Staff View: Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study

Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study

Background: Evidence on the financial experiences of cancer survivors living in settings with pluralistic health systems remains limited. We explored the out-of-pocket costs, the resulting financial impact and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country wit...

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Main Authors:	Fnu, Noorulain, Kuan, Wai-Chee, Kong, Yek-Ching, Bustamam, Ros Suzanna, Wong, Li Ping, Subramaniam, ShriDevi, Ho, Gwo Fuang, Zaharah, Hafizah, Yip, Cheng-Har, Bhoo-Pathy, Nirmala
Format:	Article
Published:	ecancer Global Foundation 2022
Subjects:	Personal finance RA Public aspects of medicine RC Internal medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Online Access:	http://eprints.um.edu.my/43944/
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spelling	my.um.eprints.439442024-01-27T03:57:50Z http://eprints.um.edu.my/43944/ Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study Fnu, Noorulain Kuan, Wai-Chee Kong, Yek-Ching Bustamam, Ros Suzanna Wong, Li Ping Subramaniam, ShriDevi Ho, Gwo Fuang Zaharah, Hafizah Yip, Cheng-Har Bhoo-Pathy, Nirmala Personal finance RA Public aspects of medicine RC Internal medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) Background: Evidence on the financial experiences of cancer survivors living in settings with pluralistic health systems remains limited. We explored the out-of-pocket costs, the resulting financial impact and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country with a government-led tax-funded public health sector, and a predominantly for-profit private health sector. Methods: Data were derived from 20 focus group discussions that were conducted in five public and private Malaysian hospitals, which included 102 adults with breast, cervical, colorectal or prostate cancers. The discussions were segregated by type of healthcare setting and gender. Thematic analysis was performed. Results: Five major themes related to cancer costs emerged: 1) cancer therapies and imaging services, 2) supportive care, 3) complementary therapies, 4) non-medical costs and 5) loss of household income. Narratives on out-of-pocket medical costs varied not only by type of healthcare setting, clinical factors and socioeconomic backgrounds, but also by private health insurance ownership. Non-health costs (e.g. transportation, food) and loss of income were nonetheless recurring themes. Coping mechanisms that were raised included changing of cancer treatment decisions, continuing work despite ill health and seeking financial assistance from third parties. Unmet needs in coping with financial distress were especially glaring among the women. Conclusion: The long-term costs of cancer (medications, cancer surveillance, supportive care, complementary medicine) should not be overlooked even in settings where there is access to highly subsidised cancer care. In such settings, patients may also have unmet needs related to non-health costs of cancer and loss of income. Copyright: © the authors. ecancer Global Foundation 2022 Article PeerReviewed Fnu, Noorulain and Kuan, Wai-Chee and Kong, Yek-Ching and Bustamam, Ros Suzanna and Wong, Li Ping and Subramaniam, ShriDevi and Ho, Gwo Fuang and Zaharah, Hafizah and Yip, Cheng-Har and Bhoo-Pathy, Nirmala (2022) Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study. ecancermedicalscience, 16. ISSN 1754-6605, DOI https://doi.org/10.3332/ecancer.2022.1449 <https://doi.org/10.3332/ecancer.2022.1449>. 10.3332/ecancer.2022.1449
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	Personal finance RA Public aspects of medicine RC Internal medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer)
spellingShingle	Personal finance RA Public aspects of medicine RC Internal medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) Fnu, Noorulain Kuan, Wai-Chee Kong, Yek-Ching Bustamam, Ros Suzanna Wong, Li Ping Subramaniam, ShriDevi Ho, Gwo Fuang Zaharah, Hafizah Yip, Cheng-Har Bhoo-Pathy, Nirmala Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study
description	Background: Evidence on the financial experiences of cancer survivors living in settings with pluralistic health systems remains limited. We explored the out-of-pocket costs, the resulting financial impact and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country with a government-led tax-funded public health sector, and a predominantly for-profit private health sector. Methods: Data were derived from 20 focus group discussions that were conducted in five public and private Malaysian hospitals, which included 102 adults with breast, cervical, colorectal or prostate cancers. The discussions were segregated by type of healthcare setting and gender. Thematic analysis was performed. Results: Five major themes related to cancer costs emerged: 1) cancer therapies and imaging services, 2) supportive care, 3) complementary therapies, 4) non-medical costs and 5) loss of household income. Narratives on out-of-pocket medical costs varied not only by type of healthcare setting, clinical factors and socioeconomic backgrounds, but also by private health insurance ownership. Non-health costs (e.g. transportation, food) and loss of income were nonetheless recurring themes. Coping mechanisms that were raised included changing of cancer treatment decisions, continuing work despite ill health and seeking financial assistance from third parties. Unmet needs in coping with financial distress were especially glaring among the women. Conclusion: The long-term costs of cancer (medications, cancer surveillance, supportive care, complementary medicine) should not be overlooked even in settings where there is access to highly subsidised cancer care. In such settings, patients may also have unmet needs related to non-health costs of cancer and loss of income. Copyright: © the authors.
format	Article
author	Fnu, Noorulain Kuan, Wai-Chee Kong, Yek-Ching Bustamam, Ros Suzanna Wong, Li Ping Subramaniam, ShriDevi Ho, Gwo Fuang Zaharah, Hafizah Yip, Cheng-Har Bhoo-Pathy, Nirmala
author_facet	Fnu, Noorulain Kuan, Wai-Chee Kong, Yek-Ching Bustamam, Ros Suzanna Wong, Li Ping Subramaniam, ShriDevi Ho, Gwo Fuang Zaharah, Hafizah Yip, Cheng-Har Bhoo-Pathy, Nirmala
author_sort	Fnu, Noorulain
title	Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study
title_short	Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study
title_full	Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study
title_fullStr	Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study
title_full_unstemmed	Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study
title_sort	cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study
publisher	ecancer Global Foundation
publishDate	2022
url	http://eprints.um.edu.my/43944/
_version_	1789424632280907776
score	13.211869

Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: A qualitative study

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