Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting.
Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting.
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DOI：
10.5888/pcd13.160005
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发表时间：
2016-04-07
影响因子：
5.5
通讯作者：
Zimmerman MA
中科院分区：
文献类型：
--
作者：
Patel MR;Kruger DJ;Cupal S;Zimmerman MA
人们对积极的财务行为（允许用财务资源维持财务稳定的行为）在减轻健康方案的成本相关不依从（CRN）方面的作用知之甚少。本研究探讨积极财务行为、财务压力与客户关系网之间的关系。数据来自2011年的“与你的健康对话”！社区调查（n = 1，234）。计算描述性统计量，以检查财务压力和CRN，慢性疾病和健康保险状况。我们使用多变量逻辑回归模型来研究积极的财务行为和财务压力之间的关系，以及它们在CRN综合评分上的相互作用，控制健康保险状况，教育水平，年龄，婚姻状况，慢性病数量和就业状况。30%的样本从事CRN。参与者报告了中度财务压力（平均值，13.85;标准差[SD] = 6.97）和中度积极的财务行为（平均值，8.84; SD = 3.24）。有雇主赞助保险、医疗补助、医疗保险、杰内塞健康计划、高血压、哮喘和糖尿病的参与者CRN的比例最高。财务压力和CRN之间的关系在那些报告较低和较高水平的积极财务行为的人之间没有显着差异（P = 0.32）。更大的经济压力与更大的CRN可能性相关（比值比[OR] = 2.49; 95%置信区间[CI]，2.08-2.99）。较高水平的积极财务行为与较低的CRN可能性相关（OR = 0.80; 95%CI，0.67-0.94）。金融知识作为促进积极金融行为的一种手段，可能有助于减少CRN。一项以提高金融知识为重点的干预战略可能与报告财务压力高的高风险群体有关。
Little is known about the role of positive financial behaviors (behaviors that allow maintenance of financial stability with financial resources) in mitigating cost-related nonadherence (CRN) to health regimens. This study examined the relationships between positive financial behaviors, financial stress, and CRN. Data came from the 2011 Speak to Your Health! Community Survey (n = 1,234). Descriptive statistics were computed to examine financial stress and CRN, by chronic condition and health insurance status. We used multivariate logistic regression models to examine the relationship between positive financial behaviors and financial stress and their interaction on a composite score of CRN, controlling for health insurance status, educational level, age, marital status, number of chronic conditions, and employment status. Thirty percent of the sample engaged in CRN. Participants reported moderate financial stress (mean, 13.85; standard deviation [SD] = 6.97), and moderate positive financial behavior (mean, 8.84; SD = 3.24). Participants with employer-sponsored insurance, Medicaid, Medicare, the Genesee Health Plan, high blood pressure, asthma, and diabetes had the highest proportion of CRN. The relationship between financial stress and CRN was not significantly different between those who reported lower versus higher levels of positive financial behavior (P = .32). Greater financial stress was associated with a greater likelihood of CRN (odds ratio [OR] = 2.49; 95% confidence interval [CI], 2.08–2.99). Higher level of positive financial behavior was associated with a lower likelihood of CRN (OR = 0.80; 95% CI, 0.67–0.94). Financial literacy as a means of promoting positive financial behavior may help reduce CRN. An intervention strategy focused on improving financial literacy may be relevant for high-risk groups who report high levels of financial stress.