title: Personal bankruptcy after traumatic brain or spinal cord injury: the role of medical debt.
abstract: OBJECTIVE
  To estimate the prevalence of medical debt among traumatic brain injury (TBI) and spinal cord injury (SCI) patients who discharged their debts through bankruptcy.
  
  
  METHODS
  A cross-sectional comparison of bankruptcy filings of injured versus randomly selected bankruptcy petitioners.
  
  
  METHODS
  Patients hospitalized with SCI or TBI (1996-2002) and personal bankruptcy petitioners (2001-2004) in western Washington State.
  
  
  METHODS
  Subjects (N=186) who filed for bankruptcy, comprised of 93 patients with previous SCI or TBI and 93 randomly selected bankruptcy petitioners.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Medical and nonmedical debt, assets, income, expenses, and employment recorded in the bankruptcy petition.
  
  
  RESULTS
  Five percent of randomly selected petitioners and 26% of petitioners with TBI or SCI had substantial medical debt (debt that accounted for more than 20% of all unsecured debts). SCI and TBI petitioners had fewer assets and were more likely to be receiving government income assistance at the time of bankruptcy than controls. SCI and TBI patients with a higher blood alcohol content at injury were more likely to have substantial medical debts (odds ratio=2.70; 95% confidence interval, 1.04-7.00).
  
  
  CONCLUSIONS
  Medical debt plays an important role in some bankruptcies after TBI or SCI. We discuss policy options for reducing financial distress after serious injury.
authors.affiliation: Department of Radiology, University of Washington, Seattle, WA, USA.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Relyea-Chew
authors.forename: William
authors.initials: W
authors.lastname: Hollingworth
authors.forename: Leighton
authors.initials: L
authors.lastname: Chan
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Comstock
authors.forename: Karen A
authors.initials: KA
authors.lastname: Overstreet
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jarvik
mesh_terms: D000328:Adult; D016361:Bankruptcy / Q000706:statistics & numerical data*; D001930:Brain Injuries / Q000191:economics* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D015995:Prevalence; D012042:Registries; D013119:Spinal Cord Injuries / Q000191:economics* / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology