Healthcare utilization and cost barriers among U.S. childhood cancer survivors
Background To evaluate healthcare utilization and cost barrier patterns among childhood cancer survivors (CCS) compared with noncancer controls. Procedure Using the 2014‐2019 Behavioral Risk Factor Surveillance System, we identified CCS
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| Veröffentlicht in: | Pediatric blood & cancer 2023-08, Vol.70 (8), p.e30443-n/a |
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| container_title | Pediatric blood & cancer |
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| creator | Nghiem, Van T. Alanaeme, Chibuike J. Mennemeyer, Stephen T. Wong, F. Lennie |
| description | Background
To evaluate healthcare utilization and cost barrier patterns among childhood cancer survivors (CCS) compared with noncancer controls.
Procedure
Using the 2014‐2019 Behavioral Risk Factor Surveillance System, we identified CCS |
| doi_str_mv | 10.1002/pbc.30443 |
| format | Article |
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To evaluate healthcare utilization and cost barrier patterns among childhood cancer survivors (CCS) compared with noncancer controls.
Procedure
Using the 2014‐2019 Behavioral Risk Factor Surveillance System, we identified CCS < 50 years and matched controls. We used chi‐squared tests to compare characteristics between the two groups. Logistic regression analyses were used to assess the likelihood of having a checkup, receiving influenza vaccine, and experiencing healthcare cost barriers (being unable to see the doctor due to cost) during the past 12 months. Conditional models accounted for the matching.
Results
We included 231 CCS and 692 controls. CCS had lower household income (p < 0.001), lower educational attainment (p = 0.021), more chronic health conditions (p < 0.001), and a higher proportion of being current smokers (p = 0.005) than controls. Both groups had similar rates of having a checkup and influenza vaccine; however, a quarter of CCS experienced healthcare cost barriers compared with 13.9% in controls (p = 0.001; regression findings: adjusted odds ratio (aOR) = 1.72, 95% confidence interval (CI): 1.11‐2.65). Compared with the youngest CCS group (18‐24 years), CCS ages 25‐29 years were five times more likely to experience healthcare cost barriers (aOR = 4.79; 95% CI, 1.39‐16.54). Among CCS, current smokers were less likely to have a checkup (aOR = 0.46; 95% CI, 0.23‐0.94). Uninsured CCS were less likely to have a checkup (aOR = 0.33; 95% CI, 0.14‐0.75) and ∼8 times more likely to experience healthcare cost barriers (aOR = 8.28; 95% CI, 3.45‐19.88).
Conclusion
CCS being 25‐29 years, uninsured, or current smokers encounter inferior outcomes in healthcare utilization and cost barriers. We suggest emphasis on programs on care transition and smoking cessation for CCS.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.30443</identifier><identifier>PMID: 37248167</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Access to care ; Childhood ; childhood cancer survivor ; Children ; Chronic illnesses ; Cigarette smoking ; costs ; Drug addiction ; Health care ; health disparities ; Health services utilization ; healthcare utilization ; Hematology ; Influenza ; long‐term follow‐up ; Oncology ; Pediatrics ; Risk factors ; Vaccines</subject><ispartof>Pediatric blood & cancer, 2023-08, Vol.70 (8), p.e30443-n/a</ispartof><rights>2023 The Authors. published by Wiley Periodicals LLC.</rights><rights>2023 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3483-f1320a984d22b2077dfc6365a2d419de78690743ea8438d14df3145aa03d43cd3</cites><orcidid>0000-0002-6039-7965 ; 0000-0002-6994-3571</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.30443$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.30443$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37248167$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nghiem, Van T.</creatorcontrib><creatorcontrib>Alanaeme, Chibuike J.</creatorcontrib><creatorcontrib>Mennemeyer, Stephen T.</creatorcontrib><creatorcontrib>Wong, F. Lennie</creatorcontrib><title>Healthcare utilization and cost barriers among U.S. childhood cancer survivors</title><title>Pediatric blood & cancer</title><addtitle>Pediatr Blood Cancer</addtitle><description>Background
To evaluate healthcare utilization and cost barrier patterns among childhood cancer survivors (CCS) compared with noncancer controls.
