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The financial burden of cancer: A longitudinal analysis of out-of-pocket healthcare costs in Australia (2009–2021)
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DOI：10.1007/s00520-026-11007-z.png)
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Abstract
En 中文
Cancer can impose substantial financial strain on patients and their families, particularly through high out-of-pocket healthcare costs. This study aims to compare out-of-pocket and catastrophic healthcare expenditures among individuals with cancer, those with non-cancer chronic conditions, and healthy individuals, and to identify socio-demographic and health-related factors associated with higher financial burden. We analysed data from four waves of the Household, Income and Labour Dynamics in Australia (HILDA) survey. Two-part and random-effects logistic regression models were used to examine associations between cancer status and total out-of-pocket and catastrophic healthcare expenditures, adjusting for socio-demographic characteristics and health service utilisation. Cancer patients had significantly higher financial burden than both healthy individuals and those with non-cancer chronic conditions. Compared to healthy individuals, cancer patients had 15% higher out-of-pocket healthcare expenditures (95% CI: 1.09–1.22) and 1.05 times higher odds of experiencing catastrophic health expenditure (95% CI: 1.03–1.06). When compared to individuals with non-cancer chronic conditions, cancer patients had 11% higher out-of-pocket healthcare expenditure (95% CI: 1.06–1.17) and 1.03 times higher odds of experiencing catastrophic spending (95% CI: 1.01–1.05). Key factors associated with higher odds of catastrophic healthcare expenditure included older age, long-term disability, lower household income, and higher education attainment. Cancer patients had higher out-of-pocket healthcare costs and higher odds of catastrophic healthcare expenditure than comparison groups. These findings highlight the need for targeted supportive care strategies and policy interventions to reduce the financial burden associated with cancer and promote equitable access to care.
Keywords:
Cancer
Out-of-pocket cost
Catastrophic healthcare expenditures
Australia
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