SearcharxivSearch

arXiv · 2312.16710

Health-related Quality of life, Financial Toxicity, Productivity Loss and Catastrophic Health Expenditures After Lung Cancer Diagnosis in Argentina

Abstract

Objective: About 12,000 people are diagnosed with lung cancer (LC) each year in Argentina, and the diagnosis has a significant personal and family. The objective of this study was to characterize the Health-Related Quality of Life (HRQoL) and the economic impact in patients with LC and in their households. Methods: Observational cross-sectional study, through validated structured questionnaires to patients with a diagnosis of Non-Small Cell Lung Cancer (NSCLC) in two referral public health care centers in Argentina. Questionnaries used: Health-Related Quality of life (EuroQol EQ-5D-3L questionnaire); financial toxicity (COST questionnaire); productivity loss (WPAI-GH, Work Productivity and Activity Impairment Questionnaire: General Health), and out-of-pocket expenses. Results: We included 101 consecutive patients (mean age 67.5 years; 55.4% men; 57.4% with advanced disease -stage III/IV-). The mean EQ-VAS was 68.8 (SD:18.3), with 82.2% describing fair or poor health. The most affected dimensions were anxiety/depression, pain, and activities of daily living. Patients reported an average 59% decrease in their ability to perform regular daily activities as measured by WPAI-GH. 54.5% reported a reduction in income due to the disease, and 19.8% lost their jobs. The annual economic productivity loss was estimated at USD 2,465 per person. 70.3%) of patients reported financial toxicity. The average out-of-pocket expenditure was USD 100.38 per person per month, which represented 18.5% of household income. Catastrophic expenditures were present in 37.1% of households. When performing subgroup analysis by disease severity, all outcomes were worse in the subpopulation with advanced disease. Conclusions Patients with NSCLC treated in public hospitals in Argentina have significant health-related quality of life and economic impact, worsening in patients with advanced disease.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Lucas Gonzalez, Andrea Alcaraz, Carolina Gabay, Monica Castro, Silvina Vigo, Eduardo Carinci, Federico Augustovski. 2023-12-27. Health-related Quality of life, Financial Toxicity, Productivity Loss and Catastrophic Health Expenditures After Lung Cancer Diagnosis in Argentina. https://arxiv.org/abs/2312.16710

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

Reducing Prescription Errors Through Information Intervention: A Field Experiment in Healthcare Operations

Drug-drug interaction (DDI) errors pose serious risks to patient safety. Existing decision-support systems often require physicians to respond to alerts, disrupting workflows and contributing to high override rates. We examine whether a non-mandatory information intervention can reduce DDI errors and foster learning. Using a randomized field experiment with India's largest electronic medical record platform, we analyze 2.81 million prescriptions from 1,700 physicians using a difference-in-differences design. Treatment physicians received real-time information highlighting DDI errors without being required to respond, while control physicians received no such information. The intervention reduced DDI errors by 8.6%, corresponding to an estimated US$4.8 million in annual hospitalization cost savings and approximately 134 lives potentially saved. We identify two mechanisms: reactive correction, whereby physicians remove errors after they are flagged, and proactive learning, whereby they avoid errors before alerts occur. While early reductions are driven primarily by correction, physicians increasingly avoid errors over time. They also become less likely to repeat previously flagged errors and reduce new errors, suggesting that learning generalizes beyond specific drug pairs. The effects are consistent across physician types and do not compromise productivity or care quality. Our findings show that non-mandatory information interventions can improve patient safety through both immediate error correction and persistent, generalizable learning.

econ.GN

How an Economy Shrinks in Space: Concavity-on-Jobs and Upward Consolidation under Demographic Decline

When a country's population declines, the aggregate economy appears to contract on the intensive margin: industrial diversity intact, every industry a little smaller. At the regional level, contraction is uneven and takes the extensive form: entire industries disappear, one after another. The relevant unit is the city: industries are nested by size - the hierarchy property of industrial location - each viable only above a minimum population. Necessity industries' thresholds bunch at the low end, so a city's industry count - and its jobs - is sharply concave in size (concavity on jobs). A modest loss pushes a small city below many thresholds at once; a large core sheds a few specialized industries, one at a time. Lost industries consolidate upward to the next city large enough to host them; for the worker it means a step down to a lower-paid local job. To recover that income, workers move up to the apex - the only city hosting the full industry range. Studying Japan - two decades ahead of the OECD, Tokyo at its apex - with worker-level panel data on the young workers who carry the migration, a wage regression in real, housing-inclusive wages identifies a Tokyo-bound migration incentive that varies by origin, following concavity on jobs.

econ.GN

Do wind and solar curtail at negative electricity prices? Incentives and evidence across two decades of German renewable support schemes

In many power systems, wind and solar generation increasingly often exceeds electricity demand. Curtailing renewable generation in those hours matters both for prices and for the physical stability of the grid. Turning off wind turbines and solar panels is technically easier than ramping down a large power station, yet support schemes often give renewables an economic incentive to keep producing at negative prices. This paper studies wind and solar energy in Germany. For each cohort of generators it estimates, hour by hour, the incentive implied by two decades of support policy. It then sets those incentives against observed behavior, using a new estimate of market-based curtailment built from reanalysis weather data. I find that in 2025, at prices below -50 EUR/MWh, almost all wind generators had an incentive to stop producing, but only half of them did. Solar is the opposite case: nearly two thirds of the potential had no incentive to curtail at all, mostly because it receives a feed-in tariff that shields it from wholesale prices. Of the exposed remainder, just over a fifth cut production. Low exposure and response rates inflate subsidy payments and make the power system harder to operate safely. I conclude that a further expansion of wind and solar requires them to respond to price signals.

econ.GN