Financial hardship common among families of children with congenital heart disease
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Financial hardship, food insecurities and delays in care due to medical costs are common among families of children with congenital heart disease, researchers reported.
“Studies have shown that financial hardship is associated with worse patient-reported outcomes,” Avital B. Ludomirsky, MD, MPP, pediatrician in the department of medicine at Boston Children’s Hospital, and colleagues wrote. “Moreover, food insecurity is associated with worse cardiovascular and other health outcomes, which could lead to a higher strain on our health care system as these children become adults.”
The cross-sectional survey study included 188 families of children with congenital heart disease (mean age, 9 years; 53% boys). Financial status was classified into no financial hardship, financial hardship but able to pay medical bills and unable to pay medical bills.
The primary outcomes were food insecurity, delayed care due to cost and cost-related medication nonadherence.
Among the cohort, 48.9% of families that reported some financial hardship due to medical bills, with 17% unable to pay any of their medical bills. Families who were unable to pay their medical bills reported higher rates of food insecurity (61.8% vs. 13.6%; P < .001) and delays in care due to cost (26.2% vs. 4.8%; P = .002) compared with those who said they did not have financial hardships due to medical bills.
Differences between the financial hardship groups persisted after adjustment for age, race/ethnicity and maternal education (OR for food insecurity = 11.2; 95% CI, 3.7-34.1; P < .001; OR for delays in care = 3.3; 95% CI, 1.3-8.5; P = .01).
Those with private insurance who were unable to pay their medical bills had significantly higher food insecurity (70.9% vs. 8%), delayed care (24.4% vs. 0.6%) and medication nonadherence (13.9% vs. 0%) than those with private insurance without financial hardship. There was a stronger association between financial hardships and adverse outcomes among patients with private insurance compared with patients with Medicaid.
There was no difference in medication adherence across all three financial hardship groups.
“A large percentage of families of children with [congenital heart disease] experienced financial hardship because of medical bills, which is associated with difficulties meeting basic needs and obtaining medical care,” the researchers wrote. “Further studies should explore whether systematic assessment of families’ financial situations during [congenital heart disease] care could improve outcomes.”
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