Background: In publicly funded healthcare systems, patients do not pay for medical visits but can experience costs stemming from travel or over-the-counter drugs. We lack information about the extent of this burden in Canadian remote regions. This study aimed to: (1) describe prostate cancer-related out-of-pocket costs and perceived financial burden, and (2) identify factors associated with such a perceived burden among prostate cancer patients living in a remote region of the province of Quebec (Canada). Methods: A cross-sectional study was conducted among 171 prostate cancer patients who consulted at the outpatient clinic of the Centre Hospitalier de Rouyn-Noranda. Results: The majority of patients (83%) had incurred out-of-pocket costs for their cancer care. The mean total cost incurred in the last three months was $517 and 22.3% reported a moderate, considerable or unsustainable burden. Multivariable analysis revealed that having incurred higher cancer-related out-of-pocket costs (OR: 1.001; 95%CI: 1.001–1.002) private drug insurance (vs. public, OR: 5.23; 95%CI: 1.13–24.17) was associated with a greater perceived financial burden. Having better physical health-related quality of life (OR: 0.95; 95%CI: 0.913–0.997), a university education (vs. elementary/high school level, OR: 0.03; 95%CI: 0.00–0.79), and an income between $40,000 and $79,999 (vs. ≤ $39,999, OR: 0.15; 95%CI: 0.03–0.69) were associated with a lower perceived burden. Conclusion: Prostate cancer patients incur out-of-pocket costs even if they were diagnosed many years ago and the perceived burden is significant. Greater attention should be paid to the development of services to help patients manage this burden.

中文翻译：

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魁北克偏远地区与前列腺癌治疗相关的自付费用和可感知的财务负担：一项横断面研究

背景：在公共资助的医疗保健系统中，患者无需支付就诊费用，但可能会因旅行或非处方药而产生费用。我们缺乏有关加拿大偏远地区这种负担程度的信息。本研究旨在：(1) 描述与前列腺癌相关的自付费用和感知的经济负担，以及 (2) 确定与居住在魁北克省偏远地区的前列腺癌患者的感知负担相关的因素（加拿大）。方法：对在 Center Hospitalier de Rouyn-Noranda 门诊就诊的 171 名前列腺癌患者进行了横断面研究。结果：大多数患者 (83%) 为他们的癌症护理支付了自付费用。过去三个月发生的平均总成本为 517 美元和 22 美元。3% 的人报告了中等、相当大或不可持续的负担。多变量分析显示，发生了更高的癌症相关自付费用（OR：1.001；95%CI：1.001–1.002）私人药物保险（相对于公共，OR：5.23；95%CI：1.13–24.17）是与更大的财务负担有关。拥有更好的身体健康相关生活质量（OR：0.95；95%CI：0.913–0.997）、大学教育（相对于小学/高中水平，OR：0.03；95%CI：0.00–0.79）和40,000 美元和 79,999 美元之间的收入（对比 ≤ 39,999 美元，OR：0.15；95%CI：0.03-0.69）与较低的感知负担相关。结论：前列腺癌患者即使在多年前被诊断出来，也会产生自付费用，而且他们认为负担很重。