Abstract
Objective
To investigate the financial toxicity (FT) related to kidney stone treatment.
Methods
We performed a cross-sectional cohort study with multi-institutional in-person and
online cohorts of stone formers. Participants were surveyed using the validated COST
tool (COmprehensive Score for financial Toxicity). The maximum score is 44 and lower
scores indicate increased FT. “Moderate FT” was defined by COST scores between 25
and 14 points and “severe FT” for scores <14. Descriptive statistics, X2 tests, T tests, Spearman correlation, and logistic regression were performed using
SPSS v28.
Results
Two hundred and forty-one participants were surveyed, including 126 in-person participants
and 115 online. A total of 60% of participants reported at least moderate FT (COST
score <26) and 26% reported severe FT (COST score <14). Patients who reported moderate
to severe FT were younger than those with low FT by a median difference of 8 years
(95%CI = 4, 12). There was a significant correlation between out-of-pocket expense
and COST scores, such that as out-of-pocket expenses increased, COST scores decreased,
(Spearman's rho =-0.406, P = <.001). Participants with moderate to severe FT tended to miss more workdays (P = .002), and their caretakers tended to miss more workdays (P = .007) due to their stone disease.
Conclusion
Most participants reported moderate to severe FT. As prior studies have shown that
patients with “moderate FT” employ cost-coping strategies (i.e., medication rationing)
and those with “severe FT” have worse health outcomes, urologists need to be sensitive
to the financial burdens of treatment experienced by such patients undergoing kidney
stone treatment.
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Article info
Publication history
Published online: September 29, 2022
Accepted:
August 17,
2022
Received:
May 23,
2022
Footnotes
Financial Disclosure: The authors did not receive support from any organization for the submitted work. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
