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Published in: Supportive Care in Cancer 9/2013

Open Access 01-09-2013 | Original Article

How much does it cost to care for survivors of colorectal cancer? Caregiver’s time, travel and out-of-pocket costs

Authors: Paul Hanly, Alan Ó Céilleachair, Mairead Skally, Eamonn O’Leary, Kanika Kapur, Patricia Fitzpatrick, Anthony Staines, Linda Sharp

Published in: Supportive Care in Cancer | Issue 9/2013

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Abstract

Purpose

Cancer treatment is increasingly delivered in an outpatient setting. This may entail a considerable economic burden for family members and friends who support patients/survivors. We estimated financial and time costs associated with informal care for colorectal cancer.

Methods

Two hundred twenty-eight carers of colorectal cancer survivors diagnosed on October 2007–September 2009 were sent a questionnaire. Informal care costs included hospital- and domestic-based foregone caregiver time, travel expenses and out-of-pocket (OOP) costs during two phases: diagnosis and treatment and ongoing care (previous 30 days). Multiple regression was used to determine cost predictors.

Results

One hundred fifty-four completed questionnaires were received (response rate = 68 %). In the diagnosis and treatment phase, weekly informal care costs per person were: hospital-based costs, incurred by 99 % of carers, mean = €393 (interquartile range (IQR), €131–€541); domestic-based time costs, incurred by 85 %, mean = €609 (IQR, €170–€976); and domestic-based OOP costs, incurred by 68 %, mean = €69 (IQR, €0–€110). Ongoing costs included domestic-based time costs incurred by 66 % (mean = €66; IQR, €0–€594) and domestic-based OOP costs incurred by 52 % (mean = €52; IQR, €0–€64). The approximate average first year informal care cost was €29,842, of which 85 % was time costs, 13 % OOP costs and 2 % travel costs. Significant cost predictors included carer age, disease stage, and survivor age.

