Multifactorial Study on the Impact of Educational Level, Employment Status, and the Need for Extraordinary Care on the Economic Impact of Cancer Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Procedures
2.2. Participants
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- Inclusion criteria: anatomopathological diagnosis of cancer, over 18 years of age, and signed voluntary consent to participate in this study.
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- Exclusion criteria: clinically impaired cognitive status (Mini-Mental State Examination (MMSE) score below 24 points), failure to correctly complete the assessment tools required for the study.
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- Withdrawal criteria: express request for withdrawal from the patient’s family, even if they had completed the informed consent document and/or did not correctly complete any of the assessment instruments required for this study.
2.3. Sample Size
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2.4. Variables
2.4.1. Study Variable
2.4.2. Socio-Demographic Variables
2.5. Measuring Instruments
2.6. Procedure and Data Collection
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- New patient admission to Medical Oncology. After analysing the adequacy of the newly admitted patient based on the inclusion and exclusion criteria, the research and main objective were presented to the patient, followed by the signing of the informed consent form and the passing of the self-completion questionnaire. Subsequently, results have been evaluated through the measurement scales (Barthel Index, Lawton–Brody, Zarit, ECOG, and EuroQol-5D).
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- Patients attending for active treatment at a day hospital (chemotherapy or radiotherapy treatment). Firstly, we proceed to analyse which patients meet the selection criteria for the study. Once it is confirmed that they meet the criteria, the study is explained to the patient so that he/she can sign the informed consent document. At this point, the evaluation of the different variables to be studied begins. Data from each of the study participants were collected and coded in the Microsoft Access database developed for the research. Statistical analysis was performed using IBM SPSS Statistics version 26.
2.7. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | Worth | Where | Investigation |
---|---|---|---|
N | 7043 | Population size | Number of people with an anatomopathological diagnosis of cancer in Salamanca in 2019. |
Z | 1960 | Statistical parameter that depends on the Conficence Level (NC). | (Z-alpha): dependent on N, with a confidence level of 95%: 1.96%. |
P | 50.00% | Probability that the studied event occurs (success). | |
Q | 50.00% | (1-P) Probability that the event studied will not occur. | |
e | 5.00% | Maximun accepted estimation error. |
Socio-Demographic Variables | N | Results |
---|---|---|
Patient’s educational level | 365 | Without studies/primary studies: 53.2% Secondary studies: 25.8% Higher studies: 21.1% |
Patient profession | 365 | Self-Employed labor active: 10.1% Employee employed: 36.4% Non-labor active: 53% Other: 38.9% |
Current employment status of the patient | 361 | Active labor force: 8.5% Unemployed: 11.5% Short-time: 0.5% Student: 0.8% Disability: 34% Retirement: 40.5% Other: 3% |
Gender of patient’s primary caregiver | 338 | Male 33.4% Female 66.6% |
