Assessment of trade-offs made by people due to financial stress from medical care in the USA

Abstract

Objectives This study aims to understand how do socio-demographic and personal factors impact the trade-offs people make in daily life in the USA due to problems in paying medical bills. Methods This study used the 2007 wave of the Health Tracking Household Survey (HTHS) data. The unit of analysis was an individual. The dependent variable was the level of trade-off. A cumulative logit model measured the effect of independent variables on the dependent variable, which was ordinal. Key findings Pre-tax family income, out-of-pocket spending for medical care during past 12 months, perceived health status, type of family, ethnicity and age had significant impact on level of trade-off experienced by individuals. Odds of making severe trade-offs increased significantly for people with low income, poor self-reported general health status, higher out-of pocket medical expenditure and single parents. Compared to white people, African-Americans were worse affected because of problems in paying medical bills. Younger people made a higher level of trade-off compared to older people because of medical debt. Conclusions Problems in paying medical bills forced people to forgo basic necessities of life, which could impact the nutritional status, access to health care and living condition of people. A higher level of trade-offs in daily life could potentially affect the health of an individual in the long run. Poor people were worst affected because of medical debt. This study could prompt policy makers to provide more support to indigent people, people with higher out-of-pocket medical expenses and those with poor health conditions to ensure adequate access to basic necessities of life.