Conclusion

Informal caregiving associated with colorectal cancer entails considerable time and OOP costs. This burden is largely unrecognised by policymakers, service providers and society in general. These types of studies may facilitate health decision-makers in better assessing the consequences of changes in cancer care organisation and delivery.
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Literature
1.
go back to reference Jemal A, Bray F, Centre MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRef Jemal A, Bray F, Centre MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90CrossRef
2.
go back to reference Kanavos P, Schurer W (2010) The dynamics of colorectal cancer management in 17 countries. Eur J Health Econ 10:S115–S129CrossRef Kanavos P, Schurer W (2010) The dynamics of colorectal cancer management in 17 countries. Eur J Health Econ 10:S115–S129CrossRef
3.
go back to reference Papastavrou E, Charalambous A, Tsangari H (2012) How do informal caregivers of patients with cancer cope: a descriptive study of the coping strategies employed. Eur J Oncol Nurs 16:258–263CrossRef Papastavrou E, Charalambous A, Tsangari H (2012) How do informal caregivers of patients with cancer cope: a descriptive study of the coping strategies employed. Eur J Oncol Nurs 16:258–263CrossRef
5.
go back to reference Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2004) Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22:4829–4836CrossRef Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2004) Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22:4829–4836CrossRef
6.
go back to reference Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2006) Restrictions in quality of life in colorectal cancer patients over three years after diagnosis: a population based study. Eur J Cancer 42:1848–1857CrossRef Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2006) Restrictions in quality of life in colorectal cancer patients over three years after diagnosis: a population based study. Eur J Cancer 42:1848–1857CrossRef
7.
go back to reference Yabroff KR, Youngmee K (2009) Time costs associated with informal caregiving for cancer survivors. Cancer 115(18 Suppl):4362–4373CrossRef Yabroff KR, Youngmee K (2009) Time costs associated with informal caregiving for cancer survivors. Cancer 115(18 Suppl):4362–4373CrossRef
9.
go back to reference Gellad ZF, Provenzale D (2010) Colorectal cancer: national and international perspective on the burden of disease and public health impact. Gastroenterology 138:2177–2190CrossRef Gellad ZF, Provenzale D (2010) Colorectal cancer: national and international perspective on the burden of disease and public health impact. Gastroenterology 138:2177–2190CrossRef
10.
go back to reference Hayman JA, Langa KM, Kabeto MU, Katz SJ, DeMonner SM, Chernew ME, Slavin MB, Fendrick AM (2001) Estimating the cost of informal caregiving for elderly patients with cancer. J Clin Oncol 19:3219–3225CrossRef Hayman JA, Langa KM, Kabeto MU, Katz SJ, DeMonner SM, Chernew ME, Slavin MB, Fendrick AM (2001) Estimating the cost of informal caregiving for elderly patients with cancer. J Clin Oncol 19:3219–3225CrossRef
11.
go back to reference Longo CJ, Fitch M, Deber RB, Williams AP (2006) Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care Cancer 14:1077–1085CrossRef Longo CJ, Fitch M, Deber RB, Williams AP (2006) Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care Cancer 14:1077–1085CrossRef
13.
go back to reference Van Houtven CH, Ramsey SD, Hornbrook MC, Atienza AA, van Ryn M (2010) Economic burden for informal caregivers of lung and colorectal cancer patients. Oncologist 15:883–893CrossRef Van Houtven CH, Ramsey SD, Hornbrook MC, Atienza AA, van Ryn M (2010) Economic burden for informal caregivers of lung and colorectal cancer patients. Oncologist 15:883–893CrossRef
14.
go back to reference Tsimicalis A, Stevens B, Ungar WJ, McKeever P, Greenberg M, Agha M, Guerriere D, Barr R, Naqvi A, Moineddin R (2012) A prospective study to determine the costs incurred by families of children newly diagnosed with cancer in Ontario. Psychooncology 21:1113–1123CrossRef Tsimicalis A, Stevens B, Ungar WJ, McKeever P, Greenberg M, Agha M, Guerriere D, Barr R, Naqvi A, Moineddin R (2012) A prospective study to determine the costs incurred by families of children newly diagnosed with cancer in Ontario. Psychooncology 21:1113–1123CrossRef
15.
go back to reference Longo CJ, Deber R, Fitch M, Williams AP, D’Souza D (2007) An examination of cancer patients’ monthly ‘out-of-pocket’ costs in Ontario, Canada. Eur J Cancer Care 16:500–507CrossRef Longo CJ, Deber R, Fitch M, Williams AP, D’Souza D (2007) An examination of cancer patients’ monthly ‘out-of-pocket’ costs in Ontario, Canada. Eur J Cancer Care 16:500–507CrossRef
16.
go back to reference van den Berg B, Spauwen P (2006) Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving. Health Econ 15:447–460CrossRef van den Berg B, Spauwen P (2006) Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving. Health Econ 15:447–460CrossRef
21.
go back to reference Efron B (1987) Better bootstrap confidence intervals. J Am Stat Assoc 82:171–185CrossRef Efron B (1987) Better bootstrap confidence intervals. J Am Stat Assoc 82:171–185CrossRef
22.
go back to reference Arozullah AM, Calhoun EA, Wolf M, Finley DK, Fitzner KA, Heckinger EA, Gorby NS, Schumock GT, Bennett CL (2004) The financial burden of cancer: estimates from a study of insured women with breast cancer. J Support Oncol 2:271–278PubMed Arozullah AM, Calhoun EA, Wolf M, Finley DK, Fitzner KA, Heckinger EA, Gorby NS, Schumock GT, Bennett CL (2004) The financial burden of cancer: estimates from a study of insured women with breast cancer. J Support Oncol 2:271–278PubMed
23.
go back to reference Yabroff KR, Davis WW, Lamont EB, Fahey A, Topor M, Brown ML, Warren JL (2007) Patient time costs associated with cancer care. J Natl Cancer Inst 99:14–23CrossRef Yabroff KR, Davis WW, Lamont EB, Fahey A, Topor M, Brown ML, Warren JL (2007) Patient time costs associated with cancer care. J Natl Cancer Inst 99:14–23CrossRef
24.
go back to reference Longo CJ, Bereza BG (2011) A comparative analysis of monthly out-of-pocket costs for patients with breast cancer as compared with other common cancers in Ontario, Canada. Curr Oncol 18:e1–e8CrossRef Longo CJ, Bereza BG (2011) A comparative analysis of monthly out-of-pocket costs for patients with breast cancer as compared with other common cancers in Ontario, Canada. Curr Oncol 18:e1–e8CrossRef
25.
go back to reference Stommel M, Given CW, Given BA (1993) The cost of cancer home care to families. Cancer 71:1867–1874CrossRef Stommel M, Given CW, Given BA (1993) The cost of cancer home care to families. Cancer 71:1867–1874CrossRef
27.
go back to reference Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, Willan A, Viola R, Coristine M, Janz T, Glossop R (2004) Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ 170:1795–1801CrossRef Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, Willan A, Viola R, Coristine M, Janz T, Glossop R (2004) Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ 170:1795–1801CrossRef
28.
go back to reference Hollenbeak CS, Short PF, Moran J (2011) The implications of cancer survivorship for spousal employment. J Cancer Surviv 5:226–234CrossRef Hollenbeak CS, Short PF, Moran J (2011) The implications of cancer survivorship for spousal employment. J Cancer Surviv 5:226–234CrossRef
29.
go back to reference Chapple A, Ziebland S, McPherson A, Summerton N (2004) Lung cancer patients’ perceptions of access to financial benefits: a qualitative study. Br J Gen Pract 54:589–594PubMedPubMedCentral Chapple A, Ziebland S, McPherson A, Summerton N (2004) Lung cancer patients’ perceptions of access to financial benefits: a qualitative study. Br J Gen Pract 54:589–594PubMedPubMedCentral
30.
go back to reference Sharp L, Carsin AE, Timmons A (2012) Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer. Psychooncology. doi:10.1002/pon.3055 CrossRef Sharp L, Carsin AE, Timmons A (2012) Associations between cancer-related financial stress and strain and psychological well-being among individuals living with cancer. Psychooncology. doi:10.​1002/​pon.​3055 CrossRef
31.
go back to reference Donnelly M, Anderson LA, Johnston BT, Watson RG, Murphy SJ, Comber H, McGuigan J, Reynolds JV, Murray LJ (2008) Oesophageal cancer: caregiver mental health and strain. Psychooncology 17:1196–1201CrossRef Donnelly M, Anderson LA, Johnston BT, Watson RG, Murphy SJ, Comber H, McGuigan J, Reynolds JV, Murray LJ (2008) Oesophageal cancer: caregiver mental health and strain. Psychooncology 17:1196–1201CrossRef
32.
go back to reference van den Berg B, Werner BF, Koopmanschap MA (2004) Economic valuation of informal care: an overview of methods and applications. Eur J Health Econ 5:36–45CrossRef van den Berg B, Werner BF, Koopmanschap MA (2004) Economic valuation of informal care: an overview of methods and applications. Eur J Health Econ 5:36–45CrossRef
Metadata
Title
How much does it cost to care for survivors of colorectal cancer? Caregiver’s time, travel and out-of-pocket costs
Authors
Paul Hanly
Alan Ó Céilleachair
Mairead Skally
Eamonn O’Leary
Kanika Kapur
Patricia Fitzpatrick
Anthony Staines
Linda Sharp
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-1834-3

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