Introducing the Downward Financial Spiral of Cancer 2552

In medicine, financial toxicity is the resultant problems that a patient experiences related to their medical care costs. Financial toxicity can affect a patient's quality of life and access to medical care. Many factors have been shown to influence survival, such as cancer type, age and stage at diagnosis, treatment selection and related physician biases, insurance status, competing health conditions, and financial resources. However, it has also been shown that access to high-quality cancer care increases the likelihood of survival and better patient quality of life. Structural barriers such as being underinsured or uninsured frequently limit access to quality cancer care. Inadequate health insurance is a significant barrier to the receipt of timely and appropriate care.

This lecture seeks to introduce 2 novel concepts to empower Oncology rehabilitation clinicians to minimize the impact of financial constraints on their patients.
 
The first is The Downward Financial Spiral of Cancer. Within the cancer treatment continuum, a spiraling interaction exists between exacerbating financial toxicity and the impact on the patient's disease course. Financial constraints impact care options, and health outcomes may be inferior. In turn, this increases the financial burden because increasingly complex medical situations are more costly; this further limits their ability to access care, and additional treatment options further diminish.

The second is Financial “Prehabilitation”. There is mounting evidence that interventions targeting economic factors can account for sizable reductions in morbidity and mortality. Clinicians could consider such proactive or preventative educational measures to anticipate and facilitate protective financial measures.

A second goal of this lecture shall be to encourage dissemination across the rehabilitation medicine landscape.