Characteristics of out-of-pocket costs for cancer patients in Ontario, Canada
Bibliographic record
Abstract
8251 Background: What costs do cancer patients still incur in Ontario's publicly-funded healthcare system, which requires universal comprehensive coverage for hospital and physician costs? Methods: We surveyed 282 patients (74 breast, 70 colorectal, 68 lung, 70 prostate) at five Ontario cancer clinics between Oct 2001 and April 2003. Among the data collected in the self-administered questionnaire was information on “out-of-pocket” (OOP) costs paid in the previous month for: drugs, homecare, homemaking, complementary and alternative medicines, vitamins and supplements, family care, travel, accommodations, devices, other direct costs, as well as a question on patient burden. Results: Incurred direct costs were highest for travel and accommodations, with average reported costs per month of $372 for imputed mileage (range $0- $6180), parking/fares ($47, range $0 -$450), and accommodations ($43, range $0- $1500). Significant average costs were also reported for devices ($46, range $0 - $2350) and drugs ($45, range $0 - $1400). This data is highly skewed by the small number of patients with non-zero OOP costs. For example, only 39 of 277 reported any costs for devices in the reporting month, but those who did often paid significant amounts. Analysis of variance and regression analysis revealed that the OOP costs had statistically significant differences between the types of cancer surveyed. Factors that increase OOP costs include: younger age, no private insurance coverage, longer distances to the clinic, and more intense treatment, although these factors collectively do not explain the majority of the variation in costs (R2<0.15). Conclusions: Ontario's health care system adequately covers the majority of direct medical costs for most cancer patients; residual OOP costs tend to be moderate (excepting travel cost). However, there still remains a noticeable population that reports their financial burden associated with cancer treatment to be “significant” (16.5%) or “unmanageable” (3.9%). Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Eli Lilly Canada, Inc. Eli Lilly & Co.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".