Aims: The primary objective is to investigate the association between the psychosocial distress levels of breast cancer patients and their concurrent and future health care needs, health care use, and health care costs, as determined at two points in time: 6 months, and 15 months after diagnosis.
There are three secondary objectives: (a) to document prevalence of and changes in distress levels, distress-related problems, health care needs, use, and costs of breast cancer at the two points in time; (b) to determine the extent to which sociodemographic variables, psychological characteristics, enabling, clinical and psychosocial factors are associated with health care needs, use, and costs of breast cancer patients at the two points in time; and (c) to determine which health care services should be available to fulfill breast cancer patients’ needs at the two points in time.
Methods: In this prospective multicenter study 900 patients fill in a questionnaire at 6 and 15 months after diagnosis. Clinical data are retrieved via medical record audits. Univariate regression analyses, hierarchical multiple regression analyses, and multilevel analyses will be used to relate the levels of distress and distress-related problems of patients (assessed 6 months after diagnosis) to their overall and domain-specific health care needs and use, and to their health care costs (assessed 6 months, and 15 months after diagnosis). A range of statistical methods (e.g., multiple regression analyses, structural equation modeling) will be used to attain the secondary objectives.
Expected results: We hypothesize that higher distress levels will be associated significantly with higher perceived need for and actual use of health care services, and with higher individual health care costs.
Expected implications: Results may be used to tailor psychosocial health care, which may reduce breast cancer patients’ health care needs, use, and costs.