ArticleJournal of the American Heart Association2020
Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non-Elderly Adults in the United States.
Article in Journal of the American Heart Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Financial Toxicity and Its Determinants in Cardiovascular Diseases: A Systematic Review and Bayesian Meta-Analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- Reducing economic burden through split-shared care model for people living with uncontrolled type 2 diabetes and polypharmacy: a multi-center randomized controlled trial.BMC health services research · 2024Trial
- Prevalence and Incidence of Heart Failure Phenotypes Among Transgender and Gender-Diverse Adults in the United States.Journal of the American Heart Association · 2026Article
- A real-world evaluation of longitudinal healthcare expenses in a health system registry of type-2 diabetes mellitus and cardiovascular disease enabled by the 21st century cures act.American journal of preventive cardiology · 2026Article
- A Patient-Informed Framework of Financial Strain Among Adults with Multimorbidity.Journal of general internal medicine · 2026Article
- The Association between Medical Debt and Food Insecurity among United States Families with Children.The Journal of pediatrics · 2025Article
- A Costly Cure: Understanding and Addressing Financial Toxicity in Cardiovascular Disease Health Care Within the Domain of Social Determinants of Health.Methodist DeBakey cardiovascular journal · 2024Review
- Economic burden of atherosclerotic cardiovascular disease: a matched case-control study in more than 450,000 Swedish individuals.BMC cardiovascular disorders · 2023Article
- Economic burden, financial stress, and cost-related coping among people with uncontrolled diabetes in the U.S.Preventive medicine reports · 2023Article
- Article
- Young Women With Acute Myocardial Infarction: Risk Prediction Model for 1-Year Hospital Readmission.CJC open · 2023Article
- Financial stress among skin cancer patients: a cross-sectional review of the 2013-2018 National Health Interview Survey.Archives of dermatological research · 2023Article
- Catastrophic pharmaceutical expenditure in patients with type 2 diabetes in Iran.International journal for equity in health · 2022Article
- Disease and debt: Findings from the 2019 Panel Study of Income Dynamics in the United States.Preventive medicine · 2022Article
- Death, long-term nursing home placement, and impoverishment after recurrent myocardial infarction.American heart journal plus : cardiology research and practice · 2021Article
- Prevalence of cardiovascular risk factors in a nationally representative adult population with inflammatory bowel disease without atherosclerotic cardiovascular disease.American journal of preventive cardiology · 2021Article
- Racial and Ethnic Disparities in Access to Health Care Among Adults in the United States: A 20-Year National Health Interview Survey Analysis, 1999-2018.medRxiv : the preprint server for health sciences · 2020Article
- Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions.Journal of the American Heart Association · 2020Review
- Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States.American journal of preventive cardiology · 2020Article
- Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non-Elderly Adults in the United States.Journal of the American Heart Association · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Background Atherosclerotic cardiovascular disease (ASCVD) has a strong association with diabetes mellitus (DM), accounting for approximately two thirds of deaths in this patient population. Many individuals with ASCVD and DM are vulnerable to financial hardship associated with treatment-related expenses. Therefore, we examined the burden of financial hardship from medical bills across the spectrum of ASCVD status with and without DM. Methods and Results Using data from the National Health Interview Survey from 2013 to 2017, we used logistic regression analysis to examine the association of ASCVD and DM status with financial hardship and an inability to pay medical bills from a representative sample of non-elderly adults in the United States. Our study population consisted of 121 672 individuals. Approximately 3.1% of the weighted population had ASCVD, 5.6% had DM, and 1.3% had both ASCVD and DM. Nearly 50% of individuals with ASCVD and DM reported financial hardship from medical bills (23% being unable to pay medical bills at all), whereas ≈28% of those with neither ASCVD nor DM reported financial hardship from medical bills (8% being unable to pay medical bills at all). Individuals with concurrent ASCVD and DM had the highest relative odds of expressing an inability to pay at all when compared with those with neither condition (odds ratio, 2.69; 95% CI, 2.21-3.28). Conclusions Individuals with concurrent ASCVD and DM are at a disproportionately high risk of being unable to pay their medical bills. The findings provide strong evidence for developing more effective public health policies that protect vulnerable populations from financial hardship.
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