The association between financial barriers and adverse clinical outcomes among patients with cardiovascular-related chronic diseases

Campbell, D. S.; Manns, Braden; Weaver, R. W.; Hemmelgarn, Brenda R.; King‐Shier, Kathryn; Sanmartin, Claudia

doi:10.1016/j.atherosclerosis.2017.06.303

Cited by 27 publications

(115 citation statements)

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“…We found that a variety of factors, called filters, influenced how impactful a financial barrier could be on any given patient, and when interpreted through an individual's worldview, their degree of resiliency was revealed. Although prior studies have suggested an association between experiencing financial barriers and adverse clinical outcomes, [7,11] the nature of this association has been uncertain. Our study suggests that the link between these 2 phenomena is likely more complex than was previously envisioned.…”

Section: Resultsmentioning

confidence: 99%

“…Our previous research has demonstrated that despite public health insurance, 12% to 20% of Canadians with cardiovascular-related chronic diseases experience financial barriers to care. [7] This is largely driven by the limited scope of public health insurance and the fact that outpatient medications for many chronic conditions are not universally covered. Even when patients are insured, they may face substantial copayments when trying to access medications at their pharmacy.…”

Section: Introductionmentioning

confidence: 99%

“…[8,9] We have also demonstrated that those who perceive having a financial barrier are more likely to self-report adverse outcomes such as requiring emergency department visits and hospitalization for their chronic disease. [7,10] Similarly, in the United States, Rahimi et al [11] demonstrated a significant association between perception of having a financial barrier and rehospitalization, as well as lower quality of life amongst myocardial infarction patients.…”

Section: Introductionmentioning

confidence: 99%

“…The presumptive mechanism for these findings is via cost-related nonadherence: those who experience financial barriers may be less likely to take prescription medications appropriately due to cost constraints, [7] resulting in poorer disease management and higher use of acute care services. However, the link between the perception of having a financial barrier and adverse health outcomes remains speculative and unproven.…”

Section: Introductionmentioning

confidence: 99%

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Finding resiliency in the face of financial barriers

Campbell¹,

Manns²,

LeBlanc

et al. 2016

Medicine

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Patients with chronic diseases often face financial barriers to optimize their health. These financial barriers may be related to direct healthcare costs such as medications or self-monitoring supplies, or indirect costs such as transportation to medical appointments. No known framework exists to understand how financial barriers impact patients’ lives or their health outcomes.We undertook a grounded theory study to develop such a framework. We used semistructured interviews with a purposive sample of participants with cardiovascular-related chronic disease (hypertension, diabetes, heart disease, or stroke) from Alberta, Canada. Interview transcripts were analyzed in triplicate, and interviews continued until saturation was reached.We interviewed 34 participants. We found that the confluence of 2 events contributed to the perception of having a financial barrier—onset of chronic disease and lack of income or health benefits. The impact of having a perceived financial barrier varied considerably. Protective, predisposing, or modifying of factors determined how impactful a financial barrier would be. An individual's particular set of factors is then shaped by their worldview. This combination of factors and lens determines one's degree of resiliency, which ultimately impacts how well they cope with their disease.The role of financial barriers is complex. How well an individual copes with their financial barriers is intimately tied to resiliency, which is related to the composite of a personal circumstances and their worldview. Our framework for understanding the experience of financial barriers can be used by both researchers and clinicians to better understand patient behavior.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Finding resiliency in the face of financial barriers

Campbell¹,

Manns²,

LeBlanc

et al. 2016

Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…The results could reflect an economic need associated with the diagnosis of a chronic disease. Individuals may not be changing the hours they work to maintain access to income, and benefits required to manage their health condition 3 24. On the other hand, a diagnosis of heart disease may be more likely to be followed by recommendations to limit the volume or strenuousness of work 25.…”

Section: Discussionmentioning

confidence: 99%