Financial Burden Associated With Hospitalisation Among Families of Childhood Brain Tumours in Australia

BACKGROUND: Families of children with cancer experience significant financial strain, even with universal healthcare. Indirect costs, such as productivity losses and non-medical expenses, are rarely included in economic evaluations, and little is known about how effectively financial aid programmes alleviate this burden. Childhood brain tumours warrant particular attention due to their complex treatment trajectories, high morbidity and substantial long-term impacts. METHODS: Parents and carers of children diagnosed with brain tumours and treated at a tertiary paediatric cancer centre in Australia completed the Family Costing Survey at three time points: baseline (6-12 weeks post-diagnosis), 12 months and 24 months. The survey captured out-of-pocket costs, productivity losses and reimbursements. Descriptive statistics and non-parametric tests examined clinical and demographic predictors of financial burden; generalised linear mixed models were used to estimate costs over time. RESULTS: Ninety-seven families were included. Financial burden per hospital visit did not differ significantly across the three time points and was driven predominantly by productivity losses, accommodation and childcare costs. Only a small proportion of families received reimbursements, which typically covered less than a quarter of total expenses. Geographic location and treatment type were the strongest predictors of burden: regional families incurred 2.06-times the costs, and rural families 1.87-times the costs, compared with metropolitan families. CONCLUSIONS: Families of children with brain tumours shoulder substantial and enduring financial burdens, with limited offset from existing support schemes. IMPLICATIONS: Strengthening and redesigning financial support systems is essential, and societal costs should be routinely incorporated into economic evaluations of paediatric cancer care.