Research progress on financial toxicity in patients with heart failure_West China Medical Journal

Authors：

WENG Lingling ¹ , CHEN Jiazeng ¹ , LI Xuelian ² , KANG Pan ³ ,  CHENG Fengqin ¹

1. Department of Nursing, Mianyang 404 Hospital, Mianyang, Sichuan 621000, P. R. China;
2. Department of Cardiovascular Medicine, Mianyang 404 Hospital, Mianyang, Sichuan 621000, P. R. China;
3. Department of Cardiac and Vascular Surgery, Mianyang 404 Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

CHENG Fengqin, Email: 1150364374@qq.com

Keywords：

Heart failure; financial toxicity; nursing

DOI：

10.7507/1002-0179.202405236

Video：

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Heart failure is a progressive disease with high readmission rate and long treatment duration, which impose a heavy financial burden on patients and their families. The resulting financial toxicity can also affect the health outcomes of patients. This article provides an in-depth analysis of the concept, evaluation tools, research status, hazards, influencing factors, and coping strategies of financial toxicity in patients with heart failure. Suggestions are put forward for the development of evaluation tools and the improvement of coping strategies for financial toxicity, aiming to provide a reference for the development of more scientific and effective systematic intervention strategies.

1.	李莹莹, 王华. 《2022 年 AHA/ACC/HFSA 心力衰竭管理指南》解读——从新指南看治疗进展. 中国心血管杂志, 2022, 27(5): 417-421.
2.	马丽媛, 王增武, 樊静, 等. 《中国心血管健康与疾病报告 2022》要点解读. 中国全科医学, 2023, 26(32): 3975-3994.
3.	Foroutan F, Rayner DG, Ross HJ, et al. Global comparison of readmission rates for patients with heart failure. J Am Coll Cardiol, 2023, 82(5): 430-444.
4.	Wang H, Chai K, Du M, et al. Prevalence and incidence of heart failure among urban patients in China: a national population-based analysis. Circ Heart Fail, 2021, 14(10): e008406.
5.	Ali HR, Valero-Elizondo J, Wang SY, et al. Subjective financial hardship due to medical bills among patients with heart failure in the united states: the 2014-2018 medical expenditure panel survey. J Card Fail, 2022, 28(9): 1424-1433.
6.	Bullock AJ, Hofstatter EW, Yushak ML, et al. Understanding patients’ attitudes toward communication about the cost of cancer care. J Oncol Pract, 2012, 8(4): e50-e58.
7.	Zafar SY, Abernethy AP. Financial toxicity, part I: a new name for a growing problem. Oncology (Williston Park), 2013, 27(2): 80-81, 149.
8.	况艺, 孙艳玲, 荆凤, 等. 癌症相关经济毒性概念分析. 护理研究, 2021, 35(20): 3695-3700.
9.	Carrera PM, Kantarjian HM, Blinder VS. The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. CA Cancer J Clin, 2018, 68(2): 153-165.
10.	王哲, 许惠靖, 王宇宇, 等. 经济毒性对慢性病患者不良健康结局影响的研究进展. 护理学报, 2023, 30(17): 34-38.
11.	Altice CK, Banegas MP, Tucker-Seeley RD, et al. Financial hardships experienced by cancer survivors: a systematic review. J Natl Cancer Inst, 2016, 109(2): djw205.
12.	Wang SY, Valero-Elizondo J, Ali HJ, et al. Out-of-pocket annual health expenditures and financial toxicity from healthcare costs in patients with heart failure in the United States. J Am Heart Assoc, 2021, 10(14): e022164.
13.	de Souza JA, Yap BJ, Hlubocky FJ, et al. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer, 2014, 120(20): 3245-3253.
14.	于慧会, 毕雪, 刘运泳. 中文版癌症患者报告结局的经济毒性量表信度和效度研究. 中华流行病学杂志, 2017, 38(8): 1118-1120.
15.	孙艳玲, 况艺, 袁潇逸, 等. 癌症生存者经济毒性现状及影响因素. 护理学杂志, 2022, 37(15): 24-27, 31.
16.	赵凌, 陈希伟, 庞兆烽, 等. 维持性血液透析患者经济毒性现状及影响因素的研究. 临床护理杂志, 2023, 22(1): 6-10.
17.	张译友, 田媛, 帕孜来提·赛登, 等. 脑卒中患者经济毒性现状及影响因素分析. 中国临床护理, 2023, 15(3): 183-186.
18.	沈雅琳, 汤利萍, 曹英, 等. 输尿管皮肤造口患者经济毒性状况及影响因素分析. 护理学杂志, 2022, 37(10): 26-29.
19.	Prawitz A, Garman E T, Sorhaindo B, et al. Incharge financial distress/financial well-being scale: development, administration, and score interpretation. Financ Couns Plan, 2006, 17(1): 34-50.
