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Financial Toxicity and Cost-Related Imaging Nonadherence in Pediatric Outpatient Imaging

Shireen E Hayatghaibi1, Gregory L Jordan2, Tucker Hansen3

  • 1Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA (S.E.H.); Department of Radiology, University of Cincinnati, Cincinnati, OH, USA (S.E.H.).

Academic Radiology
|May 18, 2026
PubMed

Insights

Nearly half of families with children needing outpatient imaging experience financial toxicity. High costs are linked to missed appointments, especially for advanced imaging like CT or MRI scans.

Area of Science:

  • Pediatric healthcare economics
  • Patient-reported outcomes
  • Medical imaging accessibility

Background:

  • Financial toxicity, a significant burden from medical costs, impacts adult patients and leads to non-adherence.
  • The prevalence and effects of financial toxicity in pediatric imaging remain largely unexamined.

Purpose of the Study:

  • To determine the prevalence and predictors of financial toxicity in families with children undergoing outpatient imaging.
  • To assess the association between financial toxicity and imaging non-adherence in this population.

Main Methods:

  • A prospective cross-sectional survey was conducted with 399 parental caregivers of children (<18 years) undergoing outpatient imaging.
  • Financial toxicity was assessed using the FACIT-COST instrument; scores <26 indicated high financial toxicity.
  • Multivariable logistic regression analyzed associations between family characteristics and high financial toxicity.

Main Results:

  • 49% of caregivers reported high financial toxicity (mean FACIT-COST score 24.6).
  • Advanced imaging (CT, MRI) was associated with increased odds of high financial toxicity (aOR 1.80).
  • Lower household income and high financial toxicity correlated with higher rates of prior cost-related imaging non-adherence (10.6% vs 3.0%).

Conclusions:

  • High financial toxicity is prevalent in families undergoing pediatric outpatient imaging.
  • Financial toxicity is significantly associated with cost-related imaging non-adherence.
  • Screening for financial toxicity during imaging encounters can identify at-risk families.
Abstract

Keywords:
CostFinancial toxicityNon-adherencePediatrics

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