BACKGROUND Although medical financial hardship (MFH) resulting from sequelae of cancer and treatment has been reported in other racial/ethnic populations, little is known about MFH among Native Hawaiian and Pacific Islander (NHPI) cancer survivors. METHODS One hundred fifty adult NHPI cancer survivors were identified from the 2014 NHPI National Health Interview Survey (NHIS). Cancer survivors were those with a history of cancer (excluding nonmelanoma/unknown type of skin cancer). MFH was defined by 3 domains: 1) material (problem paying or unable to pay medical bills); 2) psychological (worrying about paying medical bills); and 3) behavioral (delaying or forgoing medical care for financial reasons). For comparison, 2098 non-Hispanic white (NHW) cancer survivors were identified from the 2014 NHIS. Logistic regressions were used to identify sociodemographic and health factors associated with experiencing MFH. Stratified analysis by age (<65 vs ≥65 years) and sensitivity analysis using propensity score-matched NHPI and NHW cancer survivors were conducted. Nationally representative estimates were generated using survey weights. RESULTS Among elderly cancer survivors, more NHPIs reported any MFH (59% vs 32%; P = .001), psychological MFH (36% vs 22%; P = .040), and behavioral MFH (27% vs 9%; P = .004) than NHWs. Among survivors aged <65 years, NHPIs reported less MFH (46% vs. 65%; P = .034). Even after propensity score matching, these patterns persisted. Female NHPIs and NHPIs with a college degree were significantly more likely to report MFH, especially material and psychological MFH. CONCLUSIONS A significantly higher proportion of elderly NHPI cancer survivors reported MFH, and this difference persisted even after propensity score matching, which warrants further investigation.

中文翻译：

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夏威夷土著和太平洋岛民癌症幸存者报告的医疗财务困难与非西班牙裔白人相比。

背景技术尽管在其他种族/族裔人群中也报告了由于癌症和治疗后遗症引起的医疗财务困难（MFH），但夏威夷土著和太平洋岛民（NHPI）癌症幸存者对MFH知之甚少。方法从2014年NHPI国民健康访问调查（NHIS）中识别出150名成年NHPI癌症幸存者。癌症幸存者是有癌症史的患者（不包括非黑素瘤/未知类型的皮肤癌）。MFH定义为3个领域：1）物质（支付或无法支付医疗费用的问题）；2）心理上的（担心支付医疗费用）；和3）行为上的（出于经济原因推迟或放弃医疗）。为了进行比较，从2014年NHIS中确定了2098名非西班牙裔白人（NHW）癌症幸存者。Logistic回归用于确定与经历MFH相关的社会人口统计学和健康因素。进行了年龄（<65 vs≥65岁）的分层分析，并使用倾向得分匹配的NHPI和NHW癌症幸存者进行了敏感性分析。全国代表性的估计值是使用调查权重得出的。结果在老年癌症幸存者中，更多的NHPI报告了任何MFH（59％vs 32％; P = .001），心理MFH（36％vs 22％; P = .040）和行为MFH（27％vs 9％; P = .004）。在65岁以下的幸存者中，NHPI报告的MFH较少（46％比65％； P = .034）。即使倾向得分匹配，这些模式仍然存在。女性NHPI和具有大学学历的NHPI更有可能报告MFH，尤其是物质和心理MFH。