Objective  To explore the potential types of subjective economic toxicity in patients with chronic diseases and to analyze the influencing factors of different potential categories, to provide a reference for the implementation of targeted interventions.

Methods  From February to March 2024, patients with chronic diseases hospitalized in Zhuzhou Central Hospital were selected by convenience sampling method, and the data were collected using demographic data, a disease- related data questionnaire, and chronic disease economic toxicity questionnaire. Latent profile analysis, univariate analysis and multinomial Logistic regression analysis were used to determine different profiles and their influencing factors.

Results  A total of 407 chronic patients were included. The subjective economic toxicity score of patients with chronic diseases was (5.29±1.92), and the economic toxicity could be divided into three potential profiles: low economic toxicity group (41.28%), moderate economic toxicity group (44.47%), and high economic toxicity group (14.25%). The results of Logistic regression analysis showed that age, occupation, annual family income, education level, access to health knowledge, and self-care ability were the influencing factors of the potential profile of economic toxicity in patients with chronic diseases (all P<0.05).

Conclusion  There is heterogeneity in the level of economic toxicity in patients with chronic diseases, and medical staff should develop targeted intervention measures according to the classification characteristics of different profiles and their influencing factors, to reduce the level of economic toxicity in patients with chronic diseases.

1.Momtazmanesh S, Moghaddam SS, Ghamari SH, et al. Global burden of chronic respiratory diseases and risk factors, 1990—2019: an update from the Global Burden of Disease Study 2019[J]. EClinicalMedicine, 2023, 59: 101936. DOI: 10.1016/j.eclinm.2023.101936.

2.Bennett JE, Kontis V, Mathers CD, et al. NCD countdown 2030: pathways to achieving sustainable development goal target 3.4[J]. Lancet, 2020, 396(10255): 918-934. DOI: 10.1016/S0140-6736(20)31761-X.

3.Zafar SY, Peppercorn JM, Schrag D, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience[J]. Oncologist, 2013, 18(4): 381-390. DOI: 10.1634/theoncologist.2012-0279.

4.Elizondo JV, Khera R, Vahidy F, et al. Cost, resource utilization, quality of life, mental health, and financial toxicity among young adults with stroke in the United States[J]. J Am Coll Cardiol, 2020, 75(11): 1838. DOI: 10.1186/s12913-016-1423-5.

5.Lentz R, Benson AB 3rd, Kircher S. Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies[J]. J Surg Oncol, 2019, 120(1): 85-92. DOI: 10.1002/jso.25374.

6.Yu M, Chasson GS, Wang M, et al. The latent profile analysis of Chinese adolescents' anxiety: examination and validation[J]. J Anxiety Disord, 2018, 59: 74-81. DOI: 10.1016/j.janxdis.2018.09.005.

7.苏斌原,张洁婷,喻承甫,等. 大学生心理行为问题的识别: 基于潜在剖面分析[J]. 心理发展与教育, 2015, 31(3): 350-359. [Su BY, Zhang JT, Yu CF, et al. Identifying psychological or behavioral problems of college students: based on latent profile analysis[J]. Psychological Development and Education, 2015, 31(3): 350-359.] DOI: 10.1016/j.jcbs.2021.01.008.

8.WHO Collaborating Center for Disease Classification Peking Union Medical College Hospital. International statistical classification of diseases and related health problems[M]. Beiiing: People's Medical Publishing House, 1996.

9.Prawitz A, Garman ET, Sorhaindo B, et al. Incharge financial distress/financial well-being scale: development, administration, and score interpretation[J]. Financ Couns Plan, 2006, 17(1). DOI: 10.1037/t60365-000.

10.文保锋,加依娜·拉兹别克,王俊安,等. 新疆地区临床医学专业学位硕士研究生住院医师规范化培训满意度调查: 基于潜在剖面分析[J]. 医学新知, 2024, 34(6): 717-724. [Wen BF, Lrazbek JYN, Wang JA, et al. Satisfaction survey of standardized residency training for clinical medicine professional postgraduates in Xinjiang region:based on latent profile analysis[J]. Yixue Xinzhi Zazhi, 2024, 34(6): 717-724.] DOI: 10.12173/j.issn.1004-5511.202404086.

11.Peugh J, Fan X. Modeling unobserved heterogeneity using latent profile analysis: a monte carlo simulation[J]. Struct Equ Modeling, 2013, 20(4): 616-639. DOI: 10.1080/10705511.2013.824780.

12.Mejri N, Berrazega Y, Boujnah R, et al. Assessing the financial toxicity in Tunisian cancer patients using the comprehensive score for financial toxicity (COST)[J]. Support Care Cancer, 2021, 29(7): 4105-4111. DOI: 10.1007/s00520-020-05944-6.

13.Knight TG, Aguiar M, Robinson M, et al. Financial toxicity intervention improves outcomes in patients with hematologic  malignancy[J]. JCO Oncol Pract, 2022, 18(9): e1494-e1504. DOI: 10.1200/op.22.00056.

14.王柯鑫,张国艳,丁利萍,等. 基于CiteSpace慢性病经济毒性研究热点的可视化分析[J]. 医学与哲学, 2023, 44(22): 76-80. [Wang KX, Zhang GY, Ding LP, et al. Visual analysis of research hotspots on the financial toxicity of chronic diseases based on CiteSpace[J]. Medicine & Philosophy, 2023, 44(22): 76-80.] DOI: 10.12014/j.issn.1002-0772.2023.22.17.

