AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025130067
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ORIGINAL RESEARCH ARTICLE

Exploring the current status and influencing factors of financial toxicity among hospitalized cancer patients in district and county-level hospitals

Jinfeng Wang1† ,  Zhipeng Luo2† ,  Guangyi Li2†* ,  Dejin Cheng3 ,  Yan Tang2 ,  Benxin Zeng2
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1 College of Physical Education and General Health, Yibin University, Yibin, Sichuan, China
2 Department of Oncology, The Third People’s Hospital of Yibin, Yibin, Sichuan, China
3 Department of Operating Room, Anesthesia Operating Room, The Second People’s Hospital of Yibin, Yibin, Sichuan, China
†These authors contributed equally to this work.
EJMO, 025130067 https://doi.org/10.36922/EJMO025130067
Received: 25 March 2025 | Revised: 9 May 2025 | Accepted: 22 May 2025 | Published online: 12 June 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Objective: This study aimed to investigate the prevalence and determinants of financial toxicity among cancer patients hospitalized in district- and county-level medical institutions, with a focus on identifying modifiable factors to alleviate economic burdens in this vulnerable population. Methods: A cross-sectional study was conducted using cluster sampling to recruit hospitalized cancer patients. Validated questionnaires were administered to assess financial toxicity, social support (including subjective, objective, and support utilization dimensions), and psychological resilience. Descriptive statistics were utilized to characterize the prevalence of financial toxicity, while (analysis of variance and t-tests were performed to compare differences across demographic and socioeconomic subgroups. Multivariable linear regression models were subsequently developed to identify independent predictors of financial toxicity severity, controlling for potential confounding variables. Results: The study included 300 participants, predominantly characterized by low socioeconomic status: 82.34% had attained a junior high school education or less, and 94.66% reported an annual personal income below 50,000 CNY (approximately 7,000 USD). The mean financial toxicity score was 15.54 ± 4.64 (range: 5 – 25), indicating a moderate-to-severe economic strain. Income level emerged as a critical determinant, with lower annual income correlating significantly with heightened financial toxicity (F = 5.406, p=0.001). Multivariable regression analysis identified four protective factors: advanced age (β = −0.18, p<0.05), higher personal income (β = −0.32, p<0.01), greater objective social support (β = −0.21, p<0.05), and enrollment in commercial insurance (β = −0.25, p<0.01), all independently associated with reduced financial toxicity. Conclusion: The findings highlight a high prevalence of financial toxicity among low-income, less-educated cancer patients receiving care in regional healthcare settings. Structural socioeconomic disparities, particularly limited income and inadequate insurance coverage, significantly contribute to treatment-related financial hardships. Policy interventions to expand commercial insurance accessibility, coupled with community-based support programs to strengthen objective social support networks, may effectively mitigate financial toxicity in this population. Future longitudinal studies are warranted to validate these associations and evaluate targeted intervention strategies.

Keywords
Cancer
Financial toxicity
Influence factor
Low-income population
Funding
This work was supported by the Nursing Research Project Plan of the Sichuan Nursing Association (Grant No. H24067).
Conflict of interest
The authors declare they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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