Procedure
Using the 2014‐2019 Behavioral Risk Factor Surveillance System, we identified CCS < 50 years and matched controls. We used chi‐squared tests to compare characteristics between the two groups. Logistic regression analyses were used to assess the likelihood of having a checkup, receiving influenza vaccine, and experiencing healthcare cost barriers (being unable to see the doctor due to cost) during the past 12 months. Conditional models accounted for the matching.
Results
We included 231 CCS and 692 controls. CCS had lower household income (p < 0.001), lower educational attainment (p = 0.021), more chronic health conditions (p < 0.001), and a higher proportion of being current smokers (p = 0.005) than controls. Both groups had similar rates of having a checkup and influenza vaccine; however, a quarter of CCS experienced healthcare cost barriers compared with 13.9% in controls (p = 0.001; regression findings: adjusted odds ratio (aOR) = 1.72, 95% confidence interval (CI): 1.11‐2.65). Compared with the youngest CCS group (18‐24 years), CCS ages 25‐29 years were five times more likely to experience healthcare cost barriers (aOR = 4.79; 95% CI, 1.39‐16.54). Among CCS, current smokers were less likely to have a checkup (aOR = 0.46; 95% CI, 0.23‐0.94). Uninsured CCS were less likely to have a checkup (aOR = 0.33; 95% CI, 0.14‐0.75) and ∼8 times more likely to experience healthcare cost barriers (aOR = 8.28; 95% CI, 3.45‐19.88).
Conclusion
CCS being 25‐29 years, uninsured, or current smokers encounter inferior outcomes in healthcare utilization and cost barriers. We suggest emphasis on programs on care transition and smoking cessation for CCS.</description><subject>Access to care</subject><subject>Childhood</subject><subject>childhood cancer survivor</subject><subject>Children</subject><subject>Chronic illnesses</subject><subject>Cigarette smoking</subject><subject>costs</subject><subject>Drug addiction</subject><subject>Health care</subject><subject>health disparities</subject><subject>Health services utilization</subject><subject>healthcare utilization</subject><subject>Hematology</subject><subject>Influenza</subject><subject>long‐term follow‐up</subject><subject>Oncology</subject><subject>Pediatrics</subject><subject>Risk factors</subject><subject>Vaccines</subject><issn>1545-5009</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp10E9LwzAcxvEgipvTg29AAl700C7_2qZHHeqEoYLuXNIkdRltM5N2Ml-9nZ07CJ6Sw4cvPx4AzjEKMUJkvMplSBFj9AAMccSiIEI4Odz_UToAJ94vOxqjiB-DAU0I4zhOhuBpqkXZLKRwGraNKc2XaIytoagVlNY3MBfOGe08FJWt3-E8fA2hXJhSLaztiKildtC3bm3W1vlTcFSI0uuz3TsC8_u7t8k0mD0_PE5uZoGkjNOgwJQgkXKmCMkJShJVyJjGkSCK4VTphMcpShjVgjPKFWaqoJhFQiCqGJWKjsBV3105-9Fq32SV8VKXpai1bX1GOEFpgmmUdvTyD13a1tXddVvF4zhlPOrUda-ks947XWQrZyrhNhlG2XbkrBs5-xm5sxe7YptXWu3l76odGPfg05R6838pe7md9MlvmniEGg</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Nghiem, Van T.</creator><creator>Alanaeme, Chibuike J.</creator><creator>Mennemeyer, Stephen T.</creator><creator>Wong, F. Lennie</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6039-7965</orcidid><orcidid>https://orcid.org/0000-0002-6994-3571</orcidid></search><sort><creationdate>202308</creationdate><title>Healthcare utilization and cost barriers among U.S. childhood cancer survivors</title><author>Nghiem, Van T. ; Alanaeme, Chibuike J. ; Mennemeyer, Stephen T. ; Wong, F. Lennie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3483-f1320a984d22b2077dfc6365a2d419de78690743ea8438d14df3145aa03d43cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Access to care</topic><topic>Childhood</topic><topic>childhood cancer survivor</topic><topic>Children</topic><topic>Chronic illnesses</topic><topic>Cigarette smoking</topic><topic>costs</topic><topic>Drug addiction</topic><topic>Health care</topic><topic>health disparities</topic><topic>Health services utilization</topic><topic>healthcare utilization</topic><topic>Hematology</topic><topic>Influenza</topic><topic>long‐term follow‐up</topic><topic>Oncology</topic><topic>Pediatrics</topic><topic>Risk factors</topic><topic>Vaccines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nghiem, Van T.