A Comparative Study of the Impact of Countries’ Health Expenditure on the Diagnosis Experiences of Patients with Lymphoma and CLL in Europe
Topic: Quality of life, palliative care, ethics and health economics
Authors:
Funmi Bamigbola¹, Lorna Warwick², Natacha Bolaños²
¹ Research, Lymphoma Coalition, Mississauga, Canada
² Management, Lymphoma Coalition, Mississauga, Canada
Background
Lymphomas are a mixed group of cancers with a wide variety of clinical presentations, ranging from an indolent course to an aggressive disease. They are often challenging to diagnose. A long time to diagnosis of lymphoma or CLL can increase patient anxiety and negatively impact survival and quality of life.
Communication with healthcare professionals is also a key part of the patient experience at diagnosis, as patients rely on this information to make sense of their condition and care.
Aims
This study used data from the Lymphoma Coalition (LC) 2020 Global Patient Survey (GPS) on lymphomas and CLL to examine the impact of countries’ health expenditure (measured as a percentage of Gross Domestic Product [GDP]) on diagnostic experiences of patients in Europe.
Methods
- Sample: 11,878 respondents to the LC 2020 GPS (9,179 patients and 2,699 caregivers).
- Europe Subset: 4,346 patients from 36 European countries.
- Data Source for Health Expenditure: 2019 WHO Global Health Expenditure Database.
- Average Government Health Spending: 8.2%.
Countries were divided into two groups:
- Below-average health expenditure (BA-HE): n=452
- Above-average health expenditure (AA-HE): n=3,894
Data analysis included demographic comparisons and univariate, bivariate, and multivariate analyses using IBM SPSS v27.
Results
Time to Diagnosis
- BA-HE countries: 40% of patients diagnosed in less than 3 months.
- AA-HE countries: 51% diagnosed in less than 3 months.
- Delayed Diagnosis: More than 10% in both groups reported waiting more than 12 months from first GP visit to diagnosis (BA-HE: 14%; AA-HE: 13%).
Information at Diagnosis
- AA-HE patients were 2.5 times more likely to have been told their lymphoma subtype at diagnosis than BA-HE patients.
- AA-HE patients were 67% more likely to report receiving the right amount of information, compared to BA-HE patients.
Need for More Information
Patients in AA-HE countries were:
- 48% less likely to need more information about treatment options.
- 58% less likely to need more information about support for self-care.
These differences were statistically significant.
No Significant Differences Found in Need for More Information About:
- Psychological support
- Support for families
- Side effects of treatment
- Diagnosis and its meaning
- Fertility
Conclusion
Higher national health expenditure is associated with shorter diagnostic timelines and improved communication at diagnosis for lymphoma and CLL patients. Patients in above-average health expenditure countries reported better access to information and fewer unmet needs regarding treatment and self-care.
References
Citation: HemaSphere, 2022;6(S3):2983.
DOI: https://journals.lww.com/hemasphere/pages/default.aspx
Copyright Information:
- ISSN: 2572-9241
- © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.
- Licensed under CC BY-NC-ND (Attribution-NonCommercial-NoDerivs).
Summary
This study used data from the Lymphoma Coalition 2020 Global Patient Survey to examine how countries’ health expenditure affects the diagnostic experiences of lymphoma and CLL patients in Europe.
- Sample: 4,346 patients from 36 European countries.
- Comparison: Countries with below-average health expenditure (BA-HE) vs. above-average health expenditure (AA-HE), based on WHO data.
Key Findings:
- Patients in AA-HE countries were diagnosed faster: 51% within 3 months (vs. 40% in BA-HE).
- Long delays (over 12 months after first GP visit) occurred in ~13–14% of patients in both groups.
- Information at diagnosis: AA-HE patients were 2.5x more likely to be told their lymphoma subtype and 67% more likely to feel they received the right amount of information.
- Need for additional information: AA-HE patients were 48% less likely to want more treatment information and 58% less likely to want more self-care information.
- No major differences were found in psychological support, family support, treatment side effects, diagnosis meaning, or fertility information needs.
Conclusion:
Higher national health expenditure is linked to shorter diagnostic times, clearer communication, and fewer unmet informational needs for patients with lymphoma and CLL in Europe.