financial assistance

财政援助
  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:COVID-19在社会不同部门之间造成了紧张关系,但是影响是不平等的。弱势群体受到的影响最大,特别是那些就业不稳定、因失业和工资损失而经历经济困难的人。由于大流行而导致的社会变革和经济困难相结合,增加了心理健康不良的风险。一些国家已经利用财政援助来缓解新冠肺炎造成的经济困难,在韩国,中央和地方政府已经实施了COVID-19财政援助。这项研究分析了韩国COVID-19大流行期间财政援助对与工作状态相关的心理健康的影响。
    方法:本研究的参与者是在按居民登记人口状况按比例分配后,从京坪岛居民中随机选择的。选择了来自中央和地方政府的财政援助,共1000名19岁或19岁以上的成年男性和女性。采用回顾性研究前后设计,和心理健康调查,包括患者健康问卷-9(PHQ-9),应用广义焦虑症7项量表(GAD-7)。
    结果:结果显示,在COVID-19经济援助前,抑郁平均得分为5.5分,焦虑平均得分为4.4分。这与当时的全国平均水平分别为5.1和4.5相似。援助之后,抑郁评分降至4.5,焦虑评分降至3.2.在援助之前,抑郁和焦虑在工作安全感较低的临时临时工中更高,他们在心理健康方面表现出最显著的改善。对于全职工人来说,接受援助后,焦虑或抑郁无显著变化.
    结论:财政援助可以提供物质资源,也可以对心理健康产生积极影响。特别是,它对相对脆弱的群体产生了更大的影响,比如就业不稳定的人。
    BACKGROUND: COVID-19 has created tensions across different sectors of the society, but the impact has been unequal. Vulnerable people have been most affected, especially those with insecure employment and who have experienced economic hardships due to unemployment and lost wages. The combination of social change and economic hardships due to the pandemic increases the risk of poor mental health. Some countries have utilized financial assistance to alleviate economic hardships caused by COVID-19, and in South Korea, the central and local governments have implemented COVID-19 financial assistance. This study analysed the impact of financial assistance on mental health associated with working status during the COVID-19 pandemic in South Korea.
    METHODS: The participants of this study were randomly selected from residents of Gyeonggi-do after being proportionally allocated by resident registration population status. A total of 1,000 adult males and females aged 19 years or older in Gyeonggi-do who received financial assistance from the central and local governments were selected. A retrospective pre-post-study design was applied, and mental health surveys including the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7) were applied.
    RESULTS: The results show that depression scores averaged 5.5 and anxiety scores averaged 4.4 before COVID-19 Financial Assistance. It is similar to the national average of 5.1 and 4.5 respectively at that time. After the assistance, depression scores dropped to 4.5, and anxiety scores dropped to 3.2. Before the assistance, depression and anxiety were higher among temporary day labourers with less job security, and they showed the most significant improvement in mental health. For full-time workers, there was no significant change in anxiety or depression after receiving the assistance.
    CONCLUSIONS: Financial assistance can provide material resources and also positively affect mental health. In particular, it had a greater impact on the relatively vulnerable groups, such as those in unstable employment.
