OBJECTIVE: To describe the knowledge of, and attitudes toward, out-of-pocket expenses (OOPE) associated with prostate cancer treatment and the influence of OOPE on the treatment choices of patients with prostate cancer.
MATERIALS AND METHODS: We undertook a qualitative research study for which we recruited patients with clinically localized prostate cancer. Patients answered a series of open-ended questions during a semistructured interview and completed a questionnaire about the physician's role in discussing OOPE, the burden of OOPE, the effect of OOPE on treatment decisions, and previous knowledge of OOPE.
RESULTS: A total of 41 (26 white and 15 black) eligible patients were enrolled from the urology and radiation oncology practices of the University of Pennsylvania. Qualitative assessment revealed 5 major themes: (a) "my insurance takes care of it"; (b) "health is more important than cost"; (c) "I did not look into it"; (d) "I cannot afford it but would have chosen the same treatment"; and (e) "It is not my doctor's business." Most patients (38 of 41, 93%) reported that they would not have chosen a different treatment even if they had known the actual OOPE of their treatment. Patients who reported feeling burdened by OOPE were socioeconomically heterogeneous, and their treatment choices remained unaffected. Only 2 patients stated they knew "a lot" about the likely OOPE for different prostate cancer treatments before choosing their treatment.
CONCLUSION: Among insured patients with prostate cancer treated at a large academic medical center, few had knowledge of OOPE before making treatment choices.
Written by:
Jung OS, Guzzo T, Lee D, Mehler M, Christodouleas J, Deville C, Hollis G, Shah A, Vapiwala N, Wein A, Pauly M, Bekelman JE. Are you the author?
Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Health Policy Management Doctoral Program, Harvard Business School, Boston, Massachusetts; Health Care Management Department, University of Pennsylvania Wharton School of Business, Philadelphia, Pennsylvania.
Reference: Urology. 2012 Oct 23. pii: S0090-4295(12)00942-9.
doi: 10.1016/j.urology.2012.08.027
PubMed Abstract
PMID: 23102446
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