Health Insurance Literacy Linked to Financial Hardship for Cancer Patients


Patients with cancer have lower odds of economic hardship in the event that they have higher medical health insurance literacy, based on a study published in JAMA Network Open.

Researchers enrolled 404 cancer patients from 2 ambulatory infusion centers on this cross-sectional survey study.

The team assessed each patient’s perspective about their financial situation with the 12-item Comprehensive Rating for Financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) and the National Health Interview Survey. The assessment touched on 3 different hardship domains: material, psychological, and behavioral.

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The researchers also used the Health Insurance Literacy Measure (HILM) to learn more concerning the patients’ ability to pick and use medical health insurance. And the team assessed financial literacy of the participants with the National Financial Capability Study.

The proportion of patients with financial hardship was 49% based on COST–FACIT rating but 68% based on the National Health Interview Survey results. Two-thirds of patients (66%) had high financial literacy, and the mean HILM rating was 64.9 points.

The researchers found that, in multivariable analyses, each 10-point increase in HILM rating was related to significantly lower odds of economic hardship (odds ratio, 0.82; 95% CI, 0.68-0.99; P =.04). Nevertheless, the association was now not significant when the researchers adjusted for financial literacy.

The researchers noted that this study was limited by a comparatively small sample size and the incontrovertible fact that participants were self-reporting data, which could have introduced recall and reporting biases. The researchers also noted that patients with higher medical health insurance and financial literacy could have been more motivated to reply to the surveys. As well as, just one quarter of the participants were members of racial and ethnic minority groups, which can further limit the generalizability of the outcomes to a broad, increasingly diverse population.

Nevertheless, the researchers concluded that their findings could be useful in creating tailored interventions for diverse populations in the long run, given how overwhelming a cancer diagnosis may be with the extra stress of the financial elements.

“On this survey study, increased medical health insurance literacy was related to lower odds of economic hardship especially affecting the fabric and behavioral domains,” the researchers concluded.  “We also found that top financial literacy may help to mitigate the opposed outcomes related to lower medical health insurance literacy.”


Khera N, Zhang N, Hilal T, et al. Association of medical health insurance literacy with financial hardship in patients with cancer. JAMA Netw Open. 2022;5(7):e2223141. doi:10.1001/jamanetworkopen.2022.23141

This text originally appeared on Oncology Nurse Advisor


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