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A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US

IMPORTANCE: Despite major differences in their health care systems, medical crowdfunding is increasingly used to finance personal health care costs in Canada, the UK, and the US. However, little is known about the campaigns designed to raise monetary donations for medical expenses, the individuals w...

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Autores principales: Saleh, Sameh N., Ajufo, Ezimamaka, Lehmann, Christoph U., Medford, Richard J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588935/
https://www.ncbi.nlm.nih.gov/pubmed/33104206
http://dx.doi.org/10.1001/jamanetworkopen.2020.21684
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author Saleh, Sameh N.
Ajufo, Ezimamaka
Lehmann, Christoph U.
Medford, Richard J.
author_facet Saleh, Sameh N.
Ajufo, Ezimamaka
Lehmann, Christoph U.
Medford, Richard J.
author_sort Saleh, Sameh N.
collection PubMed
description IMPORTANCE: Despite major differences in their health care systems, medical crowdfunding is increasingly used to finance personal health care costs in Canada, the UK, and the US. However, little is known about the campaigns designed to raise monetary donations for medical expenses, the individuals who turn to crowdfunding, and their fundraising intent. OBJECTIVE: To examine the demographic characteristics of medical crowdfunding beneficiaries, campaign characteristics, and their association with funding success in Canada, the UK, and the US. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study extracted and manually reviewed data from GoFundMe campaigns discoverable between February 2018 and March 2019. All available campaigns on each country domain’s GoFundMe medical discovery webpage that benefitted a unique patient(s) were included from Canada, the UK, and the US. Data analysis was performed from March to December 2019. EXPOSURES: Campaign and beneficiary characteristics. MAIN OUTCOMES AND MEASURES: Log-transformed amount raised in US dollars. RESULTS: This study examined 3396 campaigns including 1091 in Canada, 1082 in the UK, and 1223 in the US. Campaigns in the US (median [IQR], $38 204 [$31 200 to $52 123]) raised more funds than campaigns in Canada ($12 662 [$9377 to $19 251]) and the UK ($6285 [$4028 to $12 348]). In the overall cohort per campaign, Black individuals raised 11.5% less (95% CI, −19.0% to −3.2%; P = .006) than non-Black individuals, and male individuals raised 5.9% more (95% CI, 2.2% to 9.7%; P = .002) than female individuals. Female (39.4% of campaigns vs 50.8% of US population; difference, 11.3%; 95% CI, 8.6% to 14.1%; P < .001) and Black (5.3% of campaigns vs 13.4% of US population; difference, 8.1%; 95% CI, 6.8% to 9.3%; P < .001) beneficiaries were underrepresented among US campaigns. Campaigns primarily for routine treatment expenses were approximately 3 times more common in the US (77.9% [272 of 349 campaigns]) than in Canada (21.9% [55 of 251 campaigns]; difference, 56.0%; 95% CI, 49.3-62.7%; P < .001) or the UK (26.6% [127 of 478 campaigns]; difference, 51.4%; 95% CI, 45.5%-57.3%; P < .001). However, campaigns for routine care were less successful overall. Approved, inaccessible care and experimental care raised 35.7% (95% CI, 25.6% to 46.7%; P < .001) and 20.9% (95% CI, 13.3% to 29.1%; P < .001), respectively, more per campaign than routine care. Campaigns primarily for alternative treatment expenses (16.1% [174 of 1079 campaigns]) were nearly 4-fold more common for cancer (23.5% [144 of 614 campaigns]) vs noncancer (6.5% [30 of 465 campaigns]) diagnoses. CONCLUSIONS AND RELEVANCE: Important differences were observed in the reasons individuals turn to medical crowdfunding in the 3 countries examined that suggest racial and gender disparities in fundraising success. More work is needed to understand the underpinnings of these findings and their implications on health care provision in the countries examined.
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spelling pubmed-75889352020-11-05 A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US Saleh, Sameh N. Ajufo, Ezimamaka Lehmann, Christoph U. Medford, Richard J. JAMA Netw Open Original Investigation IMPORTANCE: Despite major differences in their health care systems, medical crowdfunding is increasingly used to finance personal health care costs in Canada, the UK, and the US. However, little is known about the campaigns designed to raise monetary donations for medical expenses, the individuals who turn to crowdfunding, and their fundraising intent. OBJECTIVE: To examine the demographic characteristics of medical crowdfunding beneficiaries, campaign characteristics, and their association with funding success in Canada, the UK, and the US. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study extracted and manually reviewed data from GoFundMe campaigns discoverable between February 2018 and March 2019. All available campaigns on each country domain’s GoFundMe medical discovery webpage that benefitted a unique patient(s) were included from Canada, the UK, and the US. Data analysis was performed from March to December 2019. EXPOSURES: Campaign and beneficiary characteristics. MAIN OUTCOMES AND MEASURES: Log-transformed amount raised in US dollars. RESULTS: This study examined 3396 campaigns including 1091 in Canada, 1082 in the UK, and 1223 in the US. Campaigns in the US (median [IQR], $38 204 [$31 200 to $52 123]) raised more funds than campaigns in Canada ($12 662 [$9377 to $19 251]) and the UK ($6285 [$4028 to $12 348]). In the overall cohort per campaign, Black individuals raised 11.5% less (95% CI, −19.0% to −3.2%; P = .006) than non-Black individuals, and male individuals raised 5.9% more (95% CI, 2.2% to 9.7%; P = .002) than female individuals. Female (39.4% of campaigns vs 50.8% of US population; difference, 11.3%; 95% CI, 8.6% to 14.1%; P < .001) and Black (5.3% of campaigns vs 13.4% of US population; difference, 8.1%; 95% CI, 6.8% to 9.3%; P < .001) beneficiaries were underrepresented among US campaigns. Campaigns primarily for routine treatment expenses were approximately 3 times more common in the US (77.9% [272 of 349 campaigns]) than in Canada (21.9% [55 of 251 campaigns]; difference, 56.0%; 95% CI, 49.3-62.7%; P < .001) or the UK (26.6% [127 of 478 campaigns]; difference, 51.4%; 95% CI, 45.5%-57.3%; P < .001). However, campaigns for routine care were less successful overall. Approved, inaccessible care and experimental care raised 35.7% (95% CI, 25.6% to 46.7%; P < .001) and 20.9% (95% CI, 13.3% to 29.1%; P < .001), respectively, more per campaign than routine care. Campaigns primarily for alternative treatment expenses (16.1% [174 of 1079 campaigns]) were nearly 4-fold more common for cancer (23.5% [144 of 614 campaigns]) vs noncancer (6.5% [30 of 465 campaigns]) diagnoses. CONCLUSIONS AND RELEVANCE: Important differences were observed in the reasons individuals turn to medical crowdfunding in the 3 countries examined that suggest racial and gender disparities in fundraising success. More work is needed to understand the underpinnings of these findings and their implications on health care provision in the countries examined. American Medical Association 2020-10-26 /pmc/articles/PMC7588935/ /pubmed/33104206 http://dx.doi.org/10.1001/jamanetworkopen.2020.21684 Text en Copyright 2020 Saleh SN et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Saleh, Sameh N.
Ajufo, Ezimamaka
Lehmann, Christoph U.
Medford, Richard J.
A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US
title A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US
title_full A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US
title_fullStr A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US
title_full_unstemmed A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US
title_short A Comparison of Online Medical Crowdfunding in Canada, the UK, and the US
title_sort comparison of online medical crowdfunding in canada, the uk, and the us
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588935/
https://www.ncbi.nlm.nih.gov/pubmed/33104206
http://dx.doi.org/10.1001/jamanetworkopen.2020.21684
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