| Summary: | 碩士 === 中國醫藥學院 === 醫務管理研究所 === 90 === The purpose of this study was to quatify the out-of-pocket expenditure, to estimate the percentage of whole family yearly income spending on the out-of-pocket health care, to determinate the degree of the financial burden and the related factors for the patients with leukemia, lung and breast cancer.
The study was designed as a cross-sectional survey. The convenience sample consisted of 204 respondents at various stage of disease, who were interviewed at one medical center and one area hospital in central Taiwan from March to April, 2002. The structural questionnaire was investigator developed, which was conducted by content-validity and the test-retest reliability level was 85.75%. There were 25 leukemia patients, 90 lung cancer patients and 89 breast cancer patients included in this study. Data were analyzed using t-test、 ANOVA、Duncan’s multiple range test, Kruskal-Wallis and multiple regression.
Results show that the cancer patients have spent an average of $308,744 or over 70 percent of their income on the out-of-pocket for health care in 2001. The loss of income was not calculated as out-of-pocket expenditure, the mean of the loss income was amounted to $113,426. The significant related factors of the financial burden were the frequency of outpatient visit, the length of stay and whole family yearly income.
Comparison of the out-of-pocket expenditure by the type of cancer, the expense of leukemia patients (mean $703,081) was statistically significantly higher (p<0.01) than lung cancer patients($253,885) and breast cancer patients ($236,950). On a scale of 0 (low) to 10 (high), the mean financial burden of leukemia patients was 6.99, also statistically significantly higher (p<0.01) than lung cancer patients (5.37) and breast cancer patients (4.41). In comparison with out-of-pocket on chinese medicine covered by NHI (National Health Insurance), the respondents with breast cancer spend more than lung cancer patients ($2,529 and $121)(p<0.05). The annual out-of-pocket expenses on traditional chinese medicine not covered by NHI was $6,741 for patients with breast caner, and $1,290 for lung cancer patients.
The conclusion of this study was the extend of out-of-pocket expenditures may depend on ease of symptom management. The recognition of the out-of-pocket expenditures enables nurses and physician to anticipated the financial burden of illness and make necessary referrals.
Key ward: out-of-pocket expenditure, financial burden, cancer patient.
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