Economic hardship associated with managing chronic illness: a qualitative inquiry

Abstract

Background: Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness.

Psychosocial Factors Related to Underuse of Medical Services

“…52 Consistent with numerous studies in the literature, 21 , 22 our results indicate that greater smoking is associated with more physical health problems in early midlife. In accord with Jeon et al, 53 greater physical health problems are, in turn, related to more serious financial difficulty. Financial difficulty in the present study has been conceptualized as the most proximal barrier to the use of physical health services.…”

Perceived economic burden associated with an inherited cardiac condition: a qualitative inquiry with families affected by arrhythmogenic right ventricular cardiomyopathy

“…1,2 The loss of income due to illness may result in a change of economic outlook, the need to use savings, bankruptcy, decreased quality of work, and fewer employment opportunities. [1][2][3][4][5] All of these represent the economic burden of a disease.…”

“…2,3 Although lower-income patients spend a higher percentage of their income on expenses related to chronic conditions, higher-income patients also have significant out-of-pocket costs. The literature on the economic burden of illness suggests that all patients may face economic hardship of some type that is exacerbated by factors such as comorbidities, ineligibility for government support, and minority ethnic background.…”

Multi-morbidity: a system design challenge in delivering patient-centred care

“…Participants with multiple chronic illnesses, particularly older participants and migrants, were frequently overwhelmed by the requirements of self-management, and experienced increased confusion and additional costs related to self-management. [5][6][7] Economic hardships associated with self-management of multiple chronic illnesses arose through the accumulation of related out-of-pocket expenses. 6,8 A single chronic illness, type two diabetes mellitus for example, might require lifestyle changes such as dietary modification and exercise, neither of which are covered by financial rebates, and might not of themselves cause undue financial pressure.…”

“…[5][6][7] Economic hardships associated with self-management of multiple chronic illnesses arose through the accumulation of related out-of-pocket expenses. 6,8 A single chronic illness, type two diabetes mellitus for example, might require lifestyle changes such as dietary modification and exercise, neither of which are covered by financial rebates, and might not of themselves cause undue financial pressure. However, compounding incidental expenses associated with the self-management of several illnesses, such as home oxygen in the case of comorbid COPD, the out-of-pocket costs multiply.…”