Financial Hardship from Medical Bills Among Adults with Chronic Liver Diseases: National Estimates from the United States

Hepatology ◽  
2021 ◽  
Author(s):  
Carlos Lago‐Hernandez ◽  
Nghia H. Nguyen ◽  
Rohan Khera ◽  
Rohit Loomba ◽  
Sumeet K. Asrani ◽  
...  
Keyword(s):  
United States ◽  
Liver Diseases ◽  
The United States ◽  
Chronic Liver ◽  
Financial Hardship ◽  
Chronic Liver Diseases ◽  
National Estimates ◽  
Medical Bills

Trends in the Economic Burden of Chronic Liver Diseases and Cirrhosis in the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christopher Ma ◽  
Alexander S. Qian ◽  
Nghia H. Nguyen ◽  
Igor Stukalin ◽  
Stephen E. Congly ◽  
...  
Keyword(s):  
United States ◽  
Economic Burden ◽  
Liver Diseases ◽  
The United States ◽  
Chronic Liver ◽  
Chronic Liver Diseases

Changes in the Prevalence of the Most Common Causes of Chronic Liver Diseases in the United States From 1988 to 2008

2011 ◽  
Vol 9 (6) ◽  
pp. 524-530.e1 ◽  
Author(s):  
Zobair M. Younossi ◽  
Maria Stepanova ◽  
Mariam Afendy ◽  
Yun Fang ◽  
Youssef Younossi ◽  
...  
Keyword(s):  
United States ◽  
Liver Diseases ◽  
The United States ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Common Causes

scholarly journals FINANCIAL HARDSHIP FROM MEDICAL BILLS AMONG PATIENTS WITH HEART FAILURE IN THE UNITED STATES

2021 ◽  
Vol 77 (18) ◽  
pp. 785
Author(s):  
Hyeon-Ju Ali ◽  
Javier Valero Elizondo ◽  
Stephen Yishu Wang ◽  
Arvind Bhimaraj ◽  
Safi Khan ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
The United States ◽  
Financial Hardship ◽  
Patients With Heart Failure ◽  
Medical Bills

Health insurance literacy, financial hardship and financial sacrifices among cancer survivors in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1560-1560
Author(s):  
Jingxuan Zhao ◽  
Xuesong Han ◽  
Zhiyuan Zheng ◽  
Matthew P. Banegas ◽  
Donatus U. Ekwueme ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
Cancer Survivors ◽  
Financial Burden ◽  
Age Groups ◽  
The United States ◽  
Financial Hardship ◽  
Adult Cancer Survivors ◽  
Health Insurance Literacy ◽  
Medical Bills

1560 Background: Rising costs of cancer care have imposed substantial financial burden on cancer survivors. To date, little is known about the associations between potentially modifiable patient characteristics, including health insurance literacy (HIL), on financial burden among cancer survivors. This study aimed to evaluate the associations between HIL and financial hardship and financial sacrifices among adult cancer survivors in the United States. Methods: We identified 914 adult cancer survivors from the 2016 Medical Expenditure Panel Survey Experiences with Cancer Questionnaire. HIL was measured based on the question “Did you ever have a problem understanding health insurance or medical bills related to your cancer, its treatment, or the lasting effects of that treatment?” Medical financial hardship was measured in three domains—1) material (e.g. problems paying medical bills); 2) psychological (e.g. worry about large medical bills); and 3) behavioral (e.g. delay or forego healthcare because of cost). Financial sacrifices were based on questions related to changes in spending on vacation or leisure activities. We used multivariable logistic regression modeling to separately evaluate the associations between HIL problems and 1) financial hardship and 2) financial sacrifices. Results: 18.9% cancer survivors aged 18-64 years and 14.6% survivors ≥65 years reported HIL problems. Regardless of age groups, cancer survivors with HIL problems were more likely to report any material (OR =3.2; 95% CI:1.9-5.2) or psychological (OR=7.2; 95% CI: 4.1-12.7) financial hardship than those without the problems, as well as more likely to delay or forgo multiple medical care due to cost, including prescription medicine (OR=3.6; 95% CI: 1.8-7.1), specialist visit (OR=2.6; 95% CI: 1.2-5.8), and follow-up care (OR=2.1, 95% CI 1.2-4.0). Higher likelihood of reporting all measures of financial sacrifices were observed among those with HIL problems in both age groups (all p<0.05). Conclusions: Cancer survivors with HIL problems were more likely to report financial hardship and financial sacrifices than those without the problems. Improving HIL may help mitigate financial hardship.

