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The Effects of Patient Financial Bur...

Rotter, Jason Stefan.

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The Effects of Patient Financial Burden on Cancer Health Outcomes.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	The Effects of Patient Financial Burden on Cancer Health Outcomes./
作者:	Rotter, Jason Stefan.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
面頁冊數:	132 p.
附註:	Source: Dissertations Abstracts International, Volume: 80-12, Section: B.
Contained By:	Dissertations Abstracts International80-12B.
標題:	Economics. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13815307
ISBN:	9781392201770

The Effects of Patient Financial Burden on Cancer Health Outcomes.
Rotter, Jason Stefan.

The Effects of Patient Financial Burden on Cancer Health Outcomes. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 132 p.

Source: Dissertations Abstracts International, Volume: 80-12, Section: B.

Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2019.

This item must not be sold to any third party vendors.

Objective: The goal of this research is to assess the impact of individual patient financial burden on cancer health outcomesMethods: In this work we operationalized financial burden as exposure to potentially high cost prescription drugs. Data from the SEER-CAHPS survey captured an individual's self-reported delay or omission of prescription medication, as well as all-cause and cancer-specific mortality. First, we estimated the difference in delay or omission of prescription medication using variation in the low-income subsidy (LIS), a proxy for lower exposure to high-cost prescription medication. Machine learning algorithms balance LIS and non-LIS groups by observable clinical and demographic characteristics. Second, we estimated the increased hazard of all-cause and cancer specific death for individuals reporting difference in delay or omission of prescription due to cost, compared to those not reporting on the same measure. Balanced groups were again created using machine learning propensity scores. Lastly, we simulate the societal-level impact in the HER2+ breast cancer population comparing LIS-similar interventions at different levels of federal poverty line eligibility.Results: We found large and significant reductions in the probability of delay or omission of prescription medication for LIS beneficiaries compared to non-LIS beneficiaries (up to 75%). The result was robust to a number of different specifications and appears to be concentrated in a population weighted to look similar to LIS beneficiaries (i.e., a low-income population). Across all cancer sites we estimated an approximately 24% (all-cause) and 50% (cancer-specific) increase in mortality risk due to delay or omission of prescription medication resulting from high cost burden. Across a range of sensitivity and scenario analyses, we found evidence that a program which substantially reduces the cost of prescription medication for persons at or below 150% FPL, offers a cost-effective societal benefit substantively below conventionally accepted willingness to pay thresholds.Conclusions: Overall, we found evidence to support the notion that patients delay or omit prescription medication when faced with high costs, that these delays or omissions may result in higher risk of all-cause and cancer-specific mortality, and that strategies designed reduce cost for targeted populations may provide good value at the societal level.

ISBN: 9781392201770Subjects--Topical Terms:

517137
Economics.

The Effects of Patient Financial Burden on Cancer Health Outcomes.
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