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  • 文章类型: Journal Article
    背景:与老年人相比,年轻人中癌症对家庭造成的经济负担更高。先前的研究提供了与儿童癌症相关的财务毒性的见解,但对经济援助制度在减轻家庭经济负担方面的功效知之甚少。我们进行了范围审查,以确定经济援助成功和失败的决定因素。方法:搜索五个数据库,查找2000年1月1日至2022年12月1日发表的文章。使用双重过程来筛选和选择研究。通过专题内容分析,我们确定了经济援助的障碍和促成因素,按国家收入水平分类。结果:从17篇文章中,在高收入国家和中上低收入国家之间平均分配,出现了四个主要主题:(1)支持的可及性,(2)提供支持,(3)行政、(4)社会心理因素。在这些主题中,确定的推动者是(1)支持导航员,(2)在捐赠者和受益者之间建立直接联系,(3)实施数字化解决方案,提高外展能力,(4)利用文化和社区价值观鼓励捐助者参与。结论:本范围审查确定了在童年背景下支持家庭的经济援助的成功和失败的决定因素,青春期,和年轻成人(CAYA)癌症。通过了解本审查中确定的障碍和促成因素,组织可以制定务实的循证护理模式和政策,以确保CAYA癌症患者的家庭获得援助是公平和适当的。
    Background: The financial burden resulting from cancers on families is higher when it arises in young people compared with older adults. Previous research has provided insight into the financial toxicities associated with childhood cancer, but less is known about the efficacy of financial aid systems in reducing the financial burden on families. We conducted a scoping review to identify the determinants of success and failure of financial aid. Methods: Five databases were searched for articles published between January 1, 2000 and December 1, 2022. Dual processes were used to screen and select studies. Through thematic content analysis, we identified barriers and enablers of financial aid, categorised by country income level. Results: From 17 articles, which were evenly split between high-income countries and upper middle- to low-income countries, four major themes emerged: (1) accessibility of support, (2) delivery of support, (3) administration, and (4) psychosocial factors. Within these themes, the enablers identified were (1) support navigators, (2) establishing a direct contact between donors and beneficiaries, (3) implementation of digital solutions to improve outreach, and (4) using cultural and community values to encourage donor engagement. Conclusions: This scoping review identified the determinants of success and failure of financial aid in supporting families in the context of childhood, adolescent, and young adult (CAYA) cancers. By understanding the barriers and enablers identified in this review, organizations could develop pragmatic evidence-based care models and policies to ensure access to assistance is equitable and appropriate for families experiencing CAYA cancers.
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  • 文章类型: Journal Article
    目的:转移性乳腺癌(MBC)患者通常由于长期和昂贵的治疗而面临巨大的经济负担。然而,对MBC患者经济负担的深入体验尚不清楚.
    方法:进行了定性访谈,以描述MBC患者的经济负担经历,关注经济负担的驱动因素,他们使用健康保险的经验,获得财政援助,以及任何由此产生的成本应对行为。使用描述性现象学方法进行主题分析,对访谈进行转录和定性分析。
    结果:共有11名MBC患者或照顾者代表参与了研究。MBC患者平均年龄为50.2岁(范围:28-65),72.7%为非西班牙裔白人。MBC患者在参与研究前平均3.1年(范围:1-9)被诊断为转移性。定性分析得出了四个主题,包括(1)财政负担的原因,(2)财政援助机制,(3)医疗保险和经济负担,(4)成本应对行为。医疗和非医疗费用都增加了参与者的经济负担。所有参与者都报告了在医疗保险和申请财政援助方面面临的挑战。无论获得援助,几乎所有患者的经济负担持续存在,并导致成本应对行为.
    结论:我们的研究结果表明,目前的医疗保险和财政援助系统复杂且难以满足患者的需求。即使MBC患者获得援助,过度的经济负担持续存在,需要使用财务应对行为,如改变药物使用,保持就业,承担债务。
    OBJECTIVE: Metastatic breast cancer (MBC) patients often face substantial financial burden due to prolonged and expensive therapy. However, in-depth experiences of financial burden among MBC patients are not well understood.
    METHODS: Qualitative interviews were conducted to describe the experiences of financial burden for MBC patients, focusing on the drivers of financial burden, their experience using their health insurance, accessing financial assistance, and any resulting cost-coping behaviors. Interviews were transcribed and qualitatively analyzed using a descriptive phenomenological approach to thematic analysis.
    RESULTS: A total of n = 11 MBC patients or caregiver representatives participated in the study. MBC patients were on average 50.2 years of age (range: 28-65) and 72.7% non-Hispanic White. MBC patients were diagnosed as metastatic an average of 3.1 years (range: 1-9) before participating in the study. Qualitative analysis resulted in four themes including (1) causes of financial burden, (2) financial assistance mechanisms, (3) health insurance and financial burden, and (4) cost-coping behaviors. Both medical and non-medical costs drove financial burden among participants. All participants reported challenges navigating their health insurance and applying for financial assistance. Regardless of gaining access to assistance, financial burden persisted for nearly all patients and resulted in cost-coping behaviors.
    CONCLUSIONS: Our findings suggest that current systems for health insurance and financial assistance are complex and difficult to meet patient needs. Even when MBC patients accessed assistance, excess financial burden persisted necessitating use of financial coping-behaviors such as altering medication use, maintaining employment, and taking on debt.
