Contemporary Patterns of Financial Toxicity Among Patients With Rheumatologic Disease in the United States.
Journal
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
ISSN: 1536-7355
Titre abrégé: J Clin Rheumatol
Pays: United States
ID NLM: 9518034
Informations de publication
Date de publication:
08 Jul 2024
08 Jul 2024
Historique:
medline:
8
7
2024
pubmed:
8
7
2024
entrez:
8
7
2024
Statut:
aheadofprint
Résumé
Rheumatologic diseases encompass a group of disabling conditions that often require expensive clinical treatments and limit an individual's ability to work and maintain a steady income. The purpose of this study was to evaluate contemporary patterns of financial toxicity among patients with rheumatologic disease and assess for any associated demographic factors. The cross-sectional National Health Interview Survey was queried from 2013 to 2018 for patients with rheumatologic disease. Patient demographics and self-reported financial metrics were collected or calculated including financial hardship from medical bills, financial distress, food insecurity, and cost-related medication (CRM) nonadherence. Multivariable logistic regressions were used to assess for factors associated with increased financial hardship. During the study period, 20.2% of 41,502 patients with rheumatologic disease faced some degree of financial hardship due to medical bills, 55.0% of whom could not pay those bills. Rheumatologic disease was associated with higher odds of financial hardship from medical bills (adjusted odds ratio, 1.29; 95% confidence interval, 1.22-1.36; p < 0.001) with similar trends for patients suffering from financial distress, food insecurity, and CRM nonadherence (p < 0.001 for all). Financial hardship among patients with rheumatologic disease was associated with being younger, male, Black, and uninsured (p < 0.001 for all). In this nationally representative study, we found that a substantial proportion of adults with rheumatologic disease in the United States struggled with paying their medical bills and suffered from food insecurity and CRM nonadherence. National health care efforts and guided public policy should be pursued to help ease the burden of financial hardship for these patients.
Sections du résumé
BACKGROUND/OBJECTIVE
OBJECTIVE
Rheumatologic diseases encompass a group of disabling conditions that often require expensive clinical treatments and limit an individual's ability to work and maintain a steady income. The purpose of this study was to evaluate contemporary patterns of financial toxicity among patients with rheumatologic disease and assess for any associated demographic factors.
METHODS
METHODS
The cross-sectional National Health Interview Survey was queried from 2013 to 2018 for patients with rheumatologic disease. Patient demographics and self-reported financial metrics were collected or calculated including financial hardship from medical bills, financial distress, food insecurity, and cost-related medication (CRM) nonadherence. Multivariable logistic regressions were used to assess for factors associated with increased financial hardship.
RESULTS
RESULTS
During the study period, 20.2% of 41,502 patients with rheumatologic disease faced some degree of financial hardship due to medical bills, 55.0% of whom could not pay those bills. Rheumatologic disease was associated with higher odds of financial hardship from medical bills (adjusted odds ratio, 1.29; 95% confidence interval, 1.22-1.36; p < 0.001) with similar trends for patients suffering from financial distress, food insecurity, and CRM nonadherence (p < 0.001 for all). Financial hardship among patients with rheumatologic disease was associated with being younger, male, Black, and uninsured (p < 0.001 for all).
CONCLUSION
CONCLUSIONS
In this nationally representative study, we found that a substantial proportion of adults with rheumatologic disease in the United States struggled with paying their medical bills and suffered from food insecurity and CRM nonadherence. National health care efforts and guided public policy should be pursued to help ease the burden of financial hardship for these patients.
Identifiants
pubmed: 38976618
doi: 10.1097/RHU.0000000000002110
pii: 00124743-990000000-00233
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Helmick CG, Felson DT, Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part I. Arthritis Rheum. 2008;58:15–25. doi:10.1002/art.23177.
doi: 10.1002/art.23177
Van Vilsteren M, Boot CR, Knol DL, et al. Productivity at work and quality of life in patients with rheumatoid arthritis. BMC Musculoskelet Disord. 2015;16:107. doi:10.1186/s12891-015-0562-x.
doi: 10.1186/s12891-015-0562-x
Rosemann T, Laux G, Kuehlein T. Osteoarthritis and functional disability: results of a cross sectional study among primary care patients in Germany. BMC Musculoskelet Disord. 2007;8:79. doi:10.1186/1471-2474-8-79.
doi: 10.1186/1471-2474-8-79
Pisu M, Martin MY. Financial toxicity: a common problem affecting patient care and health. Nat Rev Dis Primers. 2022;8:7. doi:10.1038/s41572-022-00341-1.
