经济毒性在COVID-19和长型COVID患者中很常见。然而,所经历的金融毒性程度,与其他常见的合并症相比,不确定。加剧长型COVID财务挑战的因素也不清楚。这些知识差距是通过利用2022年全国健康访谈调查(NHIS)的数据进行横截面分析来解决的。从美国抽取的代表性样本。COVID-19病例是通过自我报告的阳性测试或医生诊断确定的。长COVID被定义为经历COVID-19相关症状超过三个月。根据自我报告的十种医生诊断的情况(是/否)评估合并症。财务毒性被定义为难以支付医疗费用,与成本相关的药物不依从性,由于成本而推迟医疗保健,和/或由于成本而未获得医疗保健。我们的分析中总共包括了27,492名NHIS2022受访者,代表2.53亿美国成年人。在多变量逻辑回归模型中,患有长型COVID的成年人(不包括患有COVID-19但不包括长型COVID的受访者),与其他合并症相比,经济毒性增加,如癫痫(OR[95%CI]:1.69[1.22,2.33]),痴呆症(1.51[1.01,2.25]),癌症(1.43[1.19,1.71])或呼吸/心血管疾病(1.18[1.00,1.40]/1.23[1.02,1.47])。长期与COVID相关的金融毒性与女性有关,年龄<65岁,缺乏医疗保险,当前有偿就业,居住地,粮食不安全,疲劳,调查完成期间经历的轻度至重度抑郁症状,去医院急诊室,关节炎的存在,心血管或呼吸系统疾病,社会活动的局限性。总之,患有长COVID的美国成年人,但不是那些之前感染过COVID-19而没有长COVID的人,与常见合并症的个体相比,金融毒性的患病率更高。弱势群体面临更大的金融毒性风险。这些发现强调了评估策略以减轻经济负担和提高人们对长期COVID相关金融毒性对患者医疗保健和健康状况影响的认识的重要性。
Financial toxicity is common in individuals with COVID-19 and Long COVID. However, the extent of financial toxicity experienced, in comparison to other common comorbidities, is uncertain. Contributing factors exacerbating financial challenges in Long COVID are also unclear. These knowledge gaps are addressed via a cross-sectional analysis utilizing data from the 2022 National Health Interview Survey (NHIS), a representative sample drawn from the United States. COVID-19 cases were identified through self-reported positive testing or physician diagnoses. Long COVID was defined as experiencing COVID-19-related symptoms for more than three months. Comorbidity was assessed based on self-reported diagnoses of ten doctor-diagnosed conditions (Yes/No). Financial toxicity was defined as having difficulty paying medical bills, cost-related medication nonadherence, delaying healthcare due to cost, and/or not obtained healthcare due to cost. A total of 27,492 NHIS 2022 respondents were included in our analysis, representing 253 million U.S. adults. In multivariable logistic regression models, adults with Long COVID (excluding respondents with COVID-19 but not Long COVID), showed increased financial toxicity compared to those with other comorbidities, such as epilepsy (OR [95% CI]: 1.69 [1.22, 2.33]), dementia (1.51 [1.01, 2.25]), cancer (1.43 [1.19, 1.71]) or respiratory/cardiovascular conditions (1.18 [1.00, 1.40]/1.23 [1.02, 1.47]). Long COVID-related financial toxicity was associated with female sex, age <65 years, lack of medical insurance, current paid employment, residence region, food insecurity, fatigue, mild to severe depression symptoms experienced during the survey completion, visits to hospital emergency rooms, presence of arthritis, cardiovascular or respiratory conditions, and social activity limitations. In conclusion, American adults with Long COVID, but not those who had prior COVID-19 infection without Long COVID, exhibited a higher prevalence of financial toxicity compared to individuals with common comorbidities. Vulnerable populations were at greater risk for financial toxicity. These findings emphasize the importance of evaluating strategies to reduce economic burden and increase awareness of the effect of Long COVID-related financial toxicity on patient\'s healthcare and health status.