title: Health care worry is associated with worse outcomes in multiple sclerosis.
abstract: OBJECTIVE
  People with multiple sclerosis (MS) experience higher levels of depression and anxiety than the general population. This is the first study to examine the relationship of worry about affording health care and symptoms in MS.
  
  
  METHODS
  People with MS (n = 405) were recruited for a needs assessment study. Participants completed a structured telephone interview measuring depression, anxiety, fatigue, sleep disturbance, pain interference, social function, and perceived cognitive functioning, and rated their worry about the following: premiums increasing, income decreasing, affording health care services, insurance dropping coverage, and affording prescriptions. Multiple regression analyses controlled for age, gender, disability status, education, income, and health insurance coverage.
  
  
  RESULTS
  The highest rated worry was inability to afford health care services. Higher health care worry was reported by women, younger participants, participants with lower incomes, and those with only private (vs. public) insurance. Total level of health care worry was significantly related to depression, anxiety, fatigue, sleep disturbance, pain interference, social function, and perceived cognitive functioning.
  
  
  CONCLUSIONS
  Health care worry was significantly related to psychological, physical, and cognitive symptoms. Future research should compare health care worry in MS with other populations (i.e., healthy adults) and should examine changes in health care worry over time.
authors.affiliation: Group Health Research Institute.
authors.forename: Salene M
authors.initials: SM
authors.lastname: Jones
authors.affiliation: Department of Rehabilitation Medicine.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Amtmann
mesh_terms: D001007:Anxiety / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D020380:Needs Assessment / Q000191:economics / Q000706:statistics & numerical data; D012720:Severity of Illness Index