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  • 文章类型: Journal Article
    尽管过去二十年来全球下降,发育迟缓,也被称为“慢性营养不良”,仍然是一个影响全球近1.5亿5岁以下儿童的公共卫生问题。按年龄身高定义,发育迟缓是营养不良的结果,反复感染,和心理社会刺激不足。针对全球营养不良的方案和政策,人道主义和发展行为体投入巨大努力防止发育迟缓。这项研究使用多变量分析来研究财政援助对减少难民发育迟缓的影响,关注蒂尔基耶5岁以下的叙利亚难民儿童。使用唯一的数据集,2018年土耳其人口和健康调查叙利亚移民样本(2018年TDHS-SR),调查结果表明,财政援助大大减少了受经济控制的难民儿童发育迟缓的发生率,母亲和孩子,环境,健康相关和营养和母乳喂养的特点。然而,让家庭成员创造收入被发现是减少发育迟缓的另一个更强的预测因素。该文件还认为,如果被迫向稳定的东道国/地区迁移,难民儿童的营养状况可能会改善。此外,随着时间的推移,适应似乎也有积极的影响。
    Despite the global decrease over the last two decades, stunting, also called \'chronic malnutrition\', remains a public health issue affecting almost 150 million children under the age of 5 years globally. Defined by height-for-age, stunting is the consequence of poor nutrition, repeated infection, and inadequate psychosocial stimulation. Programmes and policies target undernutrition globally, and humanitarian and development actors invest great efforts to prevent stunting. This study uses multivariate analysis to examine the impact of financial assistance on the reduction of stunting in a refugee context, focusing on Syrian refugee children under the age of 5 years in Türkiye. Using a unique dataset, the 2018 Turkey Demographic and Health Survey Syrian Migrant Sample (2018 TDHS-SR), the findings indicate that financial assistance significantly reduces the incidence of stunting among refugee children under the control of economic, mother and children, environmental, health-related and nutritional and breastfeeding characteristics. However, having household members generate income is found to be another stronger predictor to reduce stunting. The paper also argues that the nutritional well-being of refugee children might improve if forced migration occurs towards a stable host country/region. In addition, adaptation over time also seems to have a positive influence.
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  • 文章类型: Journal Article
    背景:目前尚不清楚旨在提高住房稳定性的干预措施是否也可以改善健康结果,例如降低死亡风险和自杀发病率。这项研究的目的是估计美国退伍军人事务部(VA)对包括全因死亡率在内的健康结果的住房相关费用的临时财政援助(TFA)的潜在影响。自杀未遂,和自杀意念。
    方法:我们对2015年10月至2018年9月参加退伍军人家庭支持服务(SSVF)计划的退伍军人进行了一项回顾性全国队列研究。我们使用多变量Cox比例风险回归方法评估了TFA与健康结果之间的关联,该方法具有治疗权重的逆概率。我们在整个队列中以及分别对SSVF的快速重新安置(RRH)和无家可归预防(HP)组件中的人员进行了这些分析。结果是全因死亡率,自杀未遂,以及在SSVF登记后365天和730天的自杀意念。
    结果:我们的分析队列由41,969名独特的退伍军人组成,在SSVF计划中平均(SD)持续时间为87.6(57.4)天。在SSVF注册后365天,TFA与全因死亡率(HR:0.696,p<0.001)和自杀意念(HR:0.788,p<0.001)的风险降低相关。我们在730天发现了类似的结果(全因死亡率HR:0.811,p=0.007,自杀意念HR:0.881,p=0.037)。这些结果主要由参与SSVF的RRH组分的个体驱动。我们发现TFA和自杀企图之间没有关联。
    结论:我们发现,向面临住房不稳定的个人提供与住房相关的财政援助与改善重要的健康结果有关,例如全因死亡率和自杀意念。如果是因果关系,这些结果表明,提供住房援助的计划对个人生活的其他重要方面有积极的溢出效应。
    BACKGROUND: It is unclear whether interventions designed to increase housing stability can also lead to improved health outcomes such as reduced risk of death and suicide morbidity. The objective of this study was to estimate the potential impact of temporary financial assistance (TFA) for housing-related expenses from the US Department of Veterans Affairs (VA) on health outcomes including all-cause mortality, suicide attempt, and suicidal ideation.
