PMS49 ASSOCIATION OF FINANCIAL ACCESS TO HEALTHCARE WITH PRODUCTIVITY LOSS AND ASSOCIATEDPATIENTS’ OUT OF POCKET COSTS AMONG PATIENTS WITH RHEUMATOID DISEASES

Abstract

Evidence shows that patients with rheumatic diseases (RDs) are generally facing a heavy economic burden given who need long-term and continuous medication. However, the impact of the financial barriers on productivity and out-of-pocket costs among patients with RDs stays unclear. Therefore, the purpose of this study aimed to estimate the association of the financial access barriers to health carewith the productivity and out-of-pocket costs among patientswith RDs. A retrospective, pooled cross-sectional study was conducted using data from the National Health Interview Survey (NHIS) between 2011 and 2017. Financial access barrierwas identified if respondent answered a “yes” to any of the following NHIS survey prompts: “couldn't afford medical care”, couldn't afford dental care”, “couldn't afford eyeglasses”, “couldn't afford mental health care”, “couldn't afford follow-up care”, and “couldn't afford specialists”. Anegative binomial regression was implemented to estimate the impact on productivity, which was measured as productivity loss by using the lost workdays per year. In addition, an ordered logistic regression was used to determine the association of financial barriers with patients’ out-of-pocket costs (less than $2,000, $2,000 – 4,999, $5,000 or more). A total of 53,457 patients with RDs were identified out of 705,669 respondents for assessing the association. Thefinancial access barrier was associated with increased productivity loss compared to those without barriers with anincidence risk ratio (IRR) equaled to 1.33 (95% CI: 1.22 to 1.44, P=0.000) among patients with RDs. Besides, thebarrier was associated with higher out-of-pocket costs with an odds ratio (OR) of 1.65 (95% CI: 1.56 to 1.74, P =0.000). Rheumatoid patients with financial access barriers to health care are vulnerable to lose productivity and pay a higher level of out-of-pocket costs, suggesting strategies and interventions are necessary to increase their productivity and decrease the economic burden.