Risk Factors for Cost-Related Delays to Medical Care Among Lymphoma Patients: A 22-Year Analysis of a Nationally Representative Sample

Clin Lymphoma Myeloma Leuk. 2021 Jul;21(7):e619-e625. doi: 10.1016/j.clml.2021.02.013. Epub 2021 Mar 4.

Abstract

Background: An estimated 85,000 cases of lymphoma (Hodgkin and non-Hodgkin lymphoma) were diagnosed in the United States in 2020. Financial insecurity is known to negatively impact health outcomes. In 2021, as Americans continue to file for unemployment at rates far above pre-COVID-19 pandemic peak levels, there is a persistent need to address the economic burden of diagnoses and threat of financial stressors and its related conditions, which are already known to cause substantial economic burden.

Patients and methods: Data were obtained from the National Health Interview Survey (NHIS), a cross-sectional survey conducted annually by the National Center for Health Statistics. Two questions were asked of patients to identify potential risk factors of financial insecurity regarding patients' ability to pay medical bills. NHIS respondents between the years 1997 and 2018 self-reporting a history of lymphoma diagnoses was included in the analysis.

Results: Among over 2 million respondents to the NHIS between 1997 and 2018, 1619 individuals reported a history of lymphoma; 9.95% reported delaying medical care due to cost within the previous 12 months; and 6.52% reported not being able to afford medical care in the previous 12 months. Among the subgroups that had the highest risk of delaying medical care were patients between the ages of 25 and 64 years and the uninsured.

Conclusion: Financial burdens impede patients' abilities to access and adhere to care, which can contribute to poorer health outcomes. As financially insecure patients continue to present with lymphoma diagnoses, it is vital for practicing hematologists to understand the links among health care, financial insecurity, and demographic risk factors in order to devise and implement appropriate interventions.

Keywords: Disparity; Financial burden; Health care; Lymphoma; Medicare.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cost of Illness*
  • Cross-Sectional Studies
  • Female
  • Financial Stress*
  • Humans
  • Lymphoma / economics*
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Risk
  • Surveys and Questionnaires
  • Time-to-Treatment / economics*
  • Young Adult