Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting.

Minal R Patel,Marc A Zimmerman,Daniel J Kruger,Suzanne Cupal

doi:10.5888/pcd13.160005

Minal R Patel, Marc A Zimmerman + Show 2 more

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https://doi.org/10.5888/pcd13.160005

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Abstract

IntroductionLittle is known about the role of positive financial behaviors (behaviors that allow maintenance of financial stability with financial resources) in mitigating cost-related nonadherence (CRN) to health regimens. This study examined the relationships between positive financial behaviors, financial stress, and CRN.MethodsData came from the 2011 Speak to Your Health! Community Survey (n = 1,234). Descriptive statistics were computed to examine financial stress and CRN, by chronic condition and health insurance status. We used multivariate logistic regression models to examine the relationship between positive financial behaviors and financial stress and their interaction on a composite score of CRN, controlling for health insurance status, educational level, age, marital status, number of chronic conditions, and employment status.ResultsThirty percent of the sample engaged in CRN. Participants reported moderate financial stress (mean, 13.85; standard deviation [SD] = 6.97), and moderate positive financial behavior (mean, 8.84; SD = 3.24). Participants with employer-sponsored insurance, Medicaid, Medicare, the Genesee Health Plan, high blood pressure, asthma, and diabetes had the highest proportion of CRN. The relationship between financial stress and CRN was not significantly different between those who reported lower versus higher levels of positive financial behavior (P = .32). Greater financial stress was associated with a greater likelihood of CRN (odds ratio [OR] = 2.49; 95% confidence interval [CI], 2.08–2.99). Higher level of positive financial behavior was associated with a lower likelihood of CRN (OR = 0.80; 95% CI, 0.67–0.94).ConclusionFinancial literacy as a means of promoting positive financial behavior may help reduce CRN. An intervention strategy focused on improving financial literacy may be relevant for high-risk groups who report high levels of financial stress.

Highlights

Little is known about the role of positive financial behaviors in mitigating cost-related nonadherence (CRN) to health regimens
Higher level of positive financial behavior was associated with a lower likelihood of CRN (OR = 0.80; 95% CI, 0.67–0.94)
An intervention strategy focused on improving financial literacy may be relevant for high-risk groups who report high levels of financial stress

Summary

Introduction

Little is known about the role of positive financial behaviors (behaviors that allow maintenance of financial stability with financial resources) in mitigating cost-related nonadherence (CRN) to health regimens. One of 4 Americans reports financial difficulty in paying medical bills [1]; this difficulty has significant public health implications, especially for the 50% of the population that is managing chronic illness. 18% of chronically ill Americans report underusing medications and delaying or not fulfilling therapeutic recommendations because of cost [3], which is referred to as cost-related nonadherence (CRN) [3] and varies by therapeutic class across chronic therapies [3,4]. Half of Americans have literacy challenges with health insurance and pay more for health care out of pocket because of these challenges, despite improvements as a result of the Affordable Care Act (ACA) [8]

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