Patients with cirrhosis have considerable financial burden

(HealthDay)—The considerable financial burden of cirrhosis medical care is associated with lower surveillance for hepatocellular carcinoma (HCC), according to a study presented at The Liver Meeting, the annual meeting of the American Association for the Study of Liver Diseases, held from Nov. 8 to 12 in Boston.

Amit G. Singal, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues characterized the correlation between patient attitudes and perceived barriers and HCC surveillance receipt among 1,021 patients with cirrhosis.

The researchers found that 61.4 percent of patients received surveillance in the previous year; however, more than one-third of patients had not completed the process. The cost of testing, difficulty with the scheduling process, uncertainty about where to complete an ultrasound, and transportation difficulties were patient-reported barriers to receiving HCC surveillance (28.9, 24.1, 17.1, and 17.8 percent, respectively). Although 91.8 percent of patients reported having active insurance, the financial burden of care resulted in delaying care, needing to borrow money or go into debt, being unable to cover copays or deductibles, and expressing worry about the ability to pay medical bills (9.5, 11.8, 24.4, and 42.8 percent, respectively). The odds of HCC surveillance were lower with lack of insurance and financial distress, resulting in delayed care (odds ratios, 0.53 and 0.73, respectively).

"A better understanding of barriers to HCC surveillance, and identifying patients most likely to underuse surveillance, can inform future interventions to increase HCC surveillance and reduce HCC-related mortality," Singal said in a statement.

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