ArticleJournal of the American College of Emergency Physicians open2026
Counting the Cost: Examining Out-of-Pocket Spending on Emergency Care in Newfoundland and Labrador, Canada.
Article in Journal of the American College of Emergency Physicians open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To examine patient-reported non-disease-specific out-of-pocket costs (OOPCs) among emergency department (ED) visitors in a publicly funded health care system, including factors associated with OOPC and to explore patient experiences related to these costs. Methods: This convergent parallel mixed-method study used data collected through telephone surveys and semistructured interviews from March 1, 2021, to July 27, 2023. All patients who visited the 4 EDs (2 rural and 2 urban EDs) in Newfoundland and Labrador, Canada, were randomly selected to participate based on when they visited the ED (date and time). OOPC was defined as the total amount patients incurred from food, transportation, missed work hours, and other related expenses. Quantitative analyses included multivariable binomial and multinomial regression models adjusting for age, gender, ED location, and patient self-reported length of stay (LOS). Sensitivity analyses using multiple imputation assessed the impact of missing data. Qualitative data were analyzed using thematic analysis. Results: Among the final sample of 818 patients, 24% (199/818) reported OOPC for an ED visit. An ED length of stay of 4+ hours was associated with higher odds of incurring OOPC (adjusted odds ratio [aOR], 2.26; 95% CI, 1.29-4.15) and OOPC of ≥$200 Canadian dollars (CAD; aOR, 3.68; 95% CI, 1.21-11.19). Patients who visited urban EDs were more likely to report OOPC of ≥$200 CAD (aOR, 2.55; 95% CI, 1.09-5.99). Qualitative analysis showed 4 OOPC themes: (1) ED visits are expensive; (2) missing work hours; (3) being forced to choose between care and necessities; and (4) ongoing costs of care. Conclusion: These findings demonstrate that OOPC persist even within a publicly funded health system and underscore the importance of improving ED efficiency to reduce the financial burden on individuals seeking care.
Indexed as
Identifiers
What OpenQuestion holds
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.