James X Zhang1, James M Crowe2, David O Meltzer1,3,4. 1. a Department of Medicine , The University of Chicago , Chicago , IL , USA. 2. b School of Social Service Administration , The University of Chicago , Chicago , IL , USA. 3. c Department of Economics , The University of Chicago , Chicago , IL , USA. 4. d Harris School of Public Policy , The University of Chicago , Chicago , IL , USA.
Abstract
BACKGROUND: Cost-related non-adherence (CRN) to medical care is a persistent challenge in healthcare in the US. Gender is a key determinant of many healthcare behaviors and outcomes. Understanding variation in CRN by gender may provide opportunities to reduce disparities and improve outcomes. AIMS: This study aims to examine the differential rates in CRN by gender across a spectrum of socio-economic factors among the adult population in the US. METHOD: Data from the 2015 National Financial Capability Study (NFCS) were used for this study. CRN is identified if a respondent indicated not filling a prescription for medicine because of the cost and/or skipping a medical test, treatment, or follow-up recommended by a doctor because of the cost in the past 12 months. The differential rates in CRN by gender were assessed across socio-economic strata. A multivariable logistic regression analysis was performed to evaluate the difference in CRN rates by gender, controlling for potential confounders. RESULTS: A total of 26,287 adults were included in the analyses. Overall, the weighted CRN rate in the adult population is 19.8% for men and 26.2% for women. There was a clear pattern of differential rates in CRN across socio-economic strata by gender. Overall, men were less likely to report CRN (AOR = 0.74; 95% CI = 0.69-0.79), controlling for other risk factors. CONCLUSIONS: More research is needed to understand the behavioral aspects of gender difference in CRN. Patient-centered healthcare needs to take gender difference into account when addressing cost-related non-adherence behavior.
BACKGROUND: Cost-related non-adherence (CRN) to medical care is a persistent challenge in healthcare in the US. Gender is a key determinant of many healthcare behaviors and outcomes. Understanding variation in CRN by gender may provide opportunities to reduce disparities and improve outcomes. AIMS: This study aims to examine the differential rates in CRN by gender across a spectrum of socio-economic factors among the adult population in the US. METHOD: Data from the 2015 National Financial Capability Study (NFCS) were used for this study. CRN is identified if a respondent indicated not filling a prescription for medicine because of the cost and/or skipping a medical test, treatment, or follow-up recommended by a doctor because of the cost in the past 12 months. The differential rates in CRN by gender were assessed across socio-economic strata. A multivariable logistic regression analysis was performed to evaluate the difference in CRN rates by gender, controlling for potential confounders. RESULTS: A total of 26,287 adults were included in the analyses. Overall, the weighted CRN rate in the adult population is 19.8% for men and 26.2% for women. There was a clear pattern of differential rates in CRN across socio-economic strata by gender. Overall, men were less likely to report CRN (AOR = 0.74; 95% CI = 0.69-0.79), controlling for other risk factors. CONCLUSIONS: More research is needed to understand the behavioral aspects of gender difference in CRN. Patient-centered healthcare needs to take gender difference into account when addressing cost-related non-adherence behavior.
Entities:
Keywords:
Cost-related non-adherence; access to care; disparities; gender
Authors: Riyad Kherallah; Mahmoud Al Rifai; Ishan Kamat; Chayakrit Krittanawong; Dhruv Mahtta; Michelle T Lee; Jing Liu; Khurram Nasir; Javier Valero-Elizondo; Jaideep Patel; Mouaz H Al-Mallah; Laura A Petersen; Salim S Virani Journal: Prev Med Date: 2021-07-07 Impact factor: 4.637