Table 4.

Multivariable associations of financial burden and employment changes of survivors of adolescent and young adult cancers and changes in healthcare utilization during the COVID-19 Pandemic

Models			n	Delayed/skipped care from March 2020 to January 2021		Changes to medication obtainment or use because of the COVID-19 pandemic
				Cancer care	Other care	Obtainmenta	Use
				OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)
1	Financial toxicity	High: COST score ≤ 21	168	1.75 (0.79–3.91)	2.53 (1.31–4.89)*	1.96 (1.01–3.83)*	3.73 (1.59–8.73)*
		Low: COST score > 21	171	1	1	1	1
2	Material hardship, any cause	High: 4–11	136	3.13 (1.44–6.81)*	2.17 (1.18–3.98)*	2.72 (1.43–5.18)*	4.49 (2.05–9.80)*
		Low: 0–3	204	1	1	1	1
3	Material hardship due to COVID-19	High: 2–9	106	6.09 (2.04–18.10)*	2.67 (1.29–5.53)*	3.08 (1.41–6.75)*	3.63 (1.41–9.35)*
		Low: 0–1	131	1	1	1	1
4	Material hardship due to cancer	High: 2–9	90	5.36 (1.96–14.70)*	2.17 (1.02–4.59)*	3.08 (1.41–6.71)*	2.93 (1.18–7.27)*
		Low: 0–1	144	1	1	1	1
3	Employment or schooling changes during COVID-19 pandemic	Increased hours	67	0.89 (0.29–2.72)	0.77 (0.30–1.96)	1.18 (0.44–3.17)	4.54 (1.44–14.30)*
		Reduced hours	74	2.64 (0.98–7.10)	1.40 (0.58–3.36)	2.08 (0.88–4.88)	3.66 (1.23–10.90)*
		No change (unemployed/caregiver)	80	0.39 (0.10–1.62)	1.44 (0.64–3.20)	0.60 (0.23–1.59)	1.06 (0.29–3.85)
		No change (employed)	119	1	1	1	1

^aAdaptive behaviors to find more affordable medications

Models for cancer care exclude n = 33 and other care exclude n = 57 persons with delayed/skipped care due to provider/facility preference. Persons with no information on medication obtainment (n = 68) or use (n = 61) were excluded

All models adjust for gender, survey age, marital status, education, health insurance type, and race/ethnicity

OR, odds ratio; CI, confidence interval

COST, “COmprehensive Score for financial Toxicity”

Missing N = 104 for hardship missing due to COVID-19 and N = 107 responses for hardship due to cancer

^*p < 0.05