Cancer survivors with functional disabilities have higher health care usage and medical costs than survivors without disabilities, according to study results published in JNCI Cancer Spectrum.

Costs and health care usage vary by disability, but disabled cancer survivors typically have longer hospital stays, more office visits, and a greater number of prescriptions than other cancer survivors, researchers found.

The researchers used data from the 2015-2019 Medical Expenditure Panel Survey to estimate the use of 6 services — inpatient care, prescriptions, and the number of visits to an outpatient department, office-based physician, office-based non-physician, or emergency department — as well as the costs of these services.

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The sample included 115,039 patients, 9359 of whom were cancer survivors. Functional disabilities were more common among cancer survivors than among patients without a history of cancer (38.8% and 16.1%, respectively; P <.001).

The most common disability among cancer survivors was ambulatory disability (24.5%), followed by hearing (13.8%), independent living (12.7%), and cognition (11.5%) disabilities.

Compared to cancer survivors without disabilities, survivors with 4 or more functional disabilities had hospital stays that were 1.14 days longer, 1.43 more office-based physician visits per year, and 12.1 more prescriptions each year.

Cancer survivors with 4 or more disabilities also had an annual total cost of aggregate services that was $9537 higher than that for cancer survivors without a disability.

Disability type affected total health care costs. For example, cancer survivors whose disability prevented independent living paid the most for aggregate services, at $5046 more per year than survivors without a disability. Cancer survivors with ambulatory disabilities paid $3702 more per year than survivors without a disability.

Having disabilities was also associated with greater out-of-pocket costs. For example, cancer survivors with 4 or more disabilities paid $639 more out of pocket annually for aggregate services than cancer survivors with no disabilities.

“These findings suggest that health policy for cancer survivors with functional disability should be designed based on an understanding of the underlying mechanisms of patients’ health care needs and be tailored by type and severity of disability to improve access to care and mitigate financial hardship in more effective ways in cancer survivorship planning,” the researchers concluded.


Tak HJ, Horner RD, Lee MS, Shih YCT. Impact of functional disability on healthcare use and medical costs among cancer survivors. JNCI Cancer Spectrum. Published August 16, 2023. doi:10.1093/jncics/pkad059