title: Associations between Difficulty Paying Medical Bills and Forgone Medical and Prescription Drug Care.
abstract: Problems paying medical bills have been reported to be associated with increased stress, bankruptcy, and forgone medical care. Using the Behavioral Model for Vulnerable Populations developed by Gelberg et al as a framework, as well as data from the 2010 Ohio Family Health Survey, this study examined the relationships between difficulty paying medical bills and forgone medical and prescription drug care. Logistic regression was used to examine associations between difficulty paying medical bills and predisposing, enabling, need (health status), and health behaviors (forgoing medical care). Difficulty paying medical bills increased the effect of lack of health insurance in predicting forgone medical care and had a conditional effect on the association between education and forgone prescription drug care. Those who had less than a bachelor's degree were more likely to forgo prescription drug care than those with a bachelor's degree, but only if they had difficulty paying medical bills. Difficulty paying medical bills also accounted for the relationships between several population characteristics (eg, age, income, home ownership, health status) in predicting forgone medical and prescription drug care. Policies to cap out-of-pocket medical expenses may mitigate health disparities by addressing the impact of difficulty paying medical bills on forgone care.
authors: 1 Department of Family and Community Medicine, Northeast Ohio Medical University , Rootstown, Ohio.
authors: Kristin R
authors: KR
authors: Baughman
authors: 2 College of Public Health, Kent State University , Kent, Ohio.
authors: Ryan C
authors: RC
authors: Burke
authors: 1 Department of Family and Community Medicine, Northeast Ohio Medical University , Rootstown, Ohio.
authors: Michael S
authors: MS
authors: Hewit
authors: 3 Epidmiology and Biostatistics, Case Western Reserve University School of Medicine, Center for Health Care Research and Policy, Case Western Reserve University and The MetroHealth System , Cleveland, Ohio.
authors: Joseph J
authors: JJ
authors: Sudano
authors: 1 Department of Family and Community Medicine, Northeast Ohio Medical University , Rootstown, Ohio.
authors: James
authors: J
authors: Meeker
authors: 4 Department of Community and Family Medicine, Duke University School of Medicine , Durham, North Carolina.
authors: Sharon K
authors: SK
authors: Hull
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005251:Fees, Medical; D005260:Female; D005102:Health Expenditures; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010349:Patient Compliance; D011306:Prescription Fees; D012959:Socioeconomic Factors; D055815:Young Adult