Medical Bankruptcy in the United States, 2007: Results of a National Study
Medical Bankruptcy in the United States, 2007: Results of a National Study
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DOI：
10.1016/j.amjmed.2009.04.012
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发表时间：
2009-08-01
影响因子：
5.9
通讯作者：
Woolhandler, Steffie
中科院分区：
文献类型：
--
作者：
Himmelstein, David U.;Thorne, Deborah;Woolhandler, Steffie
背景：我们2001年在5个州进行的研究发现，医疗问题至少占所有破产案件的46.2%。自那以后，医疗费用和未参保和未参保人数增加，破产法收紧。方法：我们在2007年随机调查了2314名全国破产申请者，提取了他们的法庭记录，并采访了其中1032人。我们根据债务人陈述的申请理由、因病造成的收入损失以及其医疗债务的规模，将破产归类为医疗破产。结果：按照保守的定义，2007年所有破产中有62.1%是医疗破产；其中92%的医疗债务人的医疗债务超过5000美元，或税前家庭收入的10%。其余的人符合医疗破产的标准，因为他们因病失去了大量收入，或者抵押了一套房子来支付医疗账单。大多数医疗债务人受过良好的教育，拥有住房，并从事中产阶级的职业。四分之三的人有医疗保险。使用2001年和2007年相同的定义，可归因于医疗问题的破产比例上升了49.6%。在控制人口因素的Logistic回归分析中，2007年破产有医疗原因的几率是2001年的2.38倍。结论：疾病和医疗账单在美国破产中所占的比例很大，而且还在不断增加。(C)2009 Elsevier Inc.保留所有权利。《美国医学杂志》(2009)122,741-746
BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened.METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1032 of them. We designated bankruptcies as "medical" based on debtors' stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.RESULTS: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income. The rest met criteria for medical bankruptcy because they had lost significant income due to illness or mortgaged a home to pay medical bills. Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. In logistic regression analysis controlling for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold higher in 2007 than in 2001.CONCLUSIONS: Illness and medical bills contribute to a large and increasing share of US bankruptcies. (C) 2009 Elsevier Inc. All rights reserved. The American Journal of Medicine (2009) 122, 741-746