    METHODS: We conducted a retrospective national cohort study of Veterans who entered the VA Supportive Services for Veteran Families (SSVF) program between 10/2015 and 9/2018. We assessed the association between TFA and health outcomes using a multivariable Cox proportional hazards regression approach with inverse probability of treatment weighting. We conducted these analyses on our overall cohort as well as separately for those in the rapid re-housing (RRH) and homelessness prevention (HP) components of SSVF. Outcomes were all-cause mortality, suicide attempt, and suicidal ideation at 365 and 730 days following enrollment in SSVF.
    RESULTS: Our analysis cohort consisted of 41,969 unique Veterans with a mean (SD) duration of 87.6 (57.4) days in the SSVF program. At 365 days following SSVF enrollment, TFA was associated with a decrease in the risk of all-cause mortality (HR: 0.696, p < 0.001) and suicidal ideation (HR: 0.788, p < 0.001). We found similar results at 730 days (HR: 0.811, p = 0.007 for all-cause mortality and HR: 0.881, p = 0.037 for suicidal ideation). These results were driven primarily by individuals enrolled in the RRH component of SSVF. We found no association between TFA and suicide attempts.
    CONCLUSIONS: We find that providing housing-related financial assistance to individuals facing housing instability is associated with improvements in important health outcomes such as all-cause mortality and suicidal ideation. If causal, these results suggest that programs to provide housing assistance have positive spillover effects into other important aspects of individuals\' lives.
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  • 文章类型: Journal Article
    年轻的成人(YA)癌症幸存者比年长的幸存者经历更糟糕的财务结果。这项分析使用了期望奇迹基金会的数据来探索一次性财政赠款对财务福祉和获得医疗保健的影响。在300名受访者中,平均补助金为1526美元(标准偏差=587美元;范围为300-3000美元)。受访者报告说,支付费用的能力有所提高(t=4.45,p<0.001),提高财务决策权(t=2.79,p=0.06),医疗债务影响降低(t=2.1,p=0.04),改善交通通道(t=2.38,p=0.02),在获得财政资助后6个月,获得护理的挑战更少(t=3.0,p=0.005)。财政援助为YAs提供了支付医疗和非医疗费用的机会。
    Young adult (YA) cancer survivors experience worse financial outcomes than older survivors. This analysis used data from Expect Miracles Foundation to explore the impact of one-time financial grants on financial well-being and access to health care. Among 300 respondents, the average grant was $1526 (standard deviation = $587; range $300-$3000). Respondents reported improved ability to pay expenses (t = 4.45, p < 0.001), increased financial decision-making power (t = 2.79, p = 0.06), decreased medical debt impact (t = 2.1, p = 0.04), improved transportation access (t = 2.38, p = 0.02), and fewer challenges in accessing care (t = 3.0, p = 0.005) 6 months after receiving a financial grant. Financial assistance offers YAs an opportunity to meet medical and nonmedical expenses.
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  • 文章类型: Journal Article
    尽管低收入在美国缓刑人群中很普遍,女性罪犯比男性更有经验。然而,尽管收入和缓刑结果有联系,对可以改善女性缓刑者财务状况的计划进行了有限的研究。这项研究考察了接受政府财政援助计划和就业服务对缓刑结果的影响。研究结果表明,更频繁地接受社会保障残疾保险的参与者不太可能被监禁。影响包括扩大现金援助计划,为女缓刑犯提供更多的月收入,特别是残疾人,以提高金融稳定性和改善刑事司法结果。
    Although low income is common across the U.S. probation population, women offenders experience it more than men. However, despite the connection between income and probation outcomes, limited research has been conducted on programs that could improve the financial circumstances of female probationers. This study examined the influence on probation outcomes of receiving government financial assistance programs and employment services. The findings indicated that participants who received Social Security Disability Insurance more often were less likely to become incarcerated. Implications include expanding cash assistance programs to provide more substantial monthly incomes for women probationers, particularly those with disabilities, in order to increase financial stability and improve criminal justice outcomes.
