Effect of medical payment case management service on financial toxicity and catastrophic health expenditure in patients with bone tumors

The goal of this clinical trial is to learn if adding a medical payment case management service to the hospital's usual follow-up care can reduce the financial hardship of cancer treatment in patients of any age, including children and teenagers, who have a primary bone tumor and are scheduled to have surgery at Shanghai Sixth People's Hospital. It will also learn whether the service lowers the number of families who spend a large share of their yearly income on medical care. The main questions it aims to answer are: Does the service improve patients' scores on a questionnaire that measures financial hardship (the COST-FACIT) from the start of the study to 6 months later? Does the service lower the number of families whose out-of-pocket medical costs reach 10% or more of the family's yearly income? The study will enroll 124 patients, randomly assigned in a 1:1 ratio to two groups of 62: Payment service group: patients receive the hospital's usual follow-up care, plus help from a dedicated payment specialist (called a Co-Pay Navigator). Control group: patients receive the hospital's usual follow-up care only. They can still ask the hospital about payment questions at any time. Researchers will compare the two groups to see if the payment service reduces financial hardship. Both groups receive the whole-course patient management program of the hospital's Comprehensive Oncology Center (COC), which includes: Reminders to return for scheduled check-ups, with alerts if a check-up is missed A record of their medications, with reminders to take them as prescribed Questionnaires they fill in through the program, which the system checks for warning signs that a case manager then follows up Patient education materials about the disease and about follow-up care Online access to a case manager for questions at any time All participants will also: Answer short questionnaires about their family's medical costs at the start of the study and again about 3, 6, 9, and 12 months later, on a mobile phone and with help from the study staff if needed Have a parent or other family member who helps care for them answer a short questionnaire about the strain of caregiving Participants in the payment service group will also work with a Co-Pay Navigator, who: Reviews the family's insurance coverage and out-of-pocket costs Explains which payment programs the family may be able to use: basic medical insurance, critical illness insurance, supplemental medical insurance, charity programs, drug company assistance programs, social assistance, and fundraising Helps the family apply for these programs and follows the applications Reviews the hospital bill when the patient leaves the hospital Checks in every three months to update the family's payment plan Taking part does not involve extra clinic visits, blood tests, or study drugs, and the study does not change any medical treatment.