Marital status of patient’s primary caregiver | 338 | Singles: 14.0% Married: 72.9% Separated and divorced: 3% Widowed: 2.7% |
Age of patient’s primary caregiver | 337 | Media = 57.19 years (±14,052) Max. = 90 years. |
Degree of kinship primary caregiver of patient | 337 | Grade 1: 86%. Second degree: 5.5%. Contracted caregiver: 0.8%. |
Amount of net household income during the last fiscal year | 363 | Less than EUR 12.000: 27.1% From EUR 12.001 to EUR 24.000: 47.9% More than EUR 24.001: 24.4% |
Amount ot net household income before cancer diagnosis | 363 | Less than EUR 12.000: 21.9% From EUR 12.001 to EUR 24.000: 51.5% More than EUR 24.001: 26.1% |
Extraordinary expenses in the last year in pharmacy and paraphamacy | 274 | EUR 300: 87.6% EUR 900: 9.5% EUR 1500: 2.9% |
Extraordinary expenditure on orthopaedic equipment in the last year | 171 | EUR 300: 54.4% EUR 900: 34.5% EUR 1500: 11.1% |
Extraordinary expenditure in the last year on home help and patient accompaniment service | 54 | EUR 300: 48.1% EUR 900: 24.1% EUR 1500: 27.8% |
Average extraordinary expenditure on transfers to hospital in the last year | 236 | EUR 300: 64% EUR 900: 18.6% EUR 1500: 6.8% EUR 2400: 4.2% EUR 4500: 6.4% |
Variable | Educational Level | N | Value p | Average Range |
---|---|---|---|---|
Amount of anual net household income prior to diagnosis | No primary education/studies | 194 | p = 0.003 | 133.66 |
Secondary education (Baccalaureate/High School) | 92 | 164.25 | ||
No studies/primary studies | 194 | p = 0.000 | 114.05 | |
Higher education (University/Higher education) | 77 | 191.29 | ||
Secondary studies (Bach/Advanced) | 92 | p = 0.000 | 72.29 | |
Higher education (University/Higher) | 77 | 100.19 | ||
Amount of annual net household income in the last tax year | No primary education/studies | 194 | p = 0.018 | 135.76 |
Secondary education (Baccalaureate/High School) | 92 | 159.83 | ||
No studies/primary studies | 194 | p = 0.000 | 113.97 | |
Higher education (University/Higher education) | 77 | 191.49 | ||
Secondary studies (Bach/Advanced) | 92 | p = 0.000 | 70.10 | |
Higher education (University/Higher) | 77 | 102.80 | ||
Extraordinary expenses in the last year on home help and/or patient accompaniment service | No primary education/studies | 35 | p = 0.017 | 20.71 |
Secondary education (Baccalaureate/High School) | 10 | 31.00 | ||
No studies/primary studies | 35 | p = 0.002 | 19.87 | |
Higher education (University/Higher education) | 9 | 32.72 | ||
Secondary studies (Bach/Advanced) | 10 | p = 0.571 | 9.20 | |
Higher education (University/Higher) | 9 | 10.89 | ||
Extraordinary expenditure in the last year on housing adaptations or hospital transfers | No primary education/studies | 140 | p = 0.016 | 96.05 |
Secondary education (Baccalaureate/High School) | 63 | 115.21 | ||
No studies/primary studies | 140 | p = 0.336 | 88.45 | |
Higher education (University/Higher education) | 33 | 80.85 | ||
Secondary studies (Bach/Advanced) | 63 | p = 0.012 | 53.12 | |
Higher education (University/Higher) | 33 | 39.68 |
Variable | Educational Level | N | Value p | Average Range |
---|---|---|---|---|
Amount of anual net household income prior to diagnosis | Own-account assets | 35 | p = 0.395 | 78.34 |
Assets held for hire or reward | 133 | 86.12 | ||
Own-account labour assets | 35 | p = 0.003 | 53.91 | |
Not in employment | 53 | 38.28 | ||
Own-account labour assets | 35 | p = 0.547 | 93.61 | |
Other | 142 | 87.86 | ||
Employed persons in employment | 133 | p = 0.000 | 104.84 | |
