Abstract

Relevance. Colorectal cancer (CRC) is one of the three most prevalent malignancies in terms of incidence and mortality, both in Ukraine and worldwide. Despite Ukraine’s healthcare financing reform, out-of-pocket payments by patients remain a significant concern.

Aim. To compare the sociodemographic characteristics of patients receiving chemotherapy for CRC. This comparison was made according to whether they made OOPPs.

Materials and methods. A total of 459 people took part in this cross-sectional study. Their sociodemographic characteristics, subjective assessments of healthcare accessibility, awareness and satisfaction were analysed. Respondents who made OOPPs were compared with those who did not using the χ² test and the Cochran-Armitage trend test in R with the EZR graphical user interface.

Results. A statistically significant linear trend towards an increased frequency of OOPPs was observed. This was with increasing age (p = 0.026) and increasing settlement size (p = 0.029). However, the groups did not differ significantly in terms of sex, educational attainment, or income (p > 0.05). The likelihood of family members acknowledging payments was significantly higher than that of patients themselves (p = 0.001). Patients who made OOPPs were significantly more likely to postpone diagnosis or treatment than those who did not (21.8% versus 8.4%, p < 0.001). Patients who were better informed about services that were free of charge were less likely to make payments (p < 0.001), as shown by a strong linear trend. Patients who did not make OOPPs also reported a significantly higher level of satisfaction with the quality of care (p = 0.001).

Conclusions. The study identified several factors that could potentially be used to prevent out-of-pocket payments (OOPPs). Respondents who received chemotherapy and incurred OOPPs were more likely to be aged 60 years or older, retired and living in a regional capital. They were significantly more likely to postpone a cancer diagnosis or treatment due to anticipated financial costs, which suggests that healthcare services are not easily accessible. These patients did not know that they could get chemotherapy for free and were less satisfied with its quality. No differences were identified in relation to sex, educational attainment, or income level.