Oncology navigators’ perceptions of cancer-related financial burden and financial assistance resources

• Published in: Supportive care in cancer 2018-04, Vol.26 (4), p.1315-1321
• Main Authors: Spencer, Jennifer C., Samuel, Cleo A., Rosenstein, Donald L., Reeder-Hayes, Katherine E., Manning, Michelle L., Sellers, Jean B., Wheeler, Stephanie B.
• Format: Article
• Language: English
• Subjects: Cancer; Cancer treatment; Care and treatment; Health Care Costs; Humans; Insurance, Health; Medicaid; Medical debt; Medical Oncology; Medical research; Medicine; Medicine & Public Health; Neoplasms - economics; Neoplasms - psychology; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Patient Navigation; Rehabilitation Medicine; Social workers; Surveys and Questionnaires; United States
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-017-3958-3

Introduction As the cost of cancer treatment continues to rise, many patients are faced with significant emotional and financial burden. Oncology navigators guide patients through many aspects of care and therefore may be especially aware of patients’ financial distress. Our objective was to explore navigators’ perception of their patients’ financial burden and their role in addressing financial needs. Materials and methods We conducted a real-time online survey of attendees at an oncology navigators’ association conference. Participants included lay navigators, oncology nurse navigators, community health workers, and social workers. Questions assessed perceived burden in their patient population and their role in helping navigate patients through financial resources. Answers to open-ended questions are reported using identified themes. Results Seventy-eight respondents participated in the survey, reporting that on average 75% of their patients experienced some degree of financial toxicity related to their cancer. Only 45% of navigators felt the majority of these patients were able to get some financial assistance, most often through assistance with medical costs (73%), subsidized insurance (36%), or non-medical expenses (31%). Commonly identified barriers for patients obtaining assistance included lack of resources (50%), lack of knowledge about resources (46%), and complex/duplicative paperwork (20%). Conclusion Oncology navigators reported a high burden of financial toxicity among their patients but insufficient knowledge or resources to address this need. This study underscores the importance of improved training and coordination for addressing financial burden, and the need to address community and system-level barriers.