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Aim <p>Cancer imposes a significant financial burden on patients. This study evaluates the role of health cards in reducing financial toxicity (FT) and improving health-related quality of life (HRQOL) and psychological distress among cancer patients in Pakistan.</p> Methods <p>This cross-sectional study was conducted in Bahawalpur, Pakistan, between March and June 2024. A total of 672 cancer patients (336 with and 336 without health cards) were recruited using non-probability purposive sampling. FT was assessed using the Comprehensive Score for Financial Toxicity (COST), while HRQOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G). The Depression, Anxiety, and Stress Scale-21 (DASS-21) evaluated psychological distress.</p> Results <p>Independent <i>t</i>-tests showed significant differences between patients with and without health card coverage: FT significantly decrease from 7.21 to 13.24, HRQOL improve&#xa0;from 28.60 to 47.56, and psychological distress declined, all <i>p</i> &lt; 0.001. FT correlated positively with HRQOL (<i>r</i> = 0.814) and negatively with depression (<i>r</i> = -0.222), anxiety (<i>r</i> = -0.475), and stress (<i>r</i> = -0.675), indicating strong links between financial relief and well-being (<i>p</i> &lt; 0.001). MANOVA results indicated that health cards had a strong multivariate effect across all outcomes (Wilks’ Lambda = 0.060, <i>F</i>(5,666) = 2071.97, <i>p</i> &lt; 0.001, η<sup>2</sup> = 0.940).</p> Conclusion <p>Health cards play a crucial role in reducing FT while improving HRQOL and psychological well-being among cancer patients in Pakistan. The findings underscore the need to expand health coverage to ensure financial protection and enhance successful treatment outcomes for vulnerable populations.</p>

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Step forward: how health insurance mitigates financial toxicity in cancer care in Pakistan

  • 期刊论文

  • 发表日期：

    2025年10月16日

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  • Wajiha Ahmad Qazi,
  • Shahid Muhammad Iqbal,
  • QurratulAin Jamil

摘要

Aim

Cancer imposes a significant financial burden on patients. This study evaluates the role of health cards in reducing financial toxicity (FT) and improving health-related quality of life (HRQOL) and psychological distress among cancer patients in Pakistan.

Methods

This cross-sectional study was conducted in Bahawalpur, Pakistan, between March and June 2024. A total of 672 cancer patients (336 with and 336 without health cards) were recruited using non-probability purposive sampling. FT was assessed using the Comprehensive Score for Financial Toxicity (COST), while HRQOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G). The Depression, Anxiety, and Stress Scale-21 (DASS-21) evaluated psychological distress.

Results

Independent t-tests showed significant differences between patients with and without health card coverage: FT significantly decrease from 7.21 to 13.24, HRQOL improve from 28.60 to 47.56, and psychological distress declined, all p < 0.001. FT correlated positively with HRQOL (r = 0.814) and negatively with depression (r = -0.222), anxiety (r = -0.475), and stress (r = -0.675), indicating strong links between financial relief and well-being (p < 0.001). MANOVA results indicated that health cards had a strong multivariate effect across all outcomes (Wilks’ Lambda = 0.060, F(5,666) = 2071.97, p < 0.001, η2 = 0.940).

Conclusion

Health cards play a crucial role in reducing FT while improving HRQOL and psychological well-being among cancer patients in Pakistan. The findings underscore the need to expand health coverage to ensure financial protection and enhance successful treatment outcomes for vulnerable populations.