Association between Food Insecurity, Financial Toxicity, and Healthcare Utilization in Patients with Lymphoma

• Published in: Blood 2024-11, Vol.144, p.5042-5042
• Main Authors: Bhatt, Kishan A, DeStephano, David M., Khurana, Rhea K, Sathe, Claire, Tolu, Seda S., Cherng, Hua-Jay J., Amengual, Jennifer E., Pro, Barbara, Hershman, Dawn L, Kahn, Justine M., Beauchemin, Melissa P
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-210508

Background: Patients with cancer experience high rates of financial toxicity (FT), defined as the “harmful personal financial burden faced by patients receiving cancer therapy,” and unmet health-related social needs (HRSN: food, housing, transportation insecurity). Nationally representative studies among patients with lymphoma indicate that one in 10 meet criteria for food insecurity (FI), a modifiable HRSN impacting a wide array of health outcomes. Two such outcomes are emergency room (ED) visits and hospitalizations, both of which strain the individual patient and the healthcare system. At present, associations between FI, FT, and ED visits or hospitalizations remain unclear. Leveraging systematically collected HRSN data from a diverse cohort of patients with lymphoma, we evaluated (1) rates of FT and HRSN, and (2) associations between FT or unmet needs and healthcare utilization. Methods: Patients treated for lymphoma at a large, urban cancer center from November 2022 - June 2024, who utilized the electronic health record (EHR) to check in for clinic visits, completed an 8-item HRSN survey and a 2-item FT tool adapted from the Comprehensive Score of Financial Toxicity (COST) measure. ED visits and hospitalizations were extracted from the EHR directly. Patients were included if they had at least two clinic encounters and at least one complete survey (FT or HRSN). Descriptive statistics characterized the cohort, and chi-square tests examined associations between FI or FT and utilization. A p-value