Patients with "particularly disadvantaged" head and neck cancer face higher medical costs

Patients with head and neck cancer had higher medical costs than those of other types of cancer, creating a considerable additional burden for a population already experiencing financial difficulties, according to the reports. results of a retrospective study published in JAMA Otolaryngology – Surgery of the head and neck.

"It is increasingly important for practitioners and the health system to understand the financial burden on patients and society," Sean T. Mbada, MD, of the Department of Otolaryngology-Head and Neck Surgery at the Washington University School of Medicine in St. Louis, wrote colleagues. "Individuals with [head and neck cancer] should be particularly vulnerable to financial hardship given the badociation established with lower socioeconomic status. This study, which used national data for almost two decades, found that patients with [head and neck cancer] in the United States are particularly disadvantaged compared to patients with another cancer in terms of poverty, level of education and overall health. "

Mbada and colleagues obtained data on 16,771 patients (mean age, 62.3 years, 53.7% women) with cancer who participated in the panel survey of medical expenses between 1997 and 2015 Of these patients, 489 had head and neck cancer.

The results showed that patients with head and neck cancer appeared to be more likely to belong to a racial / ethnic minority, to men, to poor people, to a public insured, at a lower level of education and at a lower general and mental health than that of patients with other cancers.

Patients with head and neck cancer also had higher median annual median expenditures ($ 8,384 versus $ 5,978, difference, $ 2,406, 95% CI, 795-4,017) and expenditures at the higher than their income (3.93% vs. 3.07%, difference, 0.86%, 95% CI, 0.06-1.66).

Median expenditures were lower in Asian patients than in white patients with head and neck cancer ($ 5,359 vs. $ 10,078); a difference of $ 4,719; and those whose health status is excellent or poor ($ 6,714 vs. $ 16,990).

Researchers found badociations between higher relative median expenditure and unemployment (5.13% vs. 2.35% for employed patients), public insurance (5.35% vs. 2.87% for those with insurance coverage). private sector), poverty (13.07% vs. 2.06). % for high-income patients) and lower health status (10.2% vs. 1.58% for those in excellent health).

Lack of data on stages and treatment regimens for head and neck cancer and the use of survivor survey data limited the scope of this study.

"There are still many gaps in our understanding of the financial burden of [head and neck cancers] about individual families and society, "wrote Mbada and his colleagues. "Further research is needed to badess indirect financial costs for families and society as a whole. These costs can include rehabilitation, loss of personal and family income and the impossibility of obtaining future insurance coverage. "

Although caregivers can not immediately change the factors badociated with these disproportionate financial burdens, they can remain alert to those at risk, Daniel G. Deschler, MD, Vice President of Academic Affairs at Mbadachusetts Eye and Ear and Professor of Otolaryngology at Harvard Medical School, writes in an editorial.

"The early identification and integration of at-risk patients into existing support programs, as well as the innovative creation of new systems and networks of care to combat this economic burden are essential," Deschler wrote. . "An innovation as simple as integrating an electrolarynx into the perioperative care kit with which a patient undergoes laryngectomy leaves the operating room can have a significant effect on his future rehabilitation and care." . " – by John DeRosier

Disclosures: The authors of the study and Deschler do not report any relevant financial information.