Analysis of financial toxicity status and influencing factors in patients with diabetic foot

Cao Chenyu; Han Xiaomei; Zhao Zhifang; Chen Yufang; Xing Weijie; Yu Bowei; Gu Fen

doi:10.11986/j.issn.1673-873X.2025.02.09

Abstract：Objective To investigate the level of financial toxicity(FT)in patients with diabetic foot(DF)and analyze its influ-encing factors,thereby providing a scientific basis for reducing FT and formulating effective interventions.Methods A total of 202 DF patients treated at four hospitals in Shanghai were surveyed using the Comprehensive Score for Financial Toxicity Pa-tient-Reported Outcome Measure(COST-PROM),the Patient Health Questionnaire(PHQ-9),the 7-item Generalized Anxie-ty Disorder Scale(GAD-7),and the Diabetes-Specific Quality of Life Scale(DSQL).Results COST-PROM scores differed significantly across groups stratified by type of medical insurance,personal income,place of residence,out-of-pocket DF treat-ment costs,and Wagner grade among DF patients(all P＜0.05).Spearman correlation and multivariate linear regression ana-lyses revealed that COST-PROM scores were negatively correlated with DSQL,PHQ-9,and GAD-7 scores(P＜0.05).Re-sults showed that age,out-of-pocket expenses for treating DF,place of residence,Wagner grade,and GAD score were inde-pendent influencing factors in patients with DF(P＜0.05).Among patients,36 had COST-PROM score≤22 and 166 had COST-PROM score＞22;the two groups also differed significantly in"forgoing planned expenditures,""seeking others' help for medical expenses,"and"forgoing current treatment plans"(P＜0.05).Conclusion Nearly one-fifth of DF patients experi-ence high financial toxicity.Healthcare professionals should pay special attention to younger patients,those from rural areas,and patients with advanced DF,guiding them in effective coping strategies.Additionally,leveraging social and governmental support at the administrative level is essential to mitigate the adverse impacts of financial toxicity.