Patient adverse financial outcomes before and after COVID‐19 infection

Becker, Nora; Carlton, Erin; Iwashyna, Theodore J.; Scott, John W.; Moniz, Michelle H.; Ayanian, John Z.

doi:10.1002/jhm.13105

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…2 These grim disparities, which manifest at the macro level with greater loss of life expectancy among non-white patients, have also contributed to adverse financial outcomes for patients and their families. 3 In the May 2023 issue of the Journal of Hospital Medicine, Becker et al 4 and low credit score (42.4% vs. 33.8%). 4 Unfortunately, the data lacked characteristics such as individuals' race, ethnicity, income, and employment status.…”

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confidence: 99%

“…3 In the May 2023 issue of the Journal of Hospital Medicine, Becker et al 4 and low credit score (42.4% vs. 33.8%). 4 Unfortunately, the data lacked characteristics such as individuals' race, ethnicity, income, and employment status. Additionally, the study only examined commercially insured patients, and the only economic measure was the credit score-a metric that misses the experiences of the 1 in 10 US adults who do not have a credit file, a disproportionate percentage of whom are people of color.…”

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confidence: 99%

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Adding financial insult to physical injury: Economic impacts of having COVID

Woodruff

Brotman

Conway

2023

Journal of Hospital Medicine

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confidence: 99%

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confidence: 99%

Adding financial insult to physical injury: Economic impacts of having COVID

Woodruff

Brotman

Conway

2023

Journal of Hospital Medicine

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Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study

Govier,

Bui,

Hauschildt

et al. 2024

BMC Health Serv Res

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Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022.

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Financial Hardship After COVID-19 Infection: A National Prospective Veteran Cohort Study

Govier,

Bui,

Hauschildt

et al. 2024

Preprint

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Background: Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally examined the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods: We conducted a prospective, telephone-based survey. Of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results: Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4-11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0-8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1-3.6). Veterans aged <65 years had a greater risk of most financial hardships compared with Veterans aged ≥65 years. Conclusions: Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial Registration: NCT05394025, registered 05-27-2022

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Patient adverse financial outcomes before and after COVID‐19 infection

Cited by 3 publications

References 12 publications

Adding financial insult to physical injury: Economic impacts of having COVID

Adding financial insult to physical injury: Economic impacts of having COVID

Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study

Financial Hardship After COVID-19 Infection: A National Prospective Veteran Cohort Study

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