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March 29, 2026Open Access

Financial hardship among patients with lung cancer and their family caregivers: A comparative study of two institution-based samples from Hong Kong and Mainland China

Key Points

The study aims to compare the severity and prevalence of financial hardship among lung cancer patients and caregivers in Hong Kong and Mainland China.
Conducted a cross-sectional survey of 355 patient-caregiver pairs from two regions.
Collected data on sociodemographic and clinical characteristics, financial hardship, QoL, and distress.
Utilized independent sample t-tests, Chi-square tests, and OLS regression for data analysis.
Financial hardship was reported in 52% of Hong Kong patients and 42.3% in Mainland China patients.
Caregivers also experienced financial hardship, with 28% in Hong Kong and 25.2% in Mainland China.
Higher financial hardship correlated with poorer QoL and greater psychological distress.

Abstract

Objective: To investigate and compare the severity and prevalence of financial hardship among lung cancer patients and their caregivers in two institution-based samples from Hong Kong and Mainland China, emphasizing regional differences in healthcare systems and socioeconomic contexts. Methods:A cross-sectional survey of 355 patient-caregiver pairs (Hong Kong: 50; Mainland China: 305) collected data on sociodemographic and clinical characteristics, financial hardship, quality of life (QoL), and distress.Comparisons were made using independent sample t-tests, Chi-square tests, and Ordinary Least Squares (OLS) regression.Results: Financial hardship was prevalent and severe in both Hong Kong and Mainland China for both patients (52.0%vs.. 42.3%, Mean COST score: 15.04 vs.. 16.48) and Caregivers (28.0%vs.. 25.2%; Mean COST score: 18.36 vs.. 19.82).Patients' and caregivers' COST scores were strongly correlated (P CNY 30,000) in Mainland China reported less hardship than their Hong Kong counterparts ( HKD 30,000), while low-income participants (< CNY 5,000) experienced greater hardship (P < 0.05).Region employment interactions indicated that caregivers in Mainland China faced elevated financial vulnerability across employment groups.Sensitivity analysis confirmed the robustness of these findings.Conclusions: Financial hardship is prevalent among lung cancer patients and caregivers across regions, shaped by the interplay of socioeconomic position and healthcare system design.Early screening, family-centered support, and policies addressing socioeconomic inequities are essential to mitigate financial hardship across diverse healthcare settings.

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