Abstract
About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to care. However, it is unclear whether those affected discuss their financial problems with general practitioners. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate:50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Conversations about financial problems with general practitioners were reported by 22.6% (n = 135) of respondents. Individuals with a high educational level were less likely to report such conversations than those with medium educational level (aOR 0.11; 95%CI 0.01-0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background(aOR 2.09; 95%CI 1.32-3.32), the chronically ill(aOR 1.90; 95%CI 1.16-3.13) and individuals who reported high financial distress(aOR 2.15; 95%CI 1.22-3.78) and cutting on necessities to pay for medications(aOR 1.86; 95%CI 1.12-3.09) were more likely to discuss financial problems than their counterparts. Few over-indebted individuals discussed financial problems with their general practitioner. Patients' health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.
Highlights
General practitioners (GPs) are often the point of first medical contact for health problems within health care systems in Europe and have a coordinating role in many countries [1]
Conversations about financial problems with general practitioners were reported by 22.6% (n = 135) of respondents
Patients’ health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems
Summary
General practitioners (GPs) are often the point of first medical contact for health problems within health care systems in Europe and have a coordinating role in many countries [1]. A 15-year longitudinal study among 48778 adults in Finland found an association between over-indebtedness and an increased incidence of various chronic diseases including diabetes and psychoses [13] These findings suggest that overindebtedness may reflect a distinct risk factor of poor health. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to care. It is unclear whether those affected discuss their financial problems with general practitioners. This study examined patient-physician communication about financial problems in general practice among over-indebted individuals
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