20.	Head BA, Faul AC. Development and validation of a scale to measure socioeconomic well-being in persons with cancer. J Support Oncol, 2008, 6(4): 183-192.
21.	Cook C, Cole G, Asaria P, et al. The annual global economic burden of heart failure. Int J Cardiol, 2014, 171(3): 368-376.
22.	Urbich M, Globe G, Pantiri K, et al. A systematic review of medical costs associated with heart failure in the USA (2014-2020). Pharmacoeconomics, 2020, 38(11): 1219-1236.
23.	Wei C, Heidenreich PA, Sandhu AT. The economics of heart failure care. Prog Cardiovasc Dis, 2024, 82: 90-101.
24.	Yu Y, Liu J, Zhang L, et al. Perceived economic burden, mortality, and health status in patients with heart failure. JAMA Netw Open, 2024, 7(3): e241420.
25.	徐泽宇, 邱恒, 姚奕婷, 等. 医疗服务价格改革对医疗服务供方行为的影响——以心力衰竭为例. 卫生软科学, 2020, 34(10): 33-35.
26.	李洋. 沈阳市心力衰竭患者住院费用及影响因素分析. 沈阳: 沈阳医学院, 2023.
27.	马兰虎, 蓝庆肃, 武锋超, 等. 钠-葡萄糖协同转运蛋白-2 抑制剂在射血分数保留性心力衰竭中的研究进展. 华西医学, 2021, 36(9): 1288-1292.
28.	李勇, 高秀芳, 山缨, 等. 新四联为基石, 优化心力衰竭药物治疗. 中华高血压杂志, 2022, 30(10): 918-925.
29.	Gunn AH, Warraich HJ, Mentz RJ. Costs of care and financial hardship among patients with heart failure. Am Heart J, 2024, 269: 94-107.
30.	Slavin SD, Khera R, Zafar SY, et al. Financial burden, distress, and toxicity in cardiovascular disease. Am Heart J, 2021, 238: 75-84.
31.	Wideqvist M, Cui X, Magnusson C, et al. Hospital readmissions of patients with heart failure from real world: timing and associated risk factors. ESC Heart Fail, 2021, 8(2): 1388-1397.
32.	季朝红. 213 例青年心力衰竭患者临床资料的回顾性分析. 长春: 吉林大学, 2019.
33.	Valero-Elizondo J, Khera R, Saxena A, et al. Financial hardship from medical bills among nonelderly U.S. adults with atherosclerotic cardiovascular disease. J Am Coll Cardiol, 2019, 73(6): 727-732.
34.	Gunn AH, Pendyal A. Novel cardiovascular therapeutics and the risk of financial toxicity. Nat Rev Cardiol, 2024, 21(6): 349-350.
35.	Zhang H, Ning K, Wang J, et al. Research on the influence of patient cost-sharing on medical expenses and health outcomes: taking patients with heart failure as an example. Front Public Health, 2023, 11: 1121772.
36.	鲁蓓, 冯天岳, 袁杨. “互联网+”背景下慢性病长期用药管理模式探讨. 中国医疗保险, 2020(7): 57-60.
37.	中共中央国务院. 关于深化医疗保障制度改革的实施意见. 四川日报, 2021-05-01(4).
38.	孙洁, 黄艺飞, 罗屿浪, 等. 惠民保可持续发展研究. 中国医疗保险, 2024(1): 29-42.
39.	陈华蝶, 丁刘蔚, 张真才. 我国医保政策认知现状及对策——以靖江市为例. 经济研究导刊, 2022(27): 64-66.
40.	Kwok CS, Seferovic PM, Van Spall HG, et al. Early unplanned readmissions after admission to hospital with heart failure. Am J Cardiol, 2019, 124(5): 736-745.
41.	Lesyuk W, Kriza C, Kolominsky-Rabas P. Cost-of-illness studies in heart failure: a systematic review 2004-2016. BMC Cardiovasc Disord, 2018, 18(1): 74.
42.	Blum MR, Øien H, Carmichael HL, et al. Cost-effectiveness of transitional care services after hospitalization with heart failure. Ann Intern Med, 2020, 172(4): 248-257.
43.	Ma C. Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: a longitudinal observational study. J Clin Nurs, 2019, 28(13/14): 2526-2536.
44.	孙佳玲, 朱丽莎, 夏梅, 等. 三元联动护理模式在心力衰竭易损期病人中应用的研究进展. 全科护理, 2024, 22(6): 1106-1109.
45.	Edward J. Effective cost conversations: addressing financial toxicity and cost-related health literacy. Clin J Oncol Nurs, 2020, 24(2): 209-213.
46.	Yezefski T, Steelquist J, Watabayashi K, et al. Impact of trained oncology financial navigators on patient out-of-pocket spending. Am J Manag Care, 2018, 24(Suppl 5): S74-S79.
47.	Smith GH, Shore S, Allen LA, et al. Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure. J Am Heart Assoc, 2019, 8(1): e010635.
48.	Cheung CK, Jones L, Lee H, et al. Anticipatory guidance: developing a patient navigation pathway to reduce the financial toxicity of cancer. Med Res Arch, 2023, 11(10): 10.18103/mra. v11i10.4582.
49.	袁潇逸, 况艺, 阮君怡, 等. 癌症患者费用相关健康素养的概念分析. 护士进修杂志, 2024: 1-12.

