Relationship between paid leave, financial burden, and patient-reported outcomes among employed patients who have undergone bone marrow transplantation

Randy Albelda, Emily Wiemers, Theresa Hahn, Nandita D Khera, Diana Y. Salas Coronado, Gregory A. Abel

Research output: Contribution to journalArticle

Abstract

Purpose: The US does not have universal paid family and medical leave. We examine the direct effects of access to paid leave on patient-reported health, quality of life (QOL), and perceived stress of employed patients who underwent bone marrow transplantation (BMT) to treat advanced blood cancer as well as the indirect effects through reductions in the financial burden (FB) that patients face. Methods: Our cross-sectional observational study took place at three US transplantation centers in 2014 and 2015. All English-speaking cancer patients 6-month post-BMT were mailed a 43-item survey assessing financial situation, employer benefits, and patient-reported health outcomes. The sample includes the 171 respondents who were employed at the time of BMT. Results: Seemingly unrelated regression analysis confirms that patient access to paid leave was associated with reductions in all three measures of FB, and lower levels of financial hardship were related with improved health, QOL, and perceived stress outcomes. For self-reported health and perceived stress outcomes, all of the effects of patient paid leave operate indirectly through reductions in FB. For QOL outcomes, there is both a direct effect (over 80%) of paid leave and an indirect effect through reduction of FB. Conclusion: We found that paid leave affected health outcomes for BMT patients mostly through alleviating FB. These findings suggest universal paid leave policies in the US might alleviate financial hardship and have positive effects on the self-reported QOL of employed patients facing intensive medical treatments.

Original languageEnglish (US)
JournalQuality of Life Research
DOIs
StatePublished - Jan 1 2019

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Bone Marrow Transplantation
Quality of Life
Health
Psychological Stress
Family Leave
Patient Reported Outcome Measures
Observational Studies
Neoplasms
Cross-Sectional Studies
Transplantation
Regression Analysis

Keywords

  • Bone marrow transplantation
  • Cancer treatment
  • Financial burden
  • Paid leave
  • Quality of life
  • United States

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Relationship between paid leave, financial burden, and patient-reported outcomes among employed patients who have undergone bone marrow transplantation. / Albelda, Randy; Wiemers, Emily; Hahn, Theresa; Khera, Nandita D; Salas Coronado, Diana Y.; Abel, Gregory A.

In: Quality of Life Research, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Purpose: The US does not have universal paid family and medical leave. We examine the direct effects of access to paid leave on patient-reported health, quality of life (QOL), and perceived stress of employed patients who underwent bone marrow transplantation (BMT) to treat advanced blood cancer as well as the indirect effects through reductions in the financial burden (FB) that patients face. Methods: Our cross-sectional observational study took place at three US transplantation centers in 2014 and 2015. All English-speaking cancer patients 6-month post-BMT were mailed a 43-item survey assessing financial situation, employer benefits, and patient-reported health outcomes. The sample includes the 171 respondents who were employed at the time of BMT. Results: Seemingly unrelated regression analysis confirms that patient access to paid leave was associated with reductions in all three measures of FB, and lower levels of financial hardship were related with improved health, QOL, and perceived stress outcomes. For self-reported health and perceived stress outcomes, all of the effects of patient paid leave operate indirectly through reductions in FB. For QOL outcomes, there is both a direct effect (over 80{\%}) of paid leave and an indirect effect through reduction of FB. Conclusion: We found that paid leave affected health outcomes for BMT patients mostly through alleviating FB. These findings suggest universal paid leave policies in the US might alleviate financial hardship and have positive effects on the self-reported QOL of employed patients facing intensive medical treatments.",
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AU - Hahn, Theresa

AU - Khera, Nandita D

AU - Salas Coronado, Diana Y.

AU - Abel, Gregory A.

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