</creatorcontrib><creatorcontrib>Alanaeme, Chibuike J.</creatorcontrib><creatorcontrib>Mennemeyer, Stephen T.</creatorcontrib><creatorcontrib>Wong, F. Lennie</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric blood & cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nghiem, Van T.</au><au>Alanaeme, Chibuike J.</au><au>Mennemeyer, Stephen T.</au><au>Wong, F. Lennie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Healthcare utilization and cost barriers among U.S. childhood cancer survivors</atitle><jtitle>Pediatric blood & cancer</jtitle><addtitle>Pediatr Blood Cancer</addtitle><date>2023-08</date><risdate>2023</risdate><volume>70</volume><issue>8</issue><spage>e30443</spage><epage>n/a</epage><pages>e30443-n/a</pages><issn>1545-5009</issn><eissn>1545-5017</eissn><abstract>Background
To evaluate healthcare utilization and cost barrier patterns among childhood cancer survivors (CCS) compared with noncancer controls.
Procedure
Using the 2014‐2019 Behavioral Risk Factor Surveillance System, we identified CCS < 50 years and matched controls. We used chi‐squared tests to compare characteristics between the two groups. Logistic regression analyses were used to assess the likelihood of having a checkup, receiving influenza vaccine, and experiencing healthcare cost barriers (being unable to see the doctor due to cost) during the past 12 months. Conditional models accounted for the matching.
Results
We included 231 CCS and 692 controls. CCS had lower household income (p < 0.001), lower educational attainment (p = 0.021), more chronic health conditions (p < 0.001), and a higher proportion of being current smokers (p = 0.005) than controls. Both groups had similar rates of having a checkup and influenza vaccine; however, a quarter of CCS experienced healthcare cost barriers compared with 13.9% in controls (p = 0.001; regression findings: adjusted odds ratio (aOR) = 1.72, 95% confidence interval (CI): 1.11‐2.65). Compared with the youngest CCS group (18‐24 years), CCS ages 25‐29 years were five times more likely to experience healthcare cost barriers (aOR = 4.79; 95% CI, 1.39‐16.54). Among CCS, current smokers were less likely to have a checkup (aOR = 0.46; 95% CI, 0.23‐0.94). Uninsured CCS were less likely to have a checkup (aOR = 0.33; 95% CI, 0.14‐0.75) and ∼8 times more likely to experience healthcare cost barriers (aOR = 8.28; 95% CI, 3.45‐19.88).
Conclusion
CCS being 25‐29 years, uninsured, or current smokers encounter inferior outcomes in healthcare utilization and cost barriers. We suggest emphasis on programs on care transition and smoking cessation for CCS.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37248167</pmid><doi>10.1002/pbc.30443</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-6039-7965</orcidid><orcidid>https://orcid.org/0000-0002-6994-3571</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Access to care Childhood childhood cancer survivor Children Chronic illnesses Cigarette smoking costs Drug addiction Health care health disparities Health services utilization healthcare utilization Hematology Influenza long‐term follow‐up Oncology Pediatrics Risk factors Vaccines |
| title | Healthcare utilization and cost barriers among U.S. childhood cancer survivors |
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