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. 2024 Nov 16:15589447241295288.
doi: 10.1177/15589447241295288. Online ahead of print.

Financial Toxicity Among Patients With Traumatic Finger Amputation: A Retrospective Study

Victor Agbafe  1   2 , Erika D Sears  3   4 , Clarice E Gaines  3 , Jessica I Billig  5
Affiliations

Financial Toxicity Among Patients With Traumatic Finger Amputation: A Retrospective Study

Victor Agbafe et al. Hand (N Y). .

Abstract

Background: Patients face increasing financial toxicity (FT), defined as emotional distress due to the cost of medical treatment. However, little is known regarding FT in the context of upper extremity trauma.

Methods: We surveyed patients who sustained traumatic finger amputation (October 21, 2011-January 1, 2021). We collected patient-reported financial distress using the Comprehensive Score for Financial Toxicity (COST-11), where a lower score indicates worse FT. We also collected data of patients' perceptions regarding the costs of their treatment. We used linear regression to assess patient-level characteristics associated with FT as measured by the COST-11 score.

Results: Of the 191 eligible patients, 46 patients completed the survey (response rate of 24%). A total of 41 respondents (89%) received an initial treatment of revision amputation, with the remaining patients receiving a semi-occlusive dressing. Patients with commercial insurance had significantly lower COST-11 scores (ie, worse FT) than patients with Medicare (β = 7.5, 95% CI: 0.5 to 14.5) and Worker's Compensation (β = 8.7, 95% CI: 1.8 to 15.6). Patients who were single/never married had significantly worse FT (β = -11.3, 95% CI: -18.7 to -3.9). Approximately 35% (n = 16) reported that the costs were higher than expected. More than a third of patients (39%) reported decreasing spending on basic items, such as food, at least once since surgery.

Conclusion: Patients face FT when obtaining surgery following traumatic finger amputation. Variation in the FT is associated with type of insurance and marriage status, highlighting how underinsurance and social support likely affect the overall economic well-being of patients.

Keywords: cost; financial toxicity; finger amputation.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: VA has received consulting fees from Third Culture Capital. EDS was supported by a Career Development Award Number IK2 HX002592 from the US Department of Veterans Affairs Health Services R&D (HSRD) Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the US government or Veterans Administration. This study was supported by a grant from the American Foundation for Surgery of the Hand. The other authors have no other conflicts of interest. Please see COI form and manuscript. There are two grants and then one author has consulting fees from third part capital.

Figures

Figure 1.
Figure 1.
Financial costs of surgery relative to expectations.
Figure 2.
Figure 2.
Marital status and surgical cost expectations; blue bars indicate divorced patients; orange bars indicate married patients.
Figure 3.
Figure 3.
Insurance type and surgical cost expectations; orange bars indicate Medicaid insurance; blue bars indicate Workers’ Compensation; green bars indicate Medicare insurance; purple bars indicate commercial insurance.
See this image and copyright information in PMC

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