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.

scholarly journals Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
César Caraballo ◽  
Javier Valero-Elizondo ◽  
Rohan Khera ◽  
Shiwani Mahajan ◽  
Gowtham R. Grandhi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Food Insecurity ◽  
Medical Care ◽  
Financial Distress ◽  
The United States ◽  
Financial Hardship ◽  
Comorbidity Burden ◽  
Patients With Diabetes ◽  
Medical Bills

Background: The trend of increasing total and out-of-pocket expenditure among patients with diabetes mellitus represents a risk of financial hardship for Americans and a threat to medical and nonmedical needs. We aimed to describe the national scope and associated tradeoffs of financial hardship from medical bills among nonelderly individuals with diabetes mellitus. Methods and Results: We used the National Health Interview Survey data from 2013 to 2017, including adults ≤64 years old with a self-reported diagnosis of diabetes mellitus. Among 164 696 surveyed individuals, 8967 adults ≤64 years old reported having diabetes mellitus, representing 13.1 million individuals annually across the United States. The mean age was 51.6 years (SD 10.3), and 49.1% were female. A total of 41.1% were part of families that reported having financial hardship from medical bills, with 15.6% reporting an inability to pay medical bills at all. In multivariate analyses, individuals who lacked insurance, were non-Hispanic black, had low income, or had high-comorbidity burden were at higher odds of being in families with financial hardship from medical bills. When comparing the graded categories of financial hardship, there was a stepwise increase in the prevalence of high financial distress, food insecurity, cost-related nonadherence, and foregone/delayed medical care, reaching 70.5%, 49.4%, 49.5%, and 74% among those unable to pay bills, respectively. Compared with those without diabetes mellitus, individuals with diabetes mellitus had higher odds of financial hardship from medical bills (adjusted odds ratio [aOR], 1.27 [95% CI, 1.18–1.36]) or any of its consequences, including high financial distress (aOR, 1.14 [95% CI, 1.05–1.24]), food insecurity (aOR, 1.27 [95% CI, 1.16–1.40]), cost-related medication nonadherence (aOR, 1.43 [95% CI, 1.30–1.57]), and foregone/delayed medical care (aOR, 1.30 [95% CI, 1.20–1.40]). Conclusions: Nonelderly patients with diabetes mellitus have a high prevalence of financial hardship from medical bills, with deleterious consequences.

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

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.

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