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  • 文章类型: Journal Article
    目的:非小细胞肺癌(NSCLC)是最常见的肺癌形式。研究已经评估了健康的社会决定因素(SDH)与早期NSCLC预后的关联。这些研究表明,总体生存率(OS)与其他SDH之间具有统计学和临床意义(例如。g婚姻状况,教育程度)。我们研究的目的是在佛罗里达州社区肿瘤学实践中更好地了解各种SDH对晚期NSCLC患者OS的作用。方法:在这项回顾性研究中,在2014年1月1日至2018年12月31日之间确定了125例III期和IV期NSCLC患者。我们进行了Pearson卡方检验和Kruskal-Wallis检验,以评估中位数OS和几个独立变量之间的关联。包括;性别,种族,婚姻状况,保险状况,生活状态,接受财政援助(FA),酒精使用,和吸烟史。OS被定义为直至死亡日期的诊断日期。分析的其他混杂因素包括组织学,治疗方式,合并症,以及患者的表现状况。结果:我们的结果表明,与没有FA的患者相比,接受FA的患者的中位OS增加了近两倍(中位OS=1.01年与0.545年,分别为;p=0.012)。
    结论:总体而言,本研究强调了减轻晚期NSCLC患者经济负担的重要性,以及FA如何影响患者结局.然而,未来样本量更大的前瞻性队列研究有必要确定其他SDH,以及影响中位数操作系统的潜在机制,晚期NSCLC患者。
    OBJECTIVE: Non-small cell lung cancer (NSCLC) is the most prevalent form of lung cancer. Studies have evaluated the association of social determinants of health (SDH) with outcomes in early-stage NSCLC. These studies have shown statistically and clinically significant associations between overall survival (OS) and other SDH (e.g marital status, educational attainment).The aim of our study was to better understand the role of various SDH on OS in advanced-stage NSCLC patients in a community oncology practice in Florida.  Methods: In this retrospective study, 125 patients with stage III and IV NSCLC were identified between January 1, 2014, and December 31, 2018. We performed Pearson\'s chi-square and Kruskal-Wallis test to evaluate the association between median OS and several independent variables, including; gender, race, marital status, insurance status, living status, receiving financial assistance (FA), alcohol use, and smoking histories. OS is defined as the date of diagnosis up to the date of death. Other confounders that were analyzed included histology, treatment modality, comorbidities, and performance status of the patients.  Results: Our results demonstrated that patients receiving FA had nearly a two-fold increase in median OS compared to patients without FA (median OS = 1.01 years vs. 0.545 years, respectively; p = 0.012).
    CONCLUSIONS: Overall, this study highlighted the importance of reducing the financial burden of advanced-stage NSCLC on patients and how FA impacts patient outcomes. However, future prospective cohort studies with a larger sample size are warranted to identify other SDH, as well as the underlying mechanisms affecting median OS, in patients with advanced-stage NSCLC.
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  • 文章类型: Journal Article
    未经批准:尽管有广泛报道称癌症相关的经济困难,医院财政援助计划未得到充分利用。
    未经评估:快速定性研究。
    UNASSIGNED:患有复发性或转移性疾病的妇科肿瘤患者,65岁以下,财务毒性综合评分为26分或以下。
    UNASIGNED:半结构化访谈,以引起(1)财务援助意识/知识,(2)获得援助的障碍,(3)改善准入的建议。我们使用主题分析对成绩单进行了分析:开放编码,共识构建/码本,和确定突出的主题。
    UNASSIGNED:我们采访了25名患者,确定了改善获取的四个障碍和三个建议。障碍:缺乏意识,对不合格的看法,害怕负面后果,不知所措。建议:简化财务流程,提供个性化援助,并通过更早的干预来更加积极主动。
    未经评估:通过减少污名来增加访问权限,误解,更积极主动地接触有风险的患者。
    UNASSIGNED:患者可能太害怕或不知所措,无法寻求帮助。更积极主动,社会心理方法是必要的。
    Despite widespread reports of cancer-related financial hardship, hospital financial assistance programs are underutilized.
    Rapid qualitative research.
    Gynecologic oncology patients with recurrent or metastatic disease, under 65 years old, and Comprehensive Score for Financial Toxicity of 26 or under.
    Semi-structured interviews to elicit (1) financial assistance awareness/knowledge, (2) barriers to accessing assistance, and (3) suggestions for improving access. We analyzed the transcripts using thematic analysis: open coding, consensus building/codebook, and identification of salient themes.
    We interviewed 25 patients and identified four barriers and three suggestions for improving access. Barriers: lack of awareness, perceptions of ineligibility, fear of negative consequences, and being overwhelmed. Suggestions: simplifying financial processes, providing individualized assistance, and being more proactive by intervening earlier.
    Increase access by reducing stigma, misconceptions, and more proactively engaging at-risk patients.
    Patients may be too afraid or overwhelmed to ask for help. A more proactive, psychosocial approach is needed.
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