1. 李莹莹, 王华. 《2022 年 AHA/ACC/HFSA 心力衰竭管理指南》解读——从新指南看治疗进展. 中国心血管杂志, 2022, 27(5): 417-421.
2. 马丽媛, 王增武, 樊静, 等. 《中国心血管健康与疾病报告 2022》要点解读. 中国全科医学, 2023, 26(32): 3975-3994.
3. Foroutan F, Rayner DG, Ross HJ, et al. Global comparison of readmission rates for patients with heart failure. J Am Coll Cardiol, 2023, 82(5): 430-444.
4. Wang H, Chai K, Du M, et al. Prevalence and incidence of heart failure among urban patients in China: a national population-based analysis. Circ Heart Fail, 2021, 14(10): e008406.
5. Ali HR, Valero-Elizondo J, Wang SY, et al. Subjective financial hardship due to medical bills among patients with heart failure in the united states: the 2014-2018 medical expenditure panel survey. J Card Fail, 2022, 28(9): 1424-1433.
6. Bullock AJ, Hofstatter EW, Yushak ML, et al. Understanding patients’ attitudes toward communication about the cost of cancer care. J Oncol Pract, 2012, 8(4): e50-e58.
7. Zafar SY, Abernethy AP. Financial toxicity, part I: a new name for a growing problem. Oncology (Williston Park), 2013, 27(2): 80-81, 149.
8. 况艺, 孙艳玲, 荆凤, 等. 癌症相关经济毒性概念分析. 护理研究, 2021, 35(20): 3695-3700.
9. Carrera PM, Kantarjian HM, Blinder VS. The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. CA Cancer J Clin, 2018, 68(2): 153-165.
10. 王哲, 许惠靖, 王宇宇, 等. 经济毒性对慢性病患者不良健康结局影响的研究进展. 护理学报, 2023, 30(17): 34-38.
11. Altice CK, Banegas MP, Tucker-Seeley RD, et al. Financial hardships experienced by cancer survivors: a systematic review. J Natl Cancer Inst, 2016, 109(2): djw205.
12. Wang SY, Valero-Elizondo J, Ali HJ, et al. Out-of-pocket annual health expenditures and financial toxicity from healthcare costs in patients with heart failure in the United States. J Am Heart Assoc, 2021, 10(14): e022164.
13. de Souza JA, Yap BJ, Hlubocky FJ, et al. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer, 2014, 120(20): 3245-3253.
14. 于慧会, 毕雪, 刘运泳. 中文版癌症患者报告结局的经济毒性量表信度和效度研究. 中华流行病学杂志, 2017, 38(8): 1118-1120.
15. 孙艳玲, 况艺, 袁潇逸, 等. 癌症生存者经济毒性现状及影响因素. 护理学杂志, 2022, 37(15): 24-27, 31.
16. 赵凌, 陈希伟, 庞兆烽, 等. 维持性血液透析患者经济毒性现状及影响因素的研究. 临床护理杂志, 2023, 22(1): 6-10.
17. 张译友, 田媛, 帕孜来提·赛登, 等. 脑卒中患者经济毒性现状及影响因素分析. 中国临床护理, 2023, 15(3): 183-186.
18. 沈雅琳, 汤利萍, 曹英, 等. 输尿管皮肤造口患者经济毒性状况及影响因素分析. 护理学杂志, 2022, 37(10): 26-29.
19. Prawitz A, Garman E T, Sorhaindo B, et al. Incharge financial distress/financial well-being scale: development, administration, and score interpretation. Financ Couns Plan, 2006, 17(1): 34-50.
20. Head BA, Faul AC. Development and validation of a scale to measure socioeconomic well-being in persons with cancer. J Support Oncol, 2008, 6(4): 183-192.
21. Cook C, Cole G, Asaria P, et al. The annual global economic burden of heart failure. Int J Cardiol, 2014, 171(3): 368-376.
22. Urbich M, Globe G, Pantiri K, et al. A systematic review of medical costs associated with heart failure in the USA (2014-2020). Pharmacoeconomics, 2020, 38(11): 1219-1236.
23. Wei C, Heidenreich PA, Sandhu AT. The economics of heart failure care. Prog Cardiovasc Dis, 2024, 82: 90-101.
24. Yu Y, Liu J, Zhang L, et al. Perceived economic burden, mortality, and health status in patients with heart failure. JAMA Netw Open, 2024, 7(3): e241420.