15.Zafar SY. Financial toxicity of cancer care: it's time to intervene[J]. J Natl Cancer Inst, 2016, 108(5): djv370. DOI: 10.1093/jnci/djv370.

16.Thom B, Friedman DN, Aviki EM, et al. The long-term financial experiences of adolescent and young adult cancer survivors[J]. J Cancer Surviv, 2023, 17(6): 1813-1823. DOI: 10.1007/s11764-022-01280-2.

17.Corrigan KL, Fu S, Chen YS, et al. Financial toxicity impact on younger versus older adults with cancer in the setting of care delivery[J]. Cancer, 2022, 128(13): 2455-2462. DOI: 10.1002/cncr.34220.

18.Jones SMW, Yi JC, Jim HSL, et al. Age and gender differences in financial distress among hematopoietic cell transplant survivors[J]. Supportive Care Cancer, 2020, 28(9): 4361-4371. DOI: 10.1007/s00520-019-05291-1.

19.Smith GL, Banegas MP, Acquati C, et al. Navigating financial toxicity in patients with cancer: a multidisciplinary management approach[J]. CA Cancer J Clin, 2022, 72(5): 437-453. DOI: 10.3322/caac.21730.

20.Fan L, Liu L, Zhao Y, et al. Trends in the prevalence and economic burden of hypertension and its socioeconomic disparities in rural southwestern China: two repeated cross-sectional studies[J]. BMJ Open, 2023, 13(11): e076694. DOI: 10.1136/bmjopen-2023-076694.

21.Fabian A, Domschikowski J, Greiner W, et al. Financial toxicity in cancer patients treated with radiotherapy in Germany-a cross-sectional study[J]. Strahlenther Onkol, 2022, 198(12): 1053-1061. DOI: 10.1007/s00066-022-01936-z.

22.Jia Y, Jiang W, Yang B, et al. Cost drivers and financial burden for cancer-affected families in China: a systematic review[J]. Curr Oncol, 2023, 30(8): 7654-7671. DOI: 10.3390/curroncol30080555.

23.王哲,许惠靖,王宇宇,等. 经济毒性对慢性病患者不良健康结局影响的研究进展[J]. 护理学报, 2023, 30(17): 34-38. [Wang Z, Xu HJ, Wang YY, et al. Research progress on the impact of economic toxicity on adverse health outcomes of chronic disease patients [J]. Journal of Nursing, 2023, 30(17): 34-38.] DOI: 10.16460/j.issn1008-9969.2023.17.034.

24.李春生,王宥匀,宋明莎,等. 宁夏农村居民住院医疗机构选择情况及其影响因素[J]. 医学与社会, 2023, 36(11): 27-32, 44. [Li CS, Wang YY, Song MS, et al. Status of selection of inpatient medical institutions and its influencing factors of rural residents in Ningxia[J]. Medicine and Society, 2023, 36(11): 27-32, 44.] DOI: 10.13723/j.yyxysh.2023.11.005.

25.Zhao J, Freeman B, Li M. Can mobile phone apps influence people's health behavior change? An evidence review[J]. J Med Internet Res, 2016, 18(11): e287. DOI: 10.2196/jmir.5692.

26.Mackert M, Mandell D, Donovan E, et al. Mobile apps as audience-centered health communication platforms[J]. JMIR Mhealth Uhealth, 2021, 9(8): e25425. DOI: 10.2196/25425.

27.Whitehead L, Seaton P. The effectiveness of self-management mobile phone and tablet apps in long-term condition management: a systematic review[J]. J Med Internet Res, 2016, 18(5): e97. DOI: 10.2196/jmir.4883.

28.Luengo-Fernandez R, Walli-Attaei M, Gray A, et al. Economic burden of cardiovascular diseases in the European Union: a population-based cost study[J]. Eur Heart J, 2023, 44(45): 4752-4767. DOI: 10.1093/eurheartj/ehad583.

29.Hashempour R, MirHashemi SH, Mollajafari F, et al. Economic burden of diabetic foot ulcer: a case of Iran[J]. BMC Health Serv Res, 2024, 24(1): 363. DOI: 10.1186/s12913-024-10873-9.

30.Wimo A, Seeher K, Cataldi R, et al. The worldwide costs of dementia in 2019[J]. Alzheimers Dement, 2023, 19(7): 2865-2873. DOI: 10.1002/alz.12901.

31.钱志芬,王静. 基于理性行为理论的家属同步健康教育在老年溃疡性结肠炎患者中的应用[J]. 中国老年学杂志, 2021, 41(18): 4104-4107. [Qian ZF, Wang J. Application of family synchronous health education based on rational behavior theory in elderly patients with ulcerative colitis [J]. Chinese Journal of Gerontology, 2021, 41(18): 4104-4107.] DOI: 10.3969/j.issn.1005-9202.2021.18.061.

32.Weitkamp K, Feger F, Landolt SA, et al. Dyadic coping in couples facing chronic physical illness: a systematic review[J]. Front Psychol, 2021, 12: 722740. DOI: 10.3389/fpsyg.2021.722740.