ASPO Abstracts

Costs of Caregiving and Financial Burden among Informal Caregivers of African American Cancer Patients

Authors: Hastert TA, Ruterbusch JJ, Beebe-Dimmer JL, Pandolfi S, Schwartz K, Thompson H, Schwartz AG

Category: Financial Hardship Associated with Cancer
Conference Year: 2020

Abstract Body:
Background: Cancer patients commonly rely on loved ones to act as informal caregivers during and after treatment. The financial costs that caregivers experience related to caregiving and their association with caregiver financial hardship are not well understood, especially among caregivers of African American cancer survivors. Methods: Results include survey data from 346 caregivers of participants in the Detroit Research on Cancer Survivors (ROCS) cohort, a population-based study of African American survivors of breast, colorectal, lung, or prostate cancer in Metropolitan Detroit. Costs related to caregiving include medication (prescription or over the counter), logistical (transportation, groceries, home modifications), and medical bills (doctor, hospital, or clinic bills; medical supplies). Financial hardship was measured on a scale from 3-15 based on questions related to caregiver financial resources, strain, and difficulty paying caregiving costs and analyzed in tertiles (3-5, 6-8, 9+). The association between costs and financial hardship was assessed using modified Poisson regression models controlling for caregiver age, sex, income, and relationship to the survivor. Results: Caregivers were mostly women (78%), African American (91%), and 28% reported household incomes <$20,000/year. Caregivers included spouses (35%), non-married partners (8%), family members (47%) and friends (10%). Two-thirds (68%) of caregivers reported costs related to caregiving. Logistical costs were most common (62%), followed by medication costs (39%) and medical bills (13%). Medication and medical bill costs were more common among spouses (54% and 32%, respectively) compared to other relationships; while logistical costs were more common among non-married partners (71%) and family members (67%). Prevalence of high financial hardship was 30% higher among caregivers who reported any versus no caregiver costs [prevalence ratio (PR): 1.30, 95% CI: 1.12, 1.51], and these findings were similar for medication (PR: 1.23, 95% CI: 1.08, 1.39), logistic (PR: 1.32, 95% CI: 1.14, 1.53), and medical bill costs (PR: 1.28, 95% CI: 1.07, 1.53). Conclusions: Most caregivers experienced costs related to caregiving, and those costs were associated with caregiver-reported financial burden.

Keywords: financial hardship, caregivers, cancer survivorship, African American, costs