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      “It was time I could have spent better”—the barriers, enablers, and recommendations for improving access to financial aid when a child has cancer

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          Abstract

          Purpose

          A child’s cancer diagnosis imposes both short-term and long-term stress on families. This study aimed to explore (1) the barriers and enablers in alleviating the financial impacts of a child’s cancer diagnosis and treatment, and (2) areas for improvement in financial aid as suggested by stakeholders.

          Method

          This qualitative study utilised semi-structured interviews with five hospital social work team members, three charity representatives and eight parents of children treated for cancer. The interviews, which were conducted between April 2023 and January 2024, were analysed using content analysis with a deductive-inductive approach supported by Nvivo Software.

          Results

          Barriers to mitigating financial impacts included administrative difficulties (e.g. paperwork complexities, strict eligibility criteria and limited support), psychosocial factors (e.g. cognitive burden, social and societal factors), and navigational issues (e.g. poor communication, fragmented support systems). Enablers included streamlined administrative processes, assistance with navigating and applying for financial aid and community support for emotional refuge and respite. Suggested improvements included simplified application forms, offering automatic provision for certain financial aids upon diagnosis, providing infrastructure to support application processes, reallocating funds to increase navigator roles, providing tailored information through a centralised platform, and facilitating connections to parent support groups.

          Implications for cancer survivors

          The financial stress stemming from the uncertainty of a child’s cancer diagnosis can be overwhelming. Current support systems fall short in effectively mitigating this stress. This research provides empirical evidence for policy changes to enhance support for families, which is crucial to alleviate the multifaceted challenges they face.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00520-025-09347-3.

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          Most cited references27

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          Combining individual interviews and focus groups to enhance data richness.

          This paper is a presentation of the critical reflection on the types of findings obtained from the combination of individual interviews and focus groups, and how such triangulation contributes to knowledge production and synthesis. Increasingly, qualitative method triangulation is advocated as a strategy to achieve more comprehensive understandings of phenomena. Although ontological and epistemological issues pertaining to triangulation are a topic of debate, more practical discussions are needed on its potential contributions, such as enhanced data richness and depth of inquiry. Data gathered through individual interviews and focus groups from a study on patterns of cancer information-seeking behaviour are used to exemplify the added-value but also the challenges of relying on methods combination. The integration of focus group and individual interview data made three main contributions: a productive iterative process whereby an initial model of the phenomenon guided the exploration of individual accounts and successive individual data further enriched the conceptualisation of the phenomenon; identification of the individual and contextual circumstances surrounding the phenomenon, which added to the interpretation of the structure of the phenomenon; and convergence of the central characteristics of the phenomenon across focus groups and individual interviews, which enhanced trustworthiness of findings. Although the use of triangulation is promising, more work is needed to identify the added-value or various outcomes pertaining to method combination and data integration.
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            Cost-of-Illness Methodology: A Guide to Current Practices and Procedures

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              The Out-of-Pocket Cost Burden of Cancer Care—A Systematic Literature Review

              Background: Out-of-pocket costs pose a substantial economic burden to cancer patients and their families. The purpose of this study was to evaluate the literature on out-of-pocket costs of cancer care. Methods: A systematic literature review was conducted to identify studies that estimated the out-of-pocket cost burden faced by cancer patients and their caregivers. The average monthly out-of-pocket costs per patient were reported/estimated and converted to 2018 USD. Costs were reported as medical and non-medical costs and were reported across countries or country income levels by cancer site, where possible, and category. The out-of-pocket burden was estimated as the average proportion of income spent as non-reimbursable costs. Results: Among all cancers, adult patients and caregivers in the U.S. spent between USD 180 and USD 2600 per month, compared to USD 15–400 in Canada, USD 4–609 in Western Europe, and USD 58–438 in Australia. Patients with breast or colorectal cancer spent around USD 200 per month, while pediatric cancer patients spent USD 800. Patients spent USD 288 per month on cancer medications in the U.S. and USD 40 in other high-income countries (HICs). The average costs for medical consultations and in-hospital care were estimated between USD 40–71 in HICs. Cancer patients and caregivers spent 42% and 16% of their annual income on out-of-pocket expenses in low- and middle-income countries and HICs, respectively. Conclusions: We found evidence that cancer is associated with high out-of-pocket costs. Healthcare systems have an opportunity to improve the coverage of medical and non-medical costs for cancer patients to help alleviate this burden and ensure equitable access to care.
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                Author and article information

                Contributors
                huiaimegumi.lim@hdr.qut.edu.au
                Journal
                Support Care Cancer
                Support Care Cancer
                Supportive Care in Cancer
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0941-4355
                1433-7339
                15 March 2025
                15 March 2025
                2025
                : 33
                : 4
                : 284
                Affiliations
                [1 ]Australian Centre for Health Services Innovation (Aushsi), School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), ( https://ror.org/03pnv4752) Brisbane, QLD Australia
                [2 ]Children’s Health Queensland Hospital and Health Service, ( https://ror.org/00be8mn93) South Brisbane, QLD Australia
                [3 ]Duke-NUS Medical School, Health Services and Systems Research, ( https://ror.org/02j1m6098) Singapore, Singapore
                [4 ]National Heart Research Institute Singapore, National Heart Centre Singapore, ( https://ror.org/04f8k9513) Singapore, Singapore
                [5 ]Viertel Cancer Research Centre, Cancer Council Queensland, ( https://ror.org/03g5d6c96) Brisbane, QLD Australia
                [6 ]Cancer and Palliative Care Outcomes Centre at Centre for Children’s Health Research, Faculty of Health and School of Nursing, Queensland University of Technology, ( https://ror.org/03pnv4752) Brisbane, QLD Australia
                Article
                9347
                10.1007/s00520-025-09347-3
                11910398
                40088313
                d18fa193-3e53-441e-b28b-efad5c5edc55
                © The Author(s) 2025

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 17 June 2024
                : 6 March 2025
                Funding
                Funded by: The Kids’ Cancer Project (TKCP)
                Funded by: National Health and Medical Research Council
                Award ID: #2008313
                Award ID: #1173243
                Award Recipient :
                Funded by: Queensland University of Technology
                Categories
                Research
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2025

                Oncology & Radiotherapy
                childhood cancer,financial aid,financial assistance,financial support,determinants,barriers and enablers

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