{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:06:42Z","timestamp":1753862802907,"version":"3.41.2"},"reference-count":11,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T00:00:00Z","timestamp":1711756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Financial toxicity of bladder cancer care may influence how patients utilize healthcare resources, from emergency department (ED) encounters to office visits. We aim to examine whether greater household net worth (HHNW) confers differential access to healthcare resources after radical cystectomy (RC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based cohort study examined the association between HHNW and healthcare utilization costs in the 90\u2009days post\u2010RC in commercially insured patients with bladder cancer. Costs accrued from the index hospitalization to 90\u2009days after including health plan costs (HPC) and out\u2010of\u2010pocket costs (OPC). Multivariable logistic regression models were generated by encounter (acute inpatient, ED, outpatient, and office visit).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 141,903 patients were identified with HHNW categories near evenly distributed. Acute inpatient encounters incurred the greatest HPC and OPC. Office visits conferred the lowest HPC while ED visits had the lowest OPC. Black patients harbored increased odds of an acute inpatient encounter (OR 1.22, 95% CI 1.16\u20131.29) and ED encounter (OR 1.20, 95% CI 1.14\u20131.27) while Asian (OR 0.76, 95% CI 0.69\u20130.85) and Hispanic (OR 0.74, 95% CI 0.69\u20130.78, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) patients had lower odds of an outpatient encounter, compared to White counterpart. Increasing HHNW was associated with decreasing odds of acute inpatient or ED encounters and greater odds of office visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower HHNW conferred greater risk of costly inpatient encounters while greater HHNW had greater odds of less costly office visits, illustrating how financial flexibility fosters differences in healthcare utilization and lower costs. HHNW may serve as a proxy for financial flexibility and risk of financial hardship than income alone.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7116","type":"journal-article","created":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T08:14:40Z","timestamp":1711786480000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of household net worth with healthcare costs after radical cystectomy using real\u2010world data"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-6115","authenticated-orcid":false,"suffix":"III","given":"Samuel L.","family":"Washington","sequence":"first","affiliation":[{"name":"Department of Urology, Helen Diller Family Comprehensive Cancer Center University of California, San Francisco  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7233-8156","authenticated-orcid":false,"given":"Peter E.","family":"Lonergan","sequence":"additional","affiliation":[{"name":"Department of Urology, Helen Diller Family Comprehensive Cancer Center University of California, San Francisco  San Francisco California USA"},{"name":"Department of Urology St. James's Hospital  Dublin Ireland"},{"name":"Department of Surgery Trinity College  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0975-0812","authenticated-orcid":false,"given":"Anobel Y.","family":"Odisho","sequence":"additional","affiliation":[{"name":"Department of Urology, Helen Diller Family Comprehensive Cancer Center University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxwell V.","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Urology, Helen Diller Family Comprehensive Cancer Center University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3948-4968","authenticated-orcid":false,"given":"Sima P.","family":"Porten","sequence":"additional","affiliation":[{"name":"Department of Urology, Helen Diller Family Comprehensive Cancer Center University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21708"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.7.1151"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.3146"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.1680"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.07.078"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000001387"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2020.09.030"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-019-00764-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.10.049"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.11.063"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-18-1336"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.7116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T09:18:28Z","timestamp":1716283108000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.7116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,30]]},"references-count":11,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/cam4.7116"],"URL":"https:\/\/doi.org\/10.1002\/cam4.7116","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"type":"print","value":"2045-7634"},{"type":"electronic","value":"2045-7634"}],"subject":[],"published":{"date-parts":[[2024,3,30]]},"assertion":[{"value":"2023-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e7116"}}