Abstract
BackgroundReduced funding to public health care systems during economic downturns is a common phenomenon around the world. The effect of health care cost on family members of the patients has not been established. This paper aims to explore the relationship between affordability of health care and vulnerability of family members to distress levels.MethodsData of a total of 262,843 participants were obtained from 17 waves (1997–2013) of the United States National Health Interview Survey. Multinomial logistic regression was used to investigate psychological distress level as a result of having family members who experienced unmet medical needs due to cost.ResultsAmong participants without family members who experienced unmet needs for medical care due to cost, risks of having ‘moderate’ (score of 5–12) or ‘serious’ (score of 13 or above) level of psychological distress were 1.0% and 11.5%, respectively. Risks of having ‘moderate’ or ‘serious’ level of psychological distress were 3.1% and 23.4%, respectively among participants with family members who experienced unmet needs. The adjusted relative risk ratio of ‘moderate’ and ‘serious’, as compared to ‘normal’ level of psychological distress, were 1.58 (95% confidence interval: 1.47–1.69) and 2.09 (95% confidence interval: 1.78–2.45) if one’s family members experienced unmet medical needs.ConclusionsUnmet medical needs due to cost increases risk of distress levels experienced by family members. Careful planning and adequate funding to public health care system could be implemented to prevent any unnecessary detrimental effect on mental health among family members of the unwell and any further increment of the prevalence of mental illnesses. This recommendation aligns with the World Health Organization Mental Health Action Plan 2013–2020.
Highlights
Reduced funding to public health care systems during economic downturns is a common phenomenon around the world
In other words, having family members with unmet needs for medical care were associated with about 100% and 200% increase in the risk of having at least moderate and serious level of psychological distress, respectively
Overall the multivariate analyses showed that the risk of moderate or serious and serious psychological distress level were significantly higher (50% and 80%, respectively) among participants who had family members with unmet medical needs (Tables 1 and 2)
Summary
Reduced funding to public health care systems during economic downturns is a common phenomenon around the world. Health care systems in many developed countries are funded from public sources to provide equitable access to all based on needs [1]. Increased cost-sharing or more out-of-pocket expenses by patients during economic downturns or reduced health care. The financial burden can negatively impact the family members, who may already be under stress when providing daily care to their ill relatives [6,7,8]. Their mental health may be suboptimal and yet overlooked. The World Health Organization (WHO) has highlighted the importance of
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