Parking fees at hospitals may be making cancer patients more sick - study

Many Israeli medical centers in congested cities have become notorious for the high fees charged for parking in their lots by private companies. This especially affects cancer patients and their families who must come to the hospitals frequently for outpatient treatment.

Transportation to and from cancer centers for outpatient cancer treatments has been identified as one of the two most impactful out-of-pocket costs that cancer patients and their families incur, along with food costs. 

A team of radiation oncology resident physicians and a biostatistician from the University of Alberta in Canada have published a study on the problem in the Journal of Medical Imaging and Radiation Sciences entitled, “Toxic Evaluation of Parking-related Financial Toxicity Associated with Cancer Treatments in Western Canada."

How was the study conducted?

Their cross-sectional research, which assessed the parking fees for regional and community cancer centers located in Western Canada, showed connections between city-specific indices and the cost of parking at cancer centers in the region. They found that hospital parking fees may contribute to suboptimal health outcomes for cancer patients as well as a financial burden. 

Doctors often fail to recognize the difficulty surrounding financial toxicity, which is an increasingly important aspect of cancer care. It refers to the financial stress and strain experienced by patients and caregivers because of out-of-pocket expenses incurred during cancer treatment. 

It has been observed that patients alter their decisions regarding the treatment options available to them if there was a financial consequence. In fact, one study found “hidden” non-medical costs such as parking and transport contributed to an estimated wage loss of around 3.18 billion Canadian dollars for newly-diagnosed cancer patients and their families.

For this study, the public parking fees for 115 cancer centers in Western Canada were obtained, including the provinces of Alberta, Manitoba, Saskatchewan and British Columbia. These were compared against median household income statistics, city-specific cost of living data and address-specific transit scores for each city, as well as the parking fees or lack thereof for each center. 

Results

The researchers showed that the daily cost of parking significantly correlates with cancer center address transit score and city cost of living across Western Canada. Results from the study were indicative that cities with a higher cost of living have less free parking, which further aggravates the economic burden on patients.

One way to relieve this loss of income would be to provide patients who receive protracted chemotherapy or radiation therapy treatment with subsidized parking or access to transportation vouchers. Another would be to implement validated financial toxicity screening scales administered by medical professionals such as radiation therapists, nurses, physicians, and social workers prior to starting their treatment courses. 

Through early and accurate screening and identification of individuals at high risk of experiencing financial toxicity, patients can then benefit from waived or subsidized parking.

“The findings of our study should inform stakeholders and decision-makers to consider the impact of parking-related financial toxicity on vulnerable cancer patients,” stressed lead author Dr. Mustafa Al Balushi, a radiation oncologist at the University of Alberta Medical Center. “Awareness among oncology healthcare professionals and the implementation of strategies to help patients with such problems caused by parking fees must be considered.”

“Awareness among oncology healthcare professionals and the implementation of strategies to help patients with such problems caused by parking fees must be considered.”

Dr. Mustafa Al Balushi, lead author