UK Study Shows Increased Financial Burden Linked to Decreased Health Insurance Literacy

A recent study by University of Kentucky Markey Cancer Center researchers looked into the association of financial burden with health insurance literacy in colorectal cancer patients.

Recently published in Supportive Care in Cancer, the team utilized the Kentucky Cancer Registry data to collect surveys from colorectal cancer survivors in Kentucky to identify if there was a correlation between individuals suffering from financial toxicity and comprehension of health insurance.

Financial toxicity is the accumulation of the financial costs and financial distress or hardship that can affect the health and wellbeing of cancer survivors. Studies cited in the article highlight how survivors suffering from financial toxicity had a poorer quality of life, decreased survival, increased symptom burden, and a decrease in treatment compliance.

To assess if patients suffered from financial toxicity, the team designed a survey to identify financial hardship using both material and psychological measures. The survey also quantified the demographic information of the survivors, such as gender, age, employment, and living location in addition to if the patients had private insurance, the cancer stage at time of diagnosis, and health insurance literacy and numeracy. The data collected from the survey was then analyzed to identify trends in those individuals who indicated higher financial toxicity compared to those who indicated less financial toxicity.

The researchers observed a trend in patients who have a higher financial toxicity to individuals who had lower confidence and behaviors selecting and using health insurance as well lower numeracy comprehension.

The findings from the study highlight a contributing factor that could result in decreased quality of life in cancer survivors that may be overlooked when assessing patient care. The financial consequences associated with cancer treatment as demonstrated by this study and others illustrates the necessity to address this issue by providing opportunities and resources for patients to expand their health insurance literacy, numeracy and knowledge.  

“We should focus on making financial navigation services available to our patients especially our oncology patients because they’re struggling with not only their diagnosis, but financial burdens as well,” said Jean Edward, Ph.D., assistant professor in the UK College of Nursing and nurse scientist for the UK Markey Cancer Center. "We need to address financial toxicity in all of our patients, but specifically our oncology patients.”

Edward hopes the findings of the study results in increased awareness of the financial implications associated with cancer survivors, leading to improving cost-related health literacy and ultimately preventing financial hardship for cancer survivors and their families.

“We want to empower our patients with the knowledge to make appropriate and timely healthcare decisions, but the burden shouldn’t be placed on the patient if the health and insurance systems are in constant flux,” Edward said. “Especially with our patients from lower socio-economic or lower education backgrounds who may not have internet to enroll themselves in a health insurance plan or keep up with the changes in health systems or healthcare reform policies. We need to work to make the healthcare system and health insurance programs less complicated and more accessible for patients.”

This work was funded by the American Cancer Society.