title: Complex home care: Part 2- family annual income, insurance premium, and out-of-pocket expenses.
abstract: Annual costs paid by families for intravenous infusion of home parenteral nutrition (HPN) health insurance premiums, deductibles, co-payments for health services, and the wide range of out-of-pocket home health care expenses are significant. The costs of managing complex chronic care at home cannot be completely understood until all out-of-pocket costs have been defined, described, and tabulated. Non-reimbursed and out-of-pocket costs paid by families over years for complex chronic care negatively impact the financial stability of families. National health care reform must take into account the long-term financial burdens of families caring for those with complex home care. Any changes that may increase the out-of-pocket costs or health insurance costs to these families can also have a negative long-term impact on society when greater numbers of patients declare bankruptcy or qualify for medical disability.
authors.affiliation: University of Kansas School of Nursing, School of Nursing Building, Kansas City, KS, USA.
authors.forename: Ubolrat
authors.initials: U
authors.lastname: Piamjariyakul
authors.forename: Donna Macan
authors.initials: DM
authors.lastname: Yadrich
authors.forename: Vicki M
authors.initials: VM
authors.lastname: Ross
authors.forename: Carol E
authors.initials: CE
authors.lastname: Smith
authors.forename: Faye
authors.initials: F
authors.lastname: Clements
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Williams
mesh_terms: D016361:Bankruptcy / Q000191:economics; D002908:Chronic Disease; D017281:Cost of Illness; D003424:Crohn Disease / Q000191:economics / Q000523:psychology / Q000628:therapy; D003669:Deductibles and Coinsurance / Q000191:economics*; D005190:Family / Q000523:psychology; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D018166:Health Care Reform / Q000191:economics; D019538:Health Care Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008134:Long-Term Care / Q000191:economics; D008297:Male; D008489:Medical Indigency / Q000191:economics; D008875:Middle Aged; D015401:Nursing Administration Research; D016331:Parenteral Nutrition, Home / Q000191:economics* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012959:Socioeconomic Factors