Not in employment | 53 | 65.04 | ||
Employed persons in employment | 133 | p = 0.11 | 149.98 | |
Other | 142 | 126.78 | ||
Not in employment | 53 | p = 0.000 | 75.34 | |
Other | 142 | 106.46 | ||
Amount of annual net household income in the last tax year | Own-account assets | 35 | p = 0.223 | 75.69 |
Assets held for hire or reward | 133 | 86.82 | ||
Own-account labour assets | 35 | p = 0.015 | 52.37 | |
Not in employment | 5335 | 39.30 | ||
142 | ||||
Own-account labour assets | 133 | p = 0.513 | 84.01 | |
Other | 53 | 90.23 | ||
Employed persons in employment | 133 | p = 0.000 | 104.56 | |
Not in employment | 142 | 65.75 | ||
Employed persons in employment | 53 | p = 0.196 | 144.26 | |
Other | 142 | 132.13 | ||
Not in employment | p = 0.000 | 70.77 | ||
Other | 108.16 |
Variable | Degree of Relatedness of Patient’s Primary Caregiver | N | Value p | Average Range |
---|---|---|---|---|
Amount of annual net household income prior to diagnosis | Primary caregiver first degree of consanguinity | 312 | p = 0.004 | 170.16 |
Primary caregiver second degree of consaguinity | 20 | 109.48 | ||
Primary caregiver first degree of consanguinity | 312 | p = 0.180 | 158.71 | |
Contracted caregiver | 3 | 84.50 | ||
Primary caregiver second degree of | 20 | p = 0.978 | 12.05 | |
Consaguinity Contracted caregiver | 3 | 11.67 | ||
Amount of annual net household income in the last tax year | Primary caregiver first degree of consanguinity | 312 | p = 0.018 | 169.62 |
Primary caregiver second degree of consaguinity | 20 | 117.80 | ||
Primary caregiver first degree of consanguinity | 312 | p = 0.022 | 159.09 | |
Contracted caregiver | 3 | 44.50 | ||
Primary caregiver second degree of | 20 | p = 0.187 | 12.75 | |
consaguinityContracted caregiver | 3 | 7.00 | ||
Extraordinary expenditure on orthopaedic equipment in the last year | Single | 23 | p = 0.028 | 57.85 |
Married | 124 | 77.00 | ||
Single | 23 | p = 0.003 | 12.93 | |
Separated and divorced | 6 | 22.92 | ||
Single | 23 | p = 0.614 | 14.65 | |
Widowed | 6 | 16.33 | ||
Married | 124 | p = 0.058 | 64.21 | |
Separated and divorced | 6 | 92.25 | ||
Married | 124 | p = 0.516 | 65.98 | |
Widowed | 6 | 55.67 | ||
Separated and divorced | 6 | p = 0.125 | 8.33 | |
Widowed | 6 | 4.67 |
Variable | BARTHEL | N | Value p | LAWTON BRODY | N | Value p | ECOG | N | Value p | ZARIT | N | Value p | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Amount of anual net household income prior to diagnosis | Total | 48 | p = 0.186 | Total | 32 | p = 0.046 | Ecog 0 | 59 | p = 0.194 | No overload | 240 | p = 0.029 | |
Severe | 21 | Severe | 44 | Ecog 1 | 125 | Light overload | 49 | ||||||
Moderate | 47 | Moderate | 76 | Ecog 3 | 89 | Intense overload | 74 | ||||||
Slight | 131 | Light | 121 | Ecog 4 | 48 | Total | 363 | ||||||
Independent | 116 | Independent | 90 | Ecog 5 | 2 | ||||||||
Total | 363 | Total | 363 | Total | 363 | ||||||||
Amount of annual net household income in the last tax year | Total | 48 | p = 0.475 | Total | 32 | p = 0.081 | Ecog 0 | 59 | p = 0.424 | No overload | 240 | p = 0.016 | |
Severe | 21 | Severe | 44 | Ecog 1 | 125 | Light overload | 49 | ||||||
Moderate | 47 | Moderate | 76 | Ecog 3 | 89 | Intense overload | 74 | ||||||
Slight | 131 | Light | 121 | Ecog 4 | 48 | Total | 363 | ||||||
Independent | 116 | Independent | 90 | Ecog 5 | 2 | ||||||||
Total | 363 | Total | 363 | Total | 363 | ||||||||
