Financial Difficulties in Families of Hospitalized Children
Financial Difficulties in Families of Hospitalized Children
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DOI：
10.12788/jhm.3500
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发表时间：
2020-11-01
影响因子：
2.6
通讯作者：
Schroeder, Alan R.
中科院分区：
文献类型：
--
作者：
Bassett, Hannah K.;Coller, Ryan J.;Schroeder, Alan R.
背景：高昂的住院费用可能会导致一些家庭的经济困难。目的：调查住院儿童家庭中经济困难和医疗经济负担的患病率，并找出预测经济困难的因素。设计、背景和参与者：2017年10月至2018年11月在6所儿童医院对住院儿童的父母进行横断面调查。多变量Logistic回归确定了每个结果的预测因素。主要预测变量是慢性病水平(复杂慢性病，C-CD；非复杂慢性病，NC-CD；无慢性病，非CD)。结果：在644名受试者中，526名(82%)入选，其中125名(24%)经历过严重的经济困难，160名(30%)报告了医疗经济负担。在这些人中，86人(54%)表示他们的医疗经济负担是由与住院孩子相关的费用造成的。C-CD和NC-CD都不与高度财务困境相关。与非CD相比，儿童相关的医疗经济负担与C-CD和NC-CD有关(调整后的优势比[AOR]，4.98；95%CI，2.41-10.29；AOR，2.57；95%CI，1.11-5.93)。虽然家庭贫困程度与这两项指标都有关联，但所有家庭收入水平都出现了经济困难。结论：住院儿童家庭经济困难是常见的。低收入家庭和子女患有慢性病的家庭面临的风险特别大；然而，经济困难影响到儿科人口的所有群体。住院可能是识别和接触有经济困难和医疗经济负担风险的家庭的最佳机会。(C)2020年医院医学会
BACKGROUND: High costs of hospitalization may contribute to financial difficulties for some families.OBJECTIVE: To examine the prevalence of financial distress and medical financial burden in families of hospitalized children and identify factors that can predict financial difficulties.DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of parents of hospitalized children at six children's hospitals between October 2017 and November 2018.MAIN OUTCOMES AND MEASURES: The outcomes were high financial distress and medical financial burden. Multivariable logistic regression identified predictors of each outcome. The primary predictor variable was level of chronic disease (complex chronic disease, C-CD; noncomplex chronic disease, NC-CD; no chronic disease, no-CD).RESULTS: Of 644 invited participants, 526 (82%) were enrolled, with 125 (24%) experiencing high financial distress, and 160 (30%) reporting medical financial burden. Of those, 86 (54%) indicated their medical financial burden was caused by costs associated with their hospitalized child. Neither C-CD nor NC-CD were associated with high financial distress. Child-related medical financial burden was associated with both C-CD and NC-CD (adjusted odds ratio [AOR], 4.98; 95% CI, 2.41-10.29; and AOR, 2.57; 95% CI, 1.11-5.93), compared to no-CD. Although household poverty level was associated with both measures, financial difficulties occurred in all family income brackets.CONCLUSION: Financial difficulties are common in families of hospitalized children. Low-income families and those who have children with chronic conditions are at particular risk; however, financial difficulties affect all subsets of the pediatric population. Hospitalization may be a prime opportunity to identify and engage families at risk for financial distress and medical financial burden. (C) 2020 Society of Hospital Medicine