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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/24897

Title: Costs Incurred by Families of Children Newly Diagnosed with Cancer in Ontario
Authors: Tsimicalis, Argerie
Advisor: Stevens, Bonnie
Department: Nursing Science
Keywords: Cost of Illness
Pediatric Oncology
Family Perspective
Mixed Methods
Issue Date: 1-Sep-2010
Abstract: Problem: Financial strain has been reported by families of children with cancer. However, the specific costs and their impact on these families remain unknown. Objectives: (a) to identify the costs incurred by families of children newly diagnosed with cancer in Ontario, (b) to determine the variables that influence these costs, and (c) to explore the impact of these costs on families. Conceptual Framework: The conceptual framework incorporated the social, economic, disease, and treatment cost predictors with the direct and indirect cost of illness components. Setting: Two university-affiliated tertiary paediatric hospitals in Canada. Sample: English speaking parents of children newly diagnosed with cancer who were receiving treatment. Design: A prospective concurrent mixed method design. Instrumentation: The Ambulatory and Home Care Record © (AHCR) (Guerriere & Coyte, 1998) was used to record costs and an interview guide was developed to explore the impact of these costs on families. Procedure: Parents recorded the resources consumed and costs incurred during one week per month for three consecutive months beginning the 4th week following diagnosis and listed any additional costs incurred since diagnosis or between the face-to-face interviews. Parents also discussed the impact of these costs on their families in an audio taped interview. Data Analysis: Descriptive statistics and multiple regression modelling were used to describe families’ total costs (expressed in 2007 Canadian dollars) and to determine factors that influenced them. Descriptive qualitative content analytic methods were used to analyze the transcribed interview data. Results: In total, 99 parents including 28 fathers and 71 mothers completed three sets of cost diaries. The mean total three month expenditure was $28,475 (SD $12,670; range $2013 to $79,249) per family. There were no statistically significant factors that influenced families’ direct costs; however, 23% of the variance for indirect costs was explained by inpatient tertiary hospitalizations, language spoken at home, and distance to the hospital. Parents described the costs associated with their child’s illness and coping and management strategies used to lessen the financial impact including managing their expenses and seeking ways to increase their cash flow. Significance: Findings will inform health professionals and policy makers about families who are faced with potentially catastrophic costs following their child’s diagnosis with cancer.
URI: http://hdl.handle.net/1807/24897
Appears in Collections:Doctoral
Lawrence S Bloomberg Faculty of Nursing - Doctoral theses

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