Assessing Worry About Affording Healthcare in a General Population Sample.

Salene M W Jones,Nora B Henrikson,Yuxian Du,Laura Panattoni

doi:10.3389/fpsyg.2019.02622

Abstract

This study adapted a measure on worry about affording healthcare. The financial costs of healthcare are increasingly being shifted to patients. Financial burden from healthcare costs can be material (such as bankruptcy) or psychological. Psychological distress can be either worry about affording future care or distress due to material consequences and, despite evidence from clinical psychology that differentiates these types of emotional symptoms, this distinction has largely been ignored for financial burden in healthcare. We adapted a worry about affording healthcare scale for use in the general population (n = 398) to facilitate comparisons between disease groups and across countries. Participants completed a survey through an online platform. The worry about affording healthcare measure showed good reliability and validity through associations with quality of life (QOL) and measures of other types of financial burden. Worry about affording healthcare was also associated with cost-related non-adherence to medical care. Future research on patient QOL should consider worry about affording healthcare.

Highlights

Healthcare costs have been rising (Gordon N. et al, 2017)
This distinction is important as research has shown anxiety and depression are associated with different outcomes: depression and rumination is associated with insomnia, while anxiety and worry is associated with cortisol and heart rate variability (Carney et al, 2010; Ciesla et al, 2011; Aldao et al, 2013; Crowley et al, 2015; Lewis et al, 2017)
Cronbach’s alpha was over 0.9 for both versions, and both versions were significantly correlated with Financial Anxiety Scale (FAS), Financial Well-being Scale (FWS), Patient-Reported Outcomes Measurement Information System (PROMIS)-Anxiety Scale, the PROMIS quality of life (QOL) scale, and Self-administered Comorbidity Questionnaire (SCQ) in the hypothesized directions

Summary

Introduction

Healthcare costs have been rising (Gordon N. et al, 2017). Theories and systematic reviews of financial burden in healthcare have distinguished material financial burden (bankruptcy, draining savings) due to healthcare costs from psychological financial burden (Altice et al, 2017; Gordon L.G. et al, 2017). Psychological financial burden includes two distinct concepts: (1) the distress and depressivetype symptoms (such as feeling down or having little interest in activities) that result from the stress of material financial burden, and (2) worry and anxiety about affording future healthcare (Beck and Haigh, 2014). This distinction is important as research has shown anxiety and depression are associated with different outcomes: depression and rumination is associated with insomnia, while anxiety and worry is associated with cortisol and heart rate variability (Carney et al, 2010; Ciesla et al, 2011; Aldao et al, 2013; Crowley et al, 2015; Lewis et al, 2017).

Methods

Results

Conclusion