25. 徐泽宇, 邱恒, 姚奕婷, 等. 医疗服务价格改革对医疗服务供方行为的影响——以心力衰竭为例. 卫生软科学, 2020, 34(10): 33-35.
26. 李洋. 沈阳市心力衰竭患者住院费用及影响因素分析. 沈阳: 沈阳医学院, 2023.
27. 马兰虎, 蓝庆肃, 武锋超, 等. 钠-葡萄糖协同转运蛋白-2 抑制剂在射血分数保留性心力衰竭中的研究进展. 华西医学, 2021, 36(9): 1288-1292.
28. 李勇, 高秀芳, 山缨, 等. 新四联为基石, 优化心力衰竭药物治疗. 中华高血压杂志, 2022, 30(10): 918-925.
29. Gunn AH, Warraich HJ, Mentz RJ. Costs of care and financial hardship among patients with heart failure. Am Heart J, 2024, 269: 94-107.
30. Slavin SD, Khera R, Zafar SY, et al. Financial burden, distress, and toxicity in cardiovascular disease. Am Heart J, 2021, 238: 75-84.
31. Wideqvist M, Cui X, Magnusson C, et al. Hospital readmissions of patients with heart failure from real world: timing and associated risk factors. ESC Heart Fail, 2021, 8(2): 1388-1397.
32. 季朝红. 213 例青年心力衰竭患者临床资料的回顾性分析. 长春: 吉林大学, 2019.
33. Valero-Elizondo J, Khera R, Saxena A, et al. Financial hardship from medical bills among nonelderly U.S. adults with atherosclerotic cardiovascular disease. J Am Coll Cardiol, 2019, 73(6): 727-732.
34. Gunn AH, Pendyal A. Novel cardiovascular therapeutics and the risk of financial toxicity. Nat Rev Cardiol, 2024, 21(6): 349-350.
35. Zhang H, Ning K, Wang J, et al. Research on the influence of patient cost-sharing on medical expenses and health outcomes: taking patients with heart failure as an example. Front Public Health, 2023, 11: 1121772.
36. 鲁蓓, 冯天岳, 袁杨. “互联网+”背景下慢性病长期用药管理模式探讨. 中国医疗保险, 2020(7): 57-60.
37. 中共中央国务院. 关于深化医疗保障制度改革的实施意见. 四川日报, 2021-05-01(4).
38. 孙洁, 黄艺飞, 罗屿浪, 等. 惠民保可持续发展研究. 中国医疗保险, 2024(1): 29-42.
39. 陈华蝶, 丁刘蔚, 张真才. 我国医保政策认知现状及对策——以靖江市为例. 经济研究导刊, 2022(27): 64-66.
40. Kwok CS, Seferovic PM, Van Spall HG, et al. Early unplanned readmissions after admission to hospital with heart failure. Am J Cardiol, 2019, 124(5): 736-745.
41. Lesyuk W, Kriza C, Kolominsky-Rabas P. Cost-of-illness studies in heart failure: a systematic review 2004-2016. BMC Cardiovasc Disord, 2018, 18(1): 74.
42. Blum MR, Øien H, Carmichael HL, et al. Cost-effectiveness of transitional care services after hospitalization with heart failure. Ann Intern Med, 2020, 172(4): 248-257.
43. Ma C. Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: a longitudinal observational study. J Clin Nurs, 2019, 28(13/14): 2526-2536.
44. 孙佳玲, 朱丽莎, 夏梅, 等. 三元联动护理模式在心力衰竭易损期病人中应用的研究进展. 全科护理, 2024, 22(6): 1106-1109.
45. Edward J. Effective cost conversations: addressing financial toxicity and cost-related health literacy. Clin J Oncol Nurs, 2020, 24(2): 209-213.
46. Yezefski T, Steelquist J, Watabayashi K, et al. Impact of trained oncology financial navigators on patient out-of-pocket spending. Am J Manag Care, 2018, 24(Suppl 5): S74-S79.
47. Smith GH, Shore S, Allen LA, et al. Discussing out-of-pocket costs with patients: shared decision making for sacubitril-valsartan in heart failure. J Am Heart Assoc, 2019, 8(1): e010635.
48. Cheung CK, Jones L, Lee H, et al. Anticipatory guidance: developing a patient navigation pathway to reduce the financial toxicity of cancer. Med Res Arch, 2023, 11(10): 10.18103/mra. v11i10.4582.
49. 袁潇逸, 况艺, 阮君怡, 等. 癌症患者费用相关健康素养的概念分析. 护士进修杂志, 2024: 1-12.

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