K. Robin Yabroff|Jingxuan Zhao|Xuesong Han|Zhiyuan Zheng
Prevalence and Correlates of Medical Financial Hardship in the USA
American Cancer Society|American Cancer Society|American Cancer Society|American Cancer Society
high patient outofpocket oop spending medical care associated medical debt distress household finances forgoing medical care cost usato examine national prevalence medical financial hardship domains 1 material conditions increased oop expenses eg medical debt 2 psychological responses eg distress 3 coping behaviors eg forgoing care factors associated financial hardshipwe identified adults aged 1864 years n 68828 65 years n 24614 20152017 national health interview survey multivariable analyses nationally representative crosssectional survey data stratified age group 1864 years 65 yearsprevalence material psychological behavioral hardship hardship intensityapproximately 1371 million 95 ci 13271415 adults reported medical financial hardship past year hardship common material psychological behavioral domains adults aged 1864 years 289 469 212 respectively adults aged 65 years 153 284 127 respectively p 001 lower educational attainment health conditions strongly associated hardship intensity multivariable analyses age groups p 001 younger group uninsured likely report multiple domains hardship 528 compared public 265 private insurance 232 p 001 older group individuals medicare likely report hardship multiple domains 171 compared medicare public 121 medicare private coverage 101 p 001medical financial hardship common usa especially adults aged 1864 years without health insurance coverage trends towards higher patient costsharing increasing health care costs risks hardship may increase future