abstract: 'Little is known about out-of-pocket (OOP) costs incurred for medical and

  health needs by rural breast cancer survivors and what factors may be

  associated with higher OOP costs and the associated economic burden.

  Data were examined for 432 survivors participating in the Rural Breast

  Cancer Survivor Intervention trial. OOP costs were collected using the

  Work and Finances Inventory survey at baseline and four assessments

  every 3 months. Mean and median OOP costs and burden (percent of monthly

  income spent on OOP costs) were reported and factors associated with OOP

  costs and burden identified with generalized linear models fitted with

  over-dispersed gamma distributions and logarithmic links (OOP costs) and

  with beta distributions with logit link (OOP burden). OOP costs per

  month since the end of treatment were on average \$232.7 (median

  \$95.6), declined at the next assessment point to \$186.5 (median

  \$89.1), and thereafter remained at that level. Mean OOP burden was 9\%

  at baseline and between 7\% and 8\% at the next assessments. Factors

  suggestive of contributing to higher OOP costs and OOP burden were the

  following: younger age, lower income, time in survivorship from

  diagnosis, and use of supportive services. OOP costs burden rural breast

  cancer survivors, particularly those who are younger and low income.

  Research should investigate the impact of OOP costs and interventions to

  reduce economic burden.'
affiliation: 'Pisu, M (Corresponding Author), Univ Alabama Birmingham, Sch Med, 1720
  2nd Ave S,MT 636, Birmingham, AL 35294 USA.

  Pisu, Maria, Univ Alabama Birmingham, Sch Med, Div Prevent Med, Birmingham, AL USA.

  Pisu, Maria; Azuero, Andres; McNees, Patrick; Meneses, Karen, Univ Alabama Birmingham,
  Ctr Comprehens Canc, Birmingham, AL 35294 USA.

  Azuero, Andres; Benz, Rachel; Meneses, Karen, Univ Alabama Birmingham, Sch Nursing,
  Birmingham, AL USA.

  McNees, Patrick, Univ Alabama Birmingham, Sch Hlth Profess, Birmingham, AL USA.

  McNees, Patrick, Kirchner Grp, Birmingham, AL USA.'
author: Pisu, Maria and Azuero, Andres and Benz, Rachel and McNees, Patrick and Meneses,
  Karen
author-email: mpisu@uab.edu
author_list:
- family: Pisu
  given: Maria
- family: Azuero
  given: Andres
- family: Benz
  given: Rachel
- family: McNees
  given: Patrick
- family: Meneses
  given: Karen
da: '2023-09-28'
doi: 10.1002/cam4.1017
files: []
issn: 2045-7634
journal: CANCER MEDICINE
keywords: 'Burden; Cancer; costs; economics; out-of-pocket costs; rural;

  survivorship'
keywords-plus: 'CARE EXPENDITURE BURDEN; FINANCIAL BURDEN; HEALTH-CARE; ECONOMIC BURDEN;

  RESIDENCE; HARDSHIP; URBAN; LIFE; EXPERIENCES; DISPARITIES'
language: English
month: MAR
number: '3'
number-of-cited-references: '50'
pages: 572-581
papis_id: 6daefcdf36e5619dd51d6979fbd8dd5d
ref: Pisu2017outofpocketcosts
times-cited: '41'
title: Out-of-pocket costs and burden among rural breast cancer survivors
type: article
unique-id: WOS:000397854900009
usage-count-last-180-days: '1'
usage-count-since-2013: '9'
volume: '6'
web-of-science-categories: Oncology
year: '2017'