ArticleJournal of the American Heart Association2021
Out-of-Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States.
Article in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis 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
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- Integrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF).Circulation. Cardiovascular quality and outcomes · 2025Trial
- Health Care Access and Affordability for Patients With Heart Failure in Medicare Advantage vs Traditional Medicare.Journal of cardiac failure · 2026Article
- Why guideline-directed medical therapy depends on more than guidelines: microeconomics of medication use in heart failure.Heart failure reviews · 2026Review
- Article
- Article
- Medicare Advantage Benefits Design and Access to Cardiovascular Care.JAMA network open · 2026Article
- Impact of Sociodemographic Characteristics on Outcomes in Obstructive Hypertrophic Cardiomyopathy.Journal of the American Heart Association · 2026Article
- Predictors of Patient-Reported Financial Hardship in Patients Hospitalized With Critical Illness and Its Association With Patient Outcomes.CHEST critical care · 2026Article
- Annual Out-of-Pocket Medical Costs and Financial Toxicity Among Transplant Recipients in the United States.Journal of general internal medicine · 2026Article
- Prevalence, Etiology, and Antibiotic Resistance Patterns of Urinary Tract Infections in a Baghdad Hospital: Focus on UropathogenicInternational journal of microbiology · 2026Article
- When the Healthcare System Breaks a Heart: A Case of Stress Cardiomyopathy Following a Conversation With an Insurance Provider.Case reports in cardiology · 2026Article
- Metformin-Enhanced Digital Therapeutics for the Affordable Primary Prevention of Diabetes and Cardiovascular Diseases: Advancing Low-Cost Solutions for Lifestyle-Related Chronic Disorders.Healthcare (Basel, Switzerland) · 2025Article
- Racial and Ethnic Disparity in Healthcare Expenditure and Resource Utilization Among Patients with Cardiovascular Diseases.Journal of racial and ethnic health disparities · 2025Article
- Characterizing financial risk from out-of-pocket expenditures across dementia stages.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Article
- Challenges Related to Out-of-Pocket Costs in Heart Failure Management.Circulation. Heart failure · 2025Review
- Health Care Spending After Initiating Sacubitril-Valsartan vs Renin-Angiotensin System Blockers for Heart Failure Treatment.JAMA health forum · 2025Article
- Using the 5Ms Framework to Advance Aging-Responsive Care for Heart Failure with Reduced Ejection Fraction.Clinical interventions in aging · 2025Review
- Investigating the effect of forum-based training on self-care and life satisfaction in heart failure patients referred to Tehran Heart Center in 2021-2022.Journal of education and health promotion · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
Background Heart failure (HF) poses a major public health burden in the United States. We examined the burden of out-of-pocket healthcare costs on patients with HF and their families. Methods and Results In the Medical Expenditure Panel Survey, we identified all families with ≥1 adult member with HF during 2014 to 2018. Total out-of-pocket healthcare expenditures included yearly care-specific costs and insurance premiums. We evaluated 2 outcomes of financial toxicity: (1) high financial burden-total out-of-pocket healthcare expense to postsubsistence income ratio of >20%, and (2) catastrophic financial burden with the ratio of >40%-a bankrupting expense defined by the World Health Organization. There were 788 families in the Medical Expenditure Panel Survey with a member with HF representing 0.54% (95% CI, 0.48%-0.60%) of all families nationally. The overall mean annual out-of-pocket healthcare expenses were $4423 (95% CI, $3908-$4939), with medications and health insurance premiums representing the largest categories of cost. Overall, 14% (95% CI, 11%-18%) of families experienced a high burden and 5% (95% CI, 3%-6%) experienced a catastrophic burden. Among the two-fifths of families considered low income, 24% (95% CI, 18%-30%) experienced a high financial burden, whereas 10% (95% CI, 6%-14%) experienced a catastrophic burden. Low-income families had 4-fold greater risk-adjusted odds of high financial burden (odds ratio [OR] , 3.9; 95% CI, 2.3-6.6), and 14-fold greater risk-adjusted odds of catastrophic financial burden (OR, 14.2; 95% CI, 5.1-39.5) compared with middle/high-income families. Conclusions Patients with HF and their families experience large out-of-pocket healthcare expenses. A large proportion encounter financial toxicity, with a disproportionate effect on low-income families.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.