title: Financial Burden of Pediatric Cancer for Patients and Their Families.
abstract: Cancer treatment may cause financial stress for pediatric oncology patients and their families. We evaluated pediatric cancer caregivers' perceived financial burden related to socioeconomic factors (eg, parental employment) and health care use factors (eg, unexpected hospitalizations).
  
  
  
  A single-site, cross-sectional survey of primary caretakers of patients with childhood cancer was performed from July 2010 to July 2012. Eligible patients were treated at a pediatric cancer hospital, diagnosed at age ≤ 21 years and were ≤ 5 years from diagnosis (N = 254). Financial burden was rated on a visual analog scale of 0 to 100. Multivariable linear regression models were used to calculate coefficients and 95% CIs of financial burden by time since diagnosis.
  
  
  
  Mean age at diagnosis was 6.8 years (SD = 5.5 years), and average time since diagnosis was 1.6 years (SD = 1.4 years). The most common diagnosis was leukemia (41.9%). When adjusted for sex, age at diagnosis, insurance status, and rural residence, caregivers whose child was 1 to 5 years from diagnosis with ≥ 5 unexpected hospitalizations experienced 24.9 (95% CI, 9.1 to 40.7; P < .01) points higher financial burden than those with no unexpected hospitalizations. In addition, when compared with families without employment disruptions, families of children 1 to 5 years from diagnosis in which a caregiver had quit or changed jobs reported 13.4 (95% CI, 3.2 to 23.6; P = .01) points higher financial burden.
  
  
  
  Efforts to reduce unexpected hospitalizations and employment disruptions by providing more comprehensive supportive care for pediatric patients with cancer could help ease families' financial burden.
authors.affiliation: Huntsman Cancer Institute; and University of Utah, Salt Lake City, UT echo.warner@hci.utah.edu.
authors.forename: Echo L
authors.initials: EL
authors.lastname: Warner
authors.affiliation: Huntsman Cancer Institute; and University of Utah, Salt Lake City, UT.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Kirchhoff
authors.affiliation: Huntsman Cancer Institute; and University of Utah, Salt Lake City, UT.
authors.forename: Gina E
authors.initials: GE
authors.lastname: Nam
authors.affiliation: Huntsman Cancer Institute; and University of Utah, Salt Lake City, UT.
authors.forename: Mark
authors.initials: M
authors.lastname: Fluchel
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000191:economics* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D019458:Insurance Coverage; D016014:Linear Models; D008297:Male; D009369:Neoplasms / Q000191:economics*; D010290:Parents; D012959:Socioeconomic Factors; D014589:Utah; D055815:Young Adult