cost communication between cancer patients, caregivers, and oncologists and identified factors associated with communication concordance.

Methods

A national, multicenter, cross-sectional survey of patient-caregiver-oncologist triads was performed, and 725 patient-caregiver pairs, recruited by 134 oncologists in 13 cancer centers, were studied. Discordance in preferences and experiences regarding cost communication between patients, caregivers, and oncologists were assessed. Hierarchical generalized linear models were used to identify predictors of concordance and to identity the possible association of concordance with patient satisfaction and degree of trust in the physician.

Results

Although the oncologists thought that patients would be affected by the cost of care, only half of them were aware of the subjective burden experienced by their patients, and the degree of concordance for this parameter was very low (weighted kappa coefficient = 0.06). Caregivers consistently showed similar preferences to those of the patients. After controlling for covariates, the education level of patients [adjusted odds ratio (aOR) for > 12 vs. < 9 years, 2.92; 95% confidence interval (CI), 1.87–4.56], actual out-of-pocket costs [aOR for ≥ 8 million vs. < 2 million Korean Won, 0.56; 95% CI, 0.34–0.89], and physician age (aOR for ≥ 55 vs. < 45 years, 1.83; 95% CI, 1.04–3.21) were significant.

Conclusions

The results show underestimation by oncologists regarding the subjective financial burden on a patient, and poor patient-physician concordance in cost communication. Oncologists should be more cognizant of patient OOP costs that are not indexed by objective criteria, but instead involve individual patient perceptions.

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Author information

Authors and Affiliations

  1. College of Medicine, Graduate School of Health Science Business Convergence, Chungbuk National University, 1, Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do, 28644, Republic of Korea

    So Young Kim, Hye Sook Han & Jong-Hyock Park

  2. Chungbuk National University Hospital, Cheongju, Republic of Korea

    So Young Kim & Hye Sook Han

  3. Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea

    Dong Wook Shin

  4. Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea

    Boyoung Park

  5. National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea

    Boyoung Park, Hyung Kook Yang, Keeho Park & Jong-Hyock Park

  6. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Juhee Cho

  7. Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea

    Juhee Cho

  8. Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea

    Jae Hwan Oh

  9. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea

    Sun Seog Kweon

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  1. So Young Kim
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Correspondence to Jong-Hyock Park.

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Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Kim, S.Y., Shin, D.W., Park, B. et al. Cancer cost communication: experiences and preferences of patients, caregivers, and oncologists—a nationwide triad study. Support Care Cancer 26, 3517–3526 (2018). https://doi.org/10.1007/s00520-018-4201-6

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  • DOI: https://doi.org/10.1007/s00520-018-4201-6

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