Evidence map›Paper›PMID 39702658›Full record

ArticleJournal of community health2025

Health Care Financing Practices Among U.S. Amish.

Evan J Beck, Kevin E Kucharski, Kiri E Sunde

Abstract read
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In one paragraph

Article in Journal of community health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Evan J BeckUniversity of Michigan Medical School, Ann Arbor, MI, USA. beckev@med.umich.edu.ORCID 0000-0002-3292-3542
Kevin E KucharskiUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Kiri E SundeDivision of Genetics, Metabolism, and Genomic Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.

Funding

Medical School, University of Michigan N/A
6 · The paper itself

Abstract

The Amish are a rapidly growing Christian ethnoreligious group located in the U.S. and Canada. Characterized by self-reliance and a caution regarding the acceptance of modern technologies, the Amish have traditionally relied on community-based mutual aid to finance health care expenditures instead of commercial insurance or public assistance options. However, the cost, structure, and efficacy of Amish mutual aid programs are not well-described. We surveyed 1006 Amish households in 12 states using a 31-question instrument that asked respondents about demographic information, their health, and participation in mutual aid organizations. Statistical analysis was performed with returned surveys. One hundred fifty-five surveys were returned for a response rate of 15.4%. 81% of respondents reported mutual aid membership. The reported annual health care spending ranged from $500 to $18,000 among nine mutual aid organizations. More than 90% of respondents indicated that they "agree" that their community will help them pay for health care, though 39% reported "sometimes" avoiding recommended medical care due to cost. There were statistically significant differences in treatment avoidance due to cost and perceptions of affordability between Indiana Amish and those in Michigan and Wisconsin. The financing mechanisms employed in our cohort included negotiating organizations, subscription models, and voluntary donation. Though mutual aid mechanisms were ubiquitous, the success of individual organizations may depend on Amish population distribution and relationship with health systems. Providers treating this population should understand Amish practices regarding medical billing. Further studies are necessary to develop institutional best practices for Amish and other self-pay populations.

Indexed as

ChristianityFinancing, PersonalHealthcare FinancingAdultFemaleHealth ExpendituresHumansMaleMiddle AgedUnited StatesAmishHealth care financingSelf-paySurvey

Identifiers

What OpenQuestion holds

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Registered trials

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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.