Patient perceptions of asthma-related financial burden: public vs private health insurance in the United States

Patel, Minal R.; Caldwell, Cleopatra Howard; Song, Peter; Wheeler, John R. C.

doi:10.1016/j.anai.2014.07.004

Cited by 12 publications

(5 citation statements)

References 10 publications

(10 reference statements)

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“…This effect was independent of number of CMCs, which is a major indicator of need for healthcare services. Literature has introduced various factors such as gender [17], access [53], and health needs as determinants of healthcare use.…”

Section: Discussionmentioning

confidence: 99%

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Assari

Smith

Bazargan

2020

J. Racial and Ethnic Health Disparities

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Objectives We investigated the associations between poor self-rated health (SRH), hospitalization, and emergency department (ED) visits among African American older adults with diabetes mellitus (DM). Methods This survey recruited 235 non-institutionalized African American older adults (age > = 55 years) with diabetes mellitus (DM). Participants were recruited using a convenience sample from economically disadvantaged urban areas of South Los Angeles, California. Poor SRH was the independent variable. Hospitalization and ED visits in the past 12 months were the outcomes. Demographic factors, health [comorbid medical conditions (CMCs) and polypharmacy], health behaviors (smoking and drinking), and access (difficulty accessing care, dissatisfaction with the medical care, routine source of care, and visiting the same doctor) were confounders. Binary logistic regressions were used for data analysis. Results Poor SRH was associated with higher odds of hospitalization and ED visit, while all covariates were controlled. Conclusions Poor SRH may be predictive of increased healthcare utilization among African American older adults with DM. Research should test whether close monitoring of African American older adults with DM and poor SRH helps reduce their frequency of hospitalization and ED visits or not.

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Section: Discussionmentioning

confidence: 99%

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Assari

Smith

Bazargan

2020

J. Racial and Ethnic Health Disparities

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“…Health insurance coverage is a strong predictor of financial burden (6,7). Nearly half of Americans have literacy challenges with health insurance and pay more for health care out of pocket because of these challenges, despite improvements as a result of the Affordable Care Act (ACA) (8).…”

Section: Introductionmentioning

confidence: 99%

Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting

Patel¹,

Kruger²,

Cupal³

et al. 2016

Prev. Chronic Dis.

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IntroductionLittle is known about the role of positive financial behaviors (behaviors that allow maintenance of financial stability with financial resources) in mitigating cost-related nonadherence (CRN) to health regimens. This study examined the relationships between positive financial behaviors, financial stress, and CRN.MethodsData came from the 2011 Speak to Your Health! Community Survey (n = 1,234). Descriptive statistics were computed to examine financial stress and CRN, by chronic condition and health insurance status. We used multivariate logistic regression models to examine the relationship between positive financial behaviors and financial stress and their interaction on a composite score of CRN, controlling for health insurance status, educational level, age, marital status, number of chronic conditions, and employment status.ResultsThirty percent of the sample engaged in CRN. Participants reported moderate financial stress (mean, 13.85; standard deviation [SD] = 6.97), and moderate positive financial behavior (mean, 8.84; SD = 3.24). Participants with employer-sponsored insurance, Medicaid, Medicare, the Genesee Health Plan, high blood pressure, asthma, and diabetes had the highest proportion of CRN. The relationship between financial stress and CRN was not significantly different between those who reported lower versus higher levels of positive financial behavior (P = .32). Greater financial stress was associated with a greater likelihood of CRN (odds ratio [OR] = 2.49; 95% confidence interval [CI], 2.08–2.99). Higher level of positive financial behavior was associated with a lower likelihood of CRN (OR = 0.80; 95% CI, 0.67–0.94).ConclusionFinancial literacy as a means of promoting positive financial behavior may help reduce CRN. An intervention strategy focused on improving financial literacy may be relevant for high-risk groups who report high levels of financial stress.

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“…Out-of-pocket expenses for asthma management can be highly variable, with individuals reporting between $1 and $500 per month (16). Among highand low-income patients with asthma, regardless of type of health insurance, rates of CRN behaviors and perceptions of financial burden are high (17,18). Little is known about preferences and frequency of physician-patient discussions about cost/ affordability among individuals managing respiratory conditions such as asthma, especially in high-risk groups such as African Americans, where response rates were low in previous work (9,10,19,20).…”

mentioning

confidence: 99%

Physician–Patient Communication on Cost and Affordability in Asthma Care. Who Wants to Talk about It and Who Is Actually Doing It

Patel¹,

Wheeler

2014

Annals ATS

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Rationale: Patient perceptions of financial burden and rates of cost-related nonadherence are high among individuals with asthma across the socioeconomic spectrum. Little is known about preferences and frequency of physician-patient discussions about cost/ affordability among individuals managing respiratory conditions. Objectives:To examine who has a preference to discuss the cost of their asthma care with their physician, how often physicianpatient communication about cost/affordability actually is occurring, and what clinical and demographic characteristics of patients are predictive of communication.Methods: Data came from 422 African American adult women with asthma who were asked about communication preferences and practices around cost and affordability with their physician. Data were analyzed using descriptive statistics and multiple variable logistic regression models.Measurements and Main Results: Fifty-two percent (n = 219) of this sample perceived financial burden. Seventy-two percent (n = 300) reported a preference to discuss cost with their healthcare provider. Thirty-nine percent (n = 163) reported actually having a conversation with their physician about cost. Among the 61% who reported no discussion, 40% (n = 103) reported financial burden, and 55% (n = 140) reported a preference for discussion.Lower household income (P , 0.001), perception of financial burden (P , 0.001), and higher out-of-pocket expenses for medicines (P , 0.05) were significantly predictive of greater preference to communicate about cost/affordability with the doctor when adjusted for clinical and demographic characteristics. Perception of financial burden (P , 0.001), preference to discuss affordability (P , 0.001), and greater number of chronic conditions (P , 0.001) were significantly predictive of greater likelihood of communication about cost/affordability with the doctor when adjusted for clinical and demographic characteristics. Bivariate analyses revealed that patients who reported a discussion of cost were more likely to report worse asthma control and lower asthma-related quality of life.Conclusions: An imbalance is evident between patients who would like to discuss cost with their doctor and those who actually do. Patients are interested in low-cost options and a venue for addressing their concerns with a care provider; therefore, a greater understanding is needed in how to effectively and efficiently integrate these conversations and viable solutions into the delivery of health care. Additional research is necessary to determine whether communication about the cost of therapy is associated with health outcomes.

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Patient perceptions of asthma-related financial burden: public vs private health insurance in the United States

Cited by 12 publications

References 10 publications

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting

Physician–Patient Communication on Cost and Affordability in Asthma Care. Who Wants to Talk about It and Who Is Actually Doing It

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