Nandita Khera|Nan Zhang|Talal Hilal|Urshila Durani|Minji Lee|Rema Padman|Sandeep S. Voleti|Rahma Warsame|Bijan J. Borah|K. Robin Yabroff|Joan M. Griffin
Association of Health Insurance Literacy With Financial Hardship in Patients With Cancer
Mayo Clinic in Florida|Winneshiek Medical Center|Mayo Clinic in Florida|Winneshiek Medical Center|University of Mississippi|Mayo Clinic|Mayo Clinic|Carnegie Mellon University|Mayo Clinic in Florida|Winneshiek Medical Center|Mayo Clinic|Mayo Clinic|American Cancer Society|Mayo Clinic
h3importanceh3 patientreported financial hardship increasing challenge cancer care delivery health insurance literacy association financial hardship patients cancer especially controlling financial literacy well examined h3objectiveh3 examine prevalence factors association health insurance literacy financial literacy well overall individual domains financial hardship association health insurance literacy independently adjusted financial literacy patients cancer h3design setting participantsh3 crosssectional survey study recruited enrolled patients 2 separate ambulatory infusion centers mayo clinic arizona phoenix arizona university mississippi medical center jackson mississippi adult patients aged 18 years older enrolled december 2019 february 2020 august october 2020 mayo clinic arizona n 299 september 2020 january 2021 university mississippi medical center n 105 survey respondents received 5 gift card h3exposuresh3 surveys included questions sociodemographic characteristics health insurance literacy financial literacy financial knowledge financial hardship domains material hardship psychological hardship behavioral hardship h3main outcomes measuresh3 financial hardship assessed using costfacit comprehensive score financial toxicityfunctional assessment chronic illness therapy measure national health interview survey questions capture information domains financial hardship health insurance literacy measure validated 21item measure consumers ability select use health insurance five questions national financial capability study assessed financial literacy h3resultsh3 total 404 participants enrolled study median iqr age respondents 63 5471 years 219 women 54 307 nonhispanic white individuals 76 153 38 private insurance 289 72 solid tumors overall financial hardship denoted median costfacit score lt27 points reported 49 95 ci 4453 cohort prevalence financial hardship higher using national health interview survey questions 68 95 ci 6372 respondents reporting least 1 hardship domain n 276 sixtysix percent 95 ci 6069 respondents n 265 high level financial literacy mean sd health insurance literacy measure score 649 133 points multivariable analyses 10point increase health insurance literacy measure score associated lower odds financial hardship odds ratio 082 95 ci 068099ipi 04 however association longer significant adjusting financial literacy h3conclusions relevanceh3 results study showed despite high level health insurance literacy financial literacy prevalence financial hardship high although lower odds financial hardship increased health insurance literacy association longer significant financial literacy added model suggesting high level financial literacy may help mitigate adverse outcome lower health insurance literacy levels patients cancer