Prevalence of Financial Hardship and Health-Related Social Needs in Pediatric Oncology: A Practice-Level Analysis of

Melissa P Beauchemin1,2, Kathryn Henschel3, David DeStephano2

  • 1School of Nursing, Columbia University Irving Medical Center, New York, New York, USA.

Pediatric Blood & Cancer
|September 1, 2025
PubMed

Insights

Systematic screening for financial hardship and health-related social needs (HRSN) in pediatric oncology is feasible. This approach identifies at-risk families, enabling timely interventions to improve patient outcomes.

Area of Science:

  • Pediatric Oncology
  • Health Services Research
  • Social Determinants of Health

Background:

  • Screening for financial hardship and health-related social needs (HRSN) is recommended in pediatric oncology.
  • Current practices vary, with limited standardized implementation.
  • A systematic screening was implemented in a New York City pediatric oncology clinic.

Purpose of the Study:

  • To evaluate the implementation of financial hardship and HRSN screening in a pediatric oncology outpatient clinic.
  • To analyze response rates and determine the prevalence of financial hardship and HRSN.
  • To assess the feasibility of a multipronged screening approach.

Main Methods:

  • Evaluated financial hardship (2 items) and HRSN (8 items) screening.
  • Utilized in-person screening by social work teams and direct-to-patient EHR portal screening.
  • Extracted data from EHR for patients ≤18 years over a 2-year period.

Main Results:

  • 76% of 621 pediatric oncology patients responded to screening.
  • Hispanic and non-Hispanic Black patients had higher response rates.
  • 21% reported food insecurity; 76% reported financial hardship, with higher rates in Hispanic and non-Hispanic Black patients.

Conclusions:

  • Systematic screening for financial hardship and HRSN in pediatric oncology is feasible via a multipronged approach.
  • Screening is crucial for early identification of at-risk families.
  • Timely interventions can prevent financial crises and improve patient/household outcomes.
Abstract

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