scholarly journals APSA Awardee Submission: Tumor/cancer stem cell marker doublecortin-like kinase 1 in liver diseases

2016 ◽  
Vol 242 (3) ◽  
pp. 242-249 ◽  
Author(s):  
Charles B Nguyen ◽  
Courtney W Houchen ◽  
Naushad Ali
Keyword(s):  
Liver Diseases ◽  
The United States ◽  
Late Presentation ◽  
Chronic Liver ◽  
Stem Cell Marker ◽  
Cell Subpopulation ◽  
Chronic Liver Diseases ◽  
Clinical Potential ◽  
New Strategies ◽  
Hepatic Tumorigenesis

Liver diseases are the fourth leading cause of mortality among adults in the United States. Patients with chronic liver diseases such as viral hepatitis, fibrosis, and cirrhosis have significantly higher risks of developing hepatocellular carcinoma (HCC). With a dismal five-year survival rate of 11%, HCC is the third most common cause of cancer-related deaths worldwide. Regardless of the underlying cause, late presentation and a lack of effective therapy are the major impediments for successful treatment of HCC. Therefore, there is a considerable interest in developing new strategies for the prevention and treatment of chronic liver diseases at the early stages. Cancer stem cells (CSCs), a small cell subpopulation in a tumor, exhibit unlimited self-renewal and differentiation capacity. These cells are believed to play pivotal roles in the initiation, growth, metastasis, and drug-resistance of tumors. In this review, we will briefly discuss pivotal roles of the CSC marker doublecortin-like kinase 1 (DCLK1) in hepatic tumorigenesis. Recent evidence suggests that anti-DCLK1 strategies hold promising clinical potential for the treatment of cancers of the liver, pancreas, and colon.

scholarly journals National Estimates of Financial Hardship From Medical Bills and Cost-related Medication Nonadherence in Patients With Inflammatory Bowel Diseases in the United States

2020 ◽  
Author(s):  
Nghia H Nguyen ◽  
Rohan Khera ◽  
Parambir S Dulai ◽  
Brigid S Boland ◽  
Lucila Ohno-Machado ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Financial Distress ◽  
The United States ◽  
Financial Hardship ◽  
Financial Toxicity ◽  
Medication Nonadherence ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Medical Bills

Abstract Background Inflammatory bowel diseases (IBDs) are associated with substantial health care needs. We estimated the national burden and patterns of financial toxicity and its association with unplanned health care utilization in adults with IBD in the United States. Methods Using the National Health Interview survey (2015), we identified individuals with self-reported IBD and assessed national estimates of financial toxicity across domains of financial hardship due to medical bills, cost-related medication nonadherence (CRN) and adoption of cost-reducing strategies, personal and health-related financial distress (worry about expenses), and health care affordability. We also evaluated the association of financial toxicity with emergency department (ED) utilization. Results Of the estimated 3.1 million adults with IBD in the United States, 23% reported financial hardships due to medical bills, 16% of patients reported CRN, and 31% reported cost-reducing behaviors. Approximately 62% of patients reported personal and/or health-related financial distress, and 10% of patients deemed health care unaffordable. Prevalence of financial toxicity was substantial even in participants with higher education, with private insurance, and belonging to middle/high-income families, highlighting underinsurance. Inflammatory bowel disease was associated with 1.6 to 2.6 times higher odds of financial toxicity across domains compared with patients without IBD. Presence of any marker of financial toxicity was associated with higher ED utilization. Conclusions One in 4 adults with IBD experiences financial hardship due to medical bills, and 1 in 6 adults reports cost-related medication nonadherence. These financial determinates of health—especially underinsurance—have important implications in the context of value-based care.

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