PDF(Pubmed)
Abstract：
We aimed to assess the association between medical financial hardship and psychological burden and the moderating role of social and mental health support. 2021 United States National Health Interview Survey was used. Financial hardship was defined as having financial worry, material hardship, or cost-related care nonadherence. Psychological burden was measured using perceived general health status, satisfaction with life, and serious psychological distress (SPD). Of 29,370 included adults, 49% experienced financial hardship in the last 12 months. Financial hardship was associated with a higher psychological burden (odds ratio [OR], 3.58; 95% confidence interval [CI], 2.43-5.47 for SPD). Eleven percent received counseling/therapy from mental health professionals, and 90% had experienced frequent social support. Frequent social support was associated with lower financial hardship (OR, 0.71; 95% CI, 0.63-0.80) and psychological burden (OR, 0.28; 95% CI, 0.19-0.42 for SPD). Previous mental health support was associated with higher financial hardship (OR,1.40; 95% CI, 1.28-1.54) and psychological burden (OR, 9.75; 95% CI, 6.97-13.94 for SPD). Those experiencing financial hardship had lower odds of SPD if they received mental health support in the last 12 months (OR, 0.57; 95% CI, 0.39-0.85). Future interventions should also focus on improving social support and mental health for patients as a way of mitigating medical financial hardship.
摘要：
我们旨在评估医疗经济困难与心理负担之间的关系以及社会和心理健康支持的调节作用。使用2021年美国国家健康访谈调查。财务困难被定义为有财务担忧，物质上的艰苦,或与成本相关的护理不依从。使用感知的一般健康状况来衡量心理负担，对生活的满意度，和严重的心理困扰（SPD）。在29,370人中，包括成年人，49%的人在过去12个月中经历了财务困难。经济困难与更高的心理负担相关(赔率比[OR]，3.58；95%置信区间[CI]，SPD为2.43-5.47)。11％的人接受了心理健康专业人员的咨询/治疗，90%的人经历过频繁的社会支持。频繁的社会支持与较低的经济困难(或，0.71；95%CI，0.63-0.80)和心理负担(OR，0.28；95%CI，SPD为0.19-0.42）。以前的心理健康支持与更高的经济困难(或，1.40；95%CI，1.28-1.54)和心理负担(OR，9.75；95%CI，SPD为6.97-13.94）。那些经历经济困难的人如果在过去12个月内接受心理健康支持，患SPD的几率较低(或者，0.57；95%CI，0.39-0.85）。未来的干预措施还应侧重于改善患者的社会支持和心理健康，以减轻医疗困难。
