Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr 7:13:E46.
doi: 10.5888/pcd13.160005.

Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting

Affiliations

Effect of Financial Stress and Positive Financial Behaviors on Cost-Related Nonadherence to Health Regimens Among Adults in a Community-Based Setting

Minal R Patel et al. Prev Chronic Dis. .

Abstract

Introduction: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean level of financial stress, by chronic condition and health insurance status. Mean level of financial stress is a composite score based on 6 items; scores ranged from 1 to 30, with 1 indicating low levels of stress and 30 indicating levels of high stress. Speak to Your Health! Community Survey, 2011. [Table: see text]
Figure 2
Figure 2
Cost-related nonadherence behaviors, by chronic condition and health insurance status. Cost-related nonadherence is a composite binary measure of a positive response to 1 of 2 cost-cutting behaviors with the treatment regimen. Speak to Your Health! Community Survey, Michigan, 2011. [Table: see text]

References

    1. Cohen RA, Kirzinger WK. Financial burden of medical care: a family perspective. NCHS Data Brief 2014;(142):1–8. - PubMed
    1. Mathes T, Jaschinski T, Pieper D. Adherence influencing factors — a systematic review of systematic reviews. Arch Public Health 2014;72(1):37. 10.1186/2049-3258-72-37 - DOI - PMC - PubMed
    1. Piette JD, Heisler M, Wagner TH. Cost-related medication underuse among chronically ill adults: the treatments people forgo, how often, and who is at risk. Am J Public Health 2004;94(10):1782–7. 10.2105/AJPH.94.10.1782 - DOI - PMC - PubMed
    1. Yeaw J, Benner JS, Walt JG, Sian S, Smith DB. Comparing adherence and persistence across 6 chronic medication classes. J Manag Care Pharm 2009;15(9):728–40. - PMC - PubMed
    1. McHorney CA, Spain CV. Frequency of and reasons for medication non-fulfillment and non-persistence among American adults with chronic disease in 2008. Health Expect 2011;14(3):307–20. 10.1111/j.1369-7625.2010.00619.x - DOI - PMC - PubMed

Publication types