Abstract
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Background
Keywords
Findings
Author
What is already known on this subject?
What does this study add?
Background
People with chronic conditions who do not achieve therapeutic targets have a higher risk of adverse health outcomes. Failure to meet these targets may be due to a variety of barriers. This article examines self-reported financial barriers to health care among people with cardiovascular-related chronic conditions.
Data and methods
A population-based survey was administered to western Canadians with cardiovascular-related chronic conditions (n = 1,849). Associations between self-reported financial barriers and statin use, the likelihood of stopping use of prescribed medications, and emergency department visits or hospitalizations were assessed.
Results
More than 10% respondents reported general financial barriers (12%) and lack of drug insurance (14%); 4% reported financial barriers to accessing medications. Emergency department visits or hospitalizations were 70% more likely among those reporting a general financial barrier. Those reporting a financial barrier to medications were 50% less likely to take statins and three times more likely to stop using prescribed medications. Individuals without drug insurance were nearly 30% less likely to take statins.
Interpretation
In this population, self-reported financial barriers were associated with lower medication use and increased likelihood of emergency department visits or hospitalization.
Keywords
Health insurance, health services accessibility, socio-economic factors, socio-economic status
Findings
Even in a system with universal health care, financial barriers may reduce access to medical care and can affect health outcomes. Because many provincial health insurance plans do not cover prescription drugs for all citizens, some patients may not obtain indicated medications. Even those with drug coverage may still bear financial burdens, such as copayments and deductibles. [Full Text]
Author
David J.T. Campbell, Kathryn King-Shier, Brenda Hemmelgarn, Robert Weaver, and Braden Manns are with the University of Calgary, Calgary, Alberta. Paul Ronksley is with the Ottawa Hospital Research Institute, Ottawa, Ontario. Claudia Sanmartin and Deirdre Hennessy are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario. Marcello Tonelli is with the University of Alberta, Edmonton, Alberta.
What is already known on this subject?
- Despite Canada’s universal health care system, patients may perceive financial barriers when seeking care.
- Perceived financial barriers may be especially important for people with cardiovascular-related chronic conditions.
- Relationships between different types of financial barriers and health care indicators or adverse outcomes in patients with chronic conditions are not clear.
What does this study add?
- Perceived financial barriers were relatively common among people with cardiovascular-related chronic conditions.
- Patients who reported financial barriers were less likely to use statins, more likely to stop using prescribed medications, and more likely to have an emergency department visit or hospitalization related to their cardiovascular-related chronic condition.
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