doi: 10.1038/s41572-022-00341-1
Valero-Elizondo J, Chouairi F, Khera R, et al. Atherosclerotic cardiovascular disease, Cancer, and financial toxicity among adults in the United States. JACC CardioOncol. 2021;3:236–246. doi:10.1016/j.jaccao.2021.02.006.
doi: 10.1016/j.jaccao.2021.02.006
Yabroff KR, Zhao J, Han X, et al. Prevalence and correlates of medical financial hardship in the USA. J Gen Intern Med. 2019;34:1494–1502. doi:10.1007/s11606-019-05002-w.
doi: 10.1007/s11606-019-05002-w
NHIS—Methods. Published June 14, 2021. Accessed March 19, 2024. https://www.cdc.gov/nchs/nhis/methods.htm
Blewett LA, Drew JAR, King ML, et al. IPUMS Health Surveys: National Health Interview Survey, Version 7.3. Published online 2023. doi:10.18128/D070.V7.3.
Amen TB, Dee EC, Arega MA, et al. Racial and ethnic disparities in access to culturally competent Care in Patients with joint pain in the United States. J Gen Intern Med. 2022;37:682–685. doi:10.1007/s11606-021-06760-2.
doi: 10.1007/s11606-021-06760-2
Valero-Elizondo J, Khera R, Saxena A, et al. Financial hardship from medical bills among nonelderly U.S. Adults with atherosclerotic cardiovascular disease. J Am Coll Cardiol. 2019;73:727–732. doi:10.1016/j.jacc.2018.12.004.
doi: 10.1016/j.jacc.2018.12.004
Norton EC, Dowd BE, Maciejewski ML. Marginal effects—quantifying the effect of changes in risk factors in logistic regression models. JAMA. 2019;321:1304–1305. doi:10.1001/jama.2019.1954.
doi: 10.1001/jama.2019.1954
Valero-Elizondo J, Javed Z, Khera R, et al. Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey. Arch Public Health. 2022;80:248. doi:10.1186/s13690-022-00987-z.
doi: 10.1186/s13690-022-00987-z
Lentz R, Benson AB, Kircher S. Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies. J Surg Oncol. 2019;120:85–92. doi:10.1002/jso.25374.
doi: 10.1002/jso.25374
Dee EC, Nipp RD, Muralidhar V, et al. Financial worry and psychological distress among cancer survivors in the United States, 2013—2018. Support Care Cancer. 2021;29:5523–5535. doi:10.1007/s00520-021-06084-1.
doi: 10.1007/s00520-021-06084-1
Caraballo C, Valero-Elizondo J, Khera R, et al. Burden and consequences of financial hardship from medical bills among nonelderly adults with diabetes mellitus in the United States. Circ Cardiovasc Qual Outcomes. 2020;13:e006139. doi:10.1161/CIRCOUTCOMES.119.006139.
doi: 10.1161/CIRCOUTCOMES.119.006139
Khera R, Valero-Elizondo J, Nasir K. Financial toxicity in atherosclerotic cardiovascular disease in the United States: current state and future directions. JAHA. 2020;9:e017793. doi:10.1161/JAHA.120.017793.
doi: 10.1161/JAHA.120.017793
Zafar SY, Peppercorn JM, Schrag D, et al. The financial toxicity of Cancer treatment: a pilot study assessing out-of-pocket expenses and the insured Cancer Patient's experience. Oncologist. 2013;18:381–390. doi:10.1634/theoncologist.2012-0279.
doi: 10.1634/theoncologist.2012-0279
Knight TG, Deal AM, Dusetzina SB, et al. Financial toxicity in adults with Cancer: adverse outcomes and noncompliance. JOP. 2018;14:e665–e673. doi:10.1200/JOP.18.00120.
doi: 10.1200/JOP.18.00120
Piette JD, Heisler M, Wagner TH. Cost-related medication underuse among chronically ill adults: the treatments people forgo, how often, and who is at risk. Am J Public Health. 2004;94:1782–1787.
PDQ Adult Treatment Editorial Board. Financial Toxicity (Financial Distress) and Cancer Treatment (PDQ®): Patient Version. In: PDQ Cancer Information Summaries. National Cancer Institute (US); 2002. p. Accessed April 26, 2024. http://www.ncbi.nlm.nih.gov/books/NBK441635/.
Briesacher BA, Gurwitz JH, Soumerai SB. Patients at-risk for cost-related medication nonadherence: a review of the literature. J Gen Intern Med. 2007;22:864–871. doi:10.1007/s11606-007-0180-x.
doi: 10.1007/s11606-007-0180-x