Full Citation
Title: Financial Hardship Among Nonelderly Adults With CKD in the United States
Citation Type: Journal Article
Publication Year: 2021
ISBN:
ISSN: 0272-6386
DOI: 10.1053/J.AJKD.2021.04.011
NSFID:
PMCID:
PMID: 34144103
Abstract: Rationale & Objective: The burden of financial hardship among individuals with chronic kidney disease (CKD) has not been extensively studied. Therefore, we describe the scope and determinants of financial hardship among a nationally representative sample of adults with CKD. Study Design: Cross-sectional. Setting & Participants: Non-elderly adults with CKD from the 2014-2018 National Health Interview Survey. Exposure: Sociodemographic and clinical characteristics. Outcome: Financial hardship based on medical bills and consequences of financial hardship (high financial distress, food insecurity, cost-related medication non-adherence, delayed/forgone care due to cost). Financial hardship was categorized into 3 levels: no financial hardship, financial hardship but able to pay bills, and unable to pay bills at all. Financial hardship was then modeled in 2 different ways: (1) any financial hardship (regardless of ability to pay) versus no financial hardship and (2) inability to pay bills versus no financial hardship and financial hardship but able to pay bills. Analytical Approach: Nationally representative estimates of financial hardship from medical bills were computed. Multivariable logistic regression models were used to examine the associations of sociodemographic and clinical factors with the outcomes of financial hardship based on medical bills. Results: A total 1,425 individuals, representing approximately 2.1 million Americans, reported a diagnosis of CKD within the past year, of whom 46.9% (95% CI, 43.7%-50.2%) reported experiencing financial hardship from medical bills; 20.9% (95% CI, 18.5%-23.6%) reported inability to pay medical bills at all. Lack of insurance was the strongest determinant of financial hardship in this population (odds ratio, 4.06 [95% CI, 2.18-7.56]). Limitations: Self-reported nature of CKD diagnosis. Conclusions: Approximately half the non-elderly US population with CKD experiences financial hardship from medical bills that is associated strongly with lack of insurance. Evidence-based clinical and policy interventions are needed to address these hardships.
Url: https://www.sciencedirect.com/science/article/pii/S0272638621006624
User Submitted?: No
Authors: Acquah, Isaac; Valero-Elizondo, Javier; Javed, Zulqarnain; Ibrahim, Hassan N.; Patel, Kershaw V.; Ryoo Ali, Hyeon Ju; Menser, Terri; Khera, Rohan; Cainzos-Achirica, Miguel; Nasir, Khurram
Periodical (Full): American Journal of Kidney Diseases
Issue: 5
Volume: 78
Pages: 658-668
Data Collections: IPUMS Health Surveys - NHIS
Topics: Health, Poverty and Welfare
Countries: