Mental health insurance access and utilization among childhood cancer survivors

a report from the childhood cancer survivor study

Giselle K. Perez, Anne C. Kirchhoff, Christopher Recklitis, Kevin R. Krull, Karen A. Kuhlthau, Paul C. Nathan, Julia Rabin, Gregory Armstrong, Wendy Leisenring, Leslie L. Robison, Elyse R. Park

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Methods: Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. Results: There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p < 0.001). In multivariable models, males (OR = 2.96) and survivors with public (OR = 6.61) or employer-sponsored insurance (ESI; OR = 14.37) were more likely to have mental health coverage. Conclusions: Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Implications for Cancer Survivors: Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

Original languageEnglish (US)
Pages (from-to)528-536
Number of pages9
JournalJournal of Cancer Survivorship
Volume12
Issue number4
DOIs
StatePublished - Aug 1 2018

Fingerprint

Health Insurance
Survivors
Mental Health
Neoplasms
Siblings
Mental Health Services
Insurance Benefits
Delivery of Health Care
Costs and Cost Analysis
Insurance Coverage
Patient Education
Insurance
Psychological Stress
Pediatrics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Oncology(nursing)

Cite this

Perez, G. K., Kirchhoff, A. C., Recklitis, C., Krull, K. R., Kuhlthau, K. A., Nathan, P. C., ... Park, E. R. (2018). Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study. Journal of Cancer Survivorship, 12(4), 528-536. https://doi.org/10.1007/s11764-018-0691-y

Mental health insurance access and utilization among childhood cancer survivors : a report from the childhood cancer survivor study. / Perez, Giselle K.; Kirchhoff, Anne C.; Recklitis, Christopher; Krull, Kevin R.; Kuhlthau, Karen A.; Nathan, Paul C.; Rabin, Julia; Armstrong, Gregory; Leisenring, Wendy; Robison, Leslie L.; Park, Elyse R.

In: Journal of Cancer Survivorship, Vol. 12, No. 4, 01.08.2018, p. 528-536.

Research output: Contribution to journalArticle

Perez, GK, Kirchhoff, AC, Recklitis, C, Krull, KR, Kuhlthau, KA, Nathan, PC, Rabin, J, Armstrong, G, Leisenring, W, Robison, LL & Park, ER 2018, 'Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study', Journal of Cancer Survivorship, vol. 12, no. 4, pp. 528-536. https://doi.org/10.1007/s11764-018-0691-y
Perez, Giselle K. ; Kirchhoff, Anne C. ; Recklitis, Christopher ; Krull, Kevin R. ; Kuhlthau, Karen A. ; Nathan, Paul C. ; Rabin, Julia ; Armstrong, Gregory ; Leisenring, Wendy ; Robison, Leslie L. ; Park, Elyse R. / Mental health insurance access and utilization among childhood cancer survivors : a report from the childhood cancer survivor study. In: Journal of Cancer Survivorship. 2018 ; Vol. 12, No. 4. pp. 528-536.
@article{3e583b75a25b4ec0a9d014a2a2c18b12,
title = "Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study",
abstract = "Purpose: To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Methods: Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. Results: There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9{\%} survivors vs. 77.1{\%} siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4{\%}; p < 0.001). In multivariable models, males (OR = 2.96) and survivors with public (OR = 6.61) or employer-sponsored insurance (ESI; OR = 14.37) were more likely to have mental health coverage. Conclusions: Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Implications for Cancer Survivors: Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.",
author = "Perez, {Giselle K.} and Kirchhoff, {Anne C.} and Christopher Recklitis and Krull, {Kevin R.} and Kuhlthau, {Karen A.} and Nathan, {Paul C.} and Julia Rabin and Gregory Armstrong and Wendy Leisenring and Robison, {Leslie L.} and Park, {Elyse R.}",
year = "2018",
month = "8",
day = "1",
doi = "10.1007/s11764-018-0691-y",
language = "English (US)",
volume = "12",
pages = "528--536",
journal = "Journal of Cancer Survivorship",
issn = "1932-2259",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - Mental health insurance access and utilization among childhood cancer survivors

T2 - a report from the childhood cancer survivor study

AU - Perez, Giselle K.

AU - Kirchhoff, Anne C.

AU - Recklitis, Christopher

AU - Krull, Kevin R.

AU - Kuhlthau, Karen A.

AU - Nathan, Paul C.

AU - Rabin, Julia

AU - Armstrong, Gregory

AU - Leisenring, Wendy

AU - Robison, Leslie L.

AU - Park, Elyse R.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Purpose: To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Methods: Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. Results: There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p < 0.001). In multivariable models, males (OR = 2.96) and survivors with public (OR = 6.61) or employer-sponsored insurance (ESI; OR = 14.37) were more likely to have mental health coverage. Conclusions: Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Implications for Cancer Survivors: Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

AB - Purpose: To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Methods: Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. Results: There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p < 0.001). In multivariable models, males (OR = 2.96) and survivors with public (OR = 6.61) or employer-sponsored insurance (ESI; OR = 14.37) were more likely to have mental health coverage. Conclusions: Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Implications for Cancer Survivors: Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

UR - http://www.scopus.com/inward/record.url?scp=85045341511&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045341511&partnerID=8YFLogxK

U2 - 10.1007/s11764-018-0691-y

DO - 10.1007/s11764-018-0691-y

M3 - Article

VL - 12

SP - 528

EP - 536

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

IS - 4

ER -