ArticleJAMA cardiology2021
Association of Financial Hardship Because of Medical Bills With Adverse Outcomes Among Families of Children With Congenital Heart Disease.
Article in JAMA cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Social Determinants of Disparities in Mortality Outcomes in Congenital Heart Disease: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled 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
- Characteristics of children with congenital heart defects and their caregivers in three U.S. sites: the Congenital Heart Survey To Recognize Outcomes Needs and well-beinG of KIDS (CHSTRONG KIDS).Progress in pediatric cardiology · 2026Article
- Out-of-Pocket Costs and Health-Related Social Needs Among Households With Children.JAMA network open · 2026Article
- Screening of Pediatric Patients at Cardiology Clinic Identifies High Prevalence of Food Insecurity.International journal of environmental research and public health · 2026Article
- Association of Material Hardship and Clinical Outcomes in Infants with Congenital Heart Disease.Pediatric cardiology · 2026Article
- Emergency and Non-Referral Admissions as Predictors of Hospital Mortality Among Adults with Congenital Heart Diseases: A Nationwide Claim-Based Registry Study in Japan.Healthcare (Basel, Switzerland) · 2026Article
- Cost analysis of financial, productivity, and informal care burdens in families raising children with congenital anomalies.Health economics review · 2026Article
- The Association between Medical Debt and Food Insecurity among United States Families with Children.The Journal of pediatrics · 2025Article
- Loss and Grief in Parents of Children Hospitalized for Congenital Heart Disease.Hospital pediatrics · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Peripandemic outcomes of infants treated for sentinel congenital heart diseases in England and Wales.Open heart · 2025Article
- Oregon Community Benefit Reform Influenced Not-For-Profit Hospitals' Charity Care And Medical Debt Write-Off.Health affairs (Project Hope) · 2025Article
- Association between insurance type, clinical characteristics, and healthcare use in adults with congenital heart disease.International journal of cardiology. Congenital heart disease · 2024Article
- Socioeconomic Status and Access to Care for Pediatric and Adult Congenital Heart Disease in Universal Health Coverage Models.Journal of cardiovascular development and disease · 2024Review
- Associations of Medical Debt With Health Status, Premature Death, and Mortality in the US.JAMA network open · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Study on the trend of congenital heart disease inpatient costs and its influencing factors in economically underdeveloped areas of China, 2015-2020: a case study of Gansu Province.Frontiers in public health · 2024Article
- Unmet supportive care needs in families of children with chronic health conditions: an Australian cross-sectional study.World journal of pediatrics : WJP · 2023Article
- Access to Specialized Care Across the Lifespan in Tetralogy of Fallot.CJC pediatric and congenital heart disease · 2023Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Importance: Congenital heart disease (CHD) carries significant health care costs and out-of-pocket expenses for families. Little is known about how financial hardship because of medical bills affects families' access to essential needs or medical care. Objective: To assess the national prevalence of financial hardship because of medical bills among families of children with CHD in the US and the association of financial hardship with adverse outcomes. Design, Setting, and Participants: This cross-sectional survey study used data on children 17 years and younger with self-reported CHD from the National Health Interview Survey of US households between 2011 and 2017. Data were analyzed from March 2019 to April 2020. Exposures: Financial hardship because of medical bills was classified into 3 categories: no financial hardship, financial hardship but able to pay medical bills, and unable to pay medical bills. Main Outcomes and Measures: Food insecurity, delayed care because of cost, and cost-related medication nonadherence. Results: Of 188 families of children with CHD (weighted sample of 151 537 families), 48.9% reported some financial hardship because of medical bills, with 17.0% being unable to pay their medical bills at all. Compared with those who denied financial hardships because of medical bills, families who were unable to pay their medical bills reported significantly higher rates of food insecurity (61.8% [SE, 11.0] vs 13.6% [SE, 4.0]; P < .001) and delays in care because of cost (26.2% [SE, 10.4] vs 4.8% [SE, 2.5]; P = .002). Reported medication adherence did not differ across financial hardship groups. After adjusting for age, race/ethnicity, and maternal education, the differences between the groups persisted. The association of financial hardship with adverse outcomes was stronger among patients with private insurance than those with Medicaid. Conclusions and Relevance: In this study, financial hardship because of medical bills was common among families of children with CHD and was associated with high rates of food insecurity and delays in care because of cost, suggesting possible avenues for intervention.
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