Change in revenue | Total | 7 | p = 0.540 | Total | 8 | p = 0.273 | Ecog 0 | 14 | p = 0.152 | No overload | 74 | p = 0.614 | |
Severe | 10 | Severe | 11 | Ecog 1 | 50 | Light overload | 17 | ||||||
Moderate | 17 | Moderate | 32 | Ecog 2 | 36 | Intense overload | 33 | ||||||
Slight | 51 | Light | 48 | Ecog 3 | 13 | Total | 124 | ||||||
Independent | 39 | Independent | 25 | Ecog 4 | 10 | ||||||||
Total | 124 | Total | 124 | Ecog 5 | 1 | ||||||||
Total | 124 | ||||||||||||
Extraordinary expenditure in the last year pharmacy and parapharmacy | Total | 36 | p = 0.663 | Total | 27 | p = 0.957 | Ecog 0 | 35 | p = 0.328 | No overload | 179 | p = 0.095 | |
Severe | 15 | Severe | 33 | Ecog 1 | 99 | Light overload | 35 | ||||||
Moderate | 43 | Moderate | 60 | Ecog 2 | 67 | Intense overload | 60 | ||||||
Slight | 102 | Light | 94 | Ecog 3 | 36 | Total | 274 | ||||||
Independent | 78 | Independent | 60 | Ecog 4 | 35 | ||||||||
Total | 274 | Total | 274 | Ecog 5 | 2 | ||||||||
Total | 274 | ||||||||||||
Extraordinary expenditure in the last year on orthopaedic equipment | Total | 39 | p = 0.451 | Total | 26 | p = 0.142 | Ecog 0 | 13 | p = 0.693 | No overload | 92 | p = 0.302 | |
Severe | 11 | Severe | 29 | Ecog 1 | 48 | Light overload | 32 | ||||||
Moderate | 35 | Moderate | 43 | Ecog 2 | 42 | Intense overload | 47 | ||||||
Slight | 52 | Light | 43 | Ecog 3 | 27 | Total | 171 | ||||||
Independent | 34 | Independent | 31 | Ecog 4 | 39 | ||||||||
Total | 171 | Total | 171 | Ecog 5 | 2 | ||||||||
Total | 171 | ||||||||||||
Extraordinary expenditure in the last year on home help and patient accompaniment service | Total | 11 | p = 0.766 | Total | 7 | p = 0.955 | Ecog 1 | 12 | p = 0.090 | No overload | 30 | p = 0.621 | |
Severe | 4 | Severe | 8 | Ecog 2 | 21 | Light overload | 7 | ||||||
Moderate | 14 | Moderate | 23 | Ecog 3 | 10 | Intense overload | 17 | ||||||
Slight | 20 | Light | 15 | Ecog 4 | 11 | Total | 54 | ||||||
Independent | 5 | Independent | 1 | Total | 54 | ||||||||
Total | 54 | Total | 54 | ||||||||||
Extraordinary expenditure on transfers to hospital | Total | 37 | p = 0.885 | Total | 26 | p = 0.850 | Ecog 0 | 32 | p = 0.024 | No overload | 146 | p = 0.806 | |
Severe | 16 | Severe | 34 | Ecog 1 | 72 | Light overload | 33 | ||||||
Moderate | 31 | Moderate | 48 | Ecog 2 | 65 | Intense overload | 57 | ||||||
Slight | 92 | Light | 81 | Ecog 3 | 26 | Total | 236 | ||||||
Independent | 60 | Independent | 47 | Ecog 4 | 39 | ||||||||
Total | 236 | Total | 236 | Ecog 5 | 2 | ||||||||
Total | 236 |
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Martín, A.G.; Fernández Rodríguez, E.J.; Sánchez Gómez, C.; Galve, M.I.R. Multifactorial Study on the Impact of Educational Level, Employment Status, and the Need for Extraordinary Care on the Economic Impact of Cancer Patients. Healthcare 2023, 11, 1306. https://doi.org/10.3390/healthcare11091306
Martín AG, Fernández Rodríguez EJ, Sánchez Gómez C, Galve MIR. Multifactorial Study on the Impact of Educational Level, Employment Status, and the Need for Extraordinary Care on the Economic Impact of Cancer Patients. Healthcare. 2023; 11(9):1306. https://doi.org/10.3390/healthcare11091306
Chicago/Turabian StyleMartín, Alberto García, Eduardo J. Fernández Rodríguez, Celia Sánchez Gómez, and M. Isabel Rihuete Galve. 2023. "Multifactorial Study on the Impact of Educational Level, Employment Status, and the Need for Extraordinary Care on the Economic Impact of Cancer Patients" Healthcare 11, no. 9: 1306. https://doi.org/10.3390/healthcare11091306