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Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) has a strong association with diabetes mellitus (DM), accounting for approximately two thirds of deaths in this patient population. Many individuals with ASCVD and DM are vulnerable to financial hardship associated with treatment‐related exp...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660844/ https://www.ncbi.nlm.nih.gov/pubmed/32394783 http://dx.doi.org/10.1161/JAHA.119.015523 |
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author | Mszar, Reed Grandhi, Gowtham R. Valero‐Elizondo, Javier Caraballo, César Khera, Rohan Desai, Nihar Virani, Salim S. Blankstein, Ron Blaha, Michael J. Nasir, Khurram |
author_facet | Mszar, Reed Grandhi, Gowtham R. Valero‐Elizondo, Javier Caraballo, César Khera, Rohan Desai, Nihar Virani, Salim S. Blankstein, Ron Blaha, Michael J. Nasir, Khurram |
author_sort | Mszar, Reed |
collection | PubMed |
description | BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) has a strong association with diabetes mellitus (DM), accounting for approximately two thirds of deaths in this patient population. Many individuals with ASCVD and DM are vulnerable to financial hardship associated with treatment‐related expenses. Therefore, we examined the burden of financial hardship from medical bills across the spectrum of ASCVD status with and without DM. METHODS AND RESULTS: Using data from the National Health Interview Survey from 2013 to 2017, we used logistic regression analysis to examine the association of ASCVD and DM status with financial hardship and an inability to pay medical bills from a representative sample of non‐elderly adults in the United States. Our study population consisted of 121 672 individuals. Approximately 3.1% of the weighted population had ASCVD, 5.6% had DM, and 1.3% had both ASCVD and DM. Nearly 50% of individuals with ASCVD and DM reported financial hardship from medical bills (23% being unable to pay medical bills at all), whereas ≈28% of those with neither ASCVD nor DM reported financial hardship from medical bills (8% being unable to pay medical bills at all). Individuals with concurrent ASCVD and DM had the highest relative odds of expressing an inability to pay at all when compared with those with neither condition (odds ratio, 2.69; 95% CI, 2.21–3.28). CONCLUSIONS: Individuals with concurrent ASCVD and DM are at a disproportionately high risk of being unable to pay their medical bills. The findings provide strong evidence for developing more effective public health policies that protect vulnerable populations from financial hardship. |
format | Online Article Text |
id | pubmed-7660844 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76608442020-11-17 Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States Mszar, Reed Grandhi, Gowtham R. Valero‐Elizondo, Javier Caraballo, César Khera, Rohan Desai, Nihar Virani, Salim S. Blankstein, Ron Blaha, Michael J. Nasir, Khurram J Am Heart Assoc Original Research BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) has a strong association with diabetes mellitus (DM), accounting for approximately two thirds of deaths in this patient population. Many individuals with ASCVD and DM are vulnerable to financial hardship associated with treatment‐related expenses. Therefore, we examined the burden of financial hardship from medical bills across the spectrum of ASCVD status with and without DM. METHODS AND RESULTS: Using data from the National Health Interview Survey from 2013 to 2017, we used logistic regression analysis to examine the association of ASCVD and DM status with financial hardship and an inability to pay medical bills from a representative sample of non‐elderly adults in the United States. Our study population consisted of 121 672 individuals. Approximately 3.1% of the weighted population had ASCVD, 5.6% had DM, and 1.3% had both ASCVD and DM. Nearly 50% of individuals with ASCVD and DM reported financial hardship from medical bills (23% being unable to pay medical bills at all), whereas ≈28% of those with neither ASCVD nor DM reported financial hardship from medical bills (8% being unable to pay medical bills at all). Individuals with concurrent ASCVD and DM had the highest relative odds of expressing an inability to pay at all when compared with those with neither condition (odds ratio, 2.69; 95% CI, 2.21–3.28). CONCLUSIONS: Individuals with concurrent ASCVD and DM are at a disproportionately high risk of being unable to pay their medical bills. The findings provide strong evidence for developing more effective public health policies that protect vulnerable populations from financial hardship. John Wiley and Sons Inc. 2020-05-12 /pmc/articles/PMC7660844/ /pubmed/32394783 http://dx.doi.org/10.1161/JAHA.119.015523 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Mszar, Reed Grandhi, Gowtham R. Valero‐Elizondo, Javier Caraballo, César Khera, Rohan Desai, Nihar Virani, Salim S. Blankstein, Ron Blaha, Michael J. Nasir, Khurram Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States |
title | Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States |
title_full | Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States |
title_fullStr | Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States |
title_full_unstemmed | Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States |
title_short | Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States |
title_sort | cumulative burden of financial hardship from medical bills across the spectrum of diabetes mellitus and atherosclerotic cardiovascular disease among non‐elderly adults in the united states |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660844/ https://www.ncbi.nlm.nih.gov/pubmed/32394783 http://dx.doi.org/10.1161/JAHA.119.015523 |
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