title: Understanding Financial Barriers to Care in Patients With Diabetes.
abstract: Purpose The purpose of this study was to better understand the impact that financial barriers have on patients with diabetes and the strategies that they use to cope with them. Methods A secondary analysis was conducted of 24 interviews with patients who had either type 1 or type 2 diabetes and perceived financial barriers, which were previously undertaken for a larger grounded theory study. Semistructured interviews were undertaken either face-to-face or by telephone. Data analysis was performed by 3 reviewers using inductive thematic analysis. Sampling for the original study continued until data saturation was achieved. Results The predominant aspects of care to which participants described financial barriers were medications, diabetes supplies, and healthy food. A variety of strategies are used by these patients. Participants described that their health care providers had the potential to either play an important supporting role; or alternatively, that they could also worsen the impacts of financial barriers. Conclusions Patients with diabetes experience financial barriers to various aspects of their care. While they use a variety of strategies to overcome their barriers, their health care providers can play a particularly important role in helping them manage these important barriers that impact their care and outcomes. Providers should ask patients about the existence of financial barriers, and employ strategies to mitigate against their impact.
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Sanmartin, Dr King-Shier).|Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Edwards).|Interdisciplinary Chronic Disease Collaboration, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr King-Shier).
authors.forename: David J T
authors.initials: DJ
authors.lastname: Campbell
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Sanmartin, Dr King-Shier).|Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Edwards).|O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Manns, Dr Hemmelgarn, Dr King-Shier).|Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Manns, Dr Hemmelgarn, Dr King-Shier).
authors.forename: Braden J
authors.initials: BJ
authors.lastname: Manns
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Sanmartin, Dr King-Shier).|Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Edwards).|Interdisciplinary Chronic Disease Collaboration, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr King-Shier).|O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Manns, Dr Hemmelgarn, Dr King-Shier).|Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Manns, Dr Hemmelgarn, Dr King-Shier).
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Sanmartin, Dr King-Shier).|Health Analysis Division, Statistics Canada, Ottawa, Ontario (Dr Sanmartin).
authors.forename: Claudia
authors.initials: C
authors.lastname: Sanmartin
authors.affiliation: Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Edwards).
authors.forename: Alun
authors.initials: A
authors.lastname: Edwards
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr Sanmartin, Dr King-Shier).|Interdisciplinary Chronic Disease Collaboration, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Campbell, Dr Manns, Dr Hemmelgarn, Dr King-Shier).|O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Manns, Dr Hemmelgarn, Dr King-Shier).|Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta (Dr Manns, Dr Hemmelgarn, Dr King-Shier).|Faculty of Nursing, University of Calgary, Calgary, Alberta (Dr King-Shier).
authors.forename: Kathryn
authors.initials: K
authors.lastname: King-Shier
mesh_terms: D000223:Adaptation, Psychological; D017281:Cost of Illness; D003922:Diabetes Mellitus, Type 1 / Q000191:economics* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000523:psychology; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research