Barriers to Asthma Care for Low-Income, High Cost-Sharing
(HealthDay News) – Cost-related barriers to care for children with asthma are concentrated in low-income families with higher cost-sharing levels, according to a study published online May 19 in JAMA Pediatrics.
Vicki Fung, PhD, from Massachusetts General Hospital in Boston, and colleagues surveyed 769 parents of children aged 4–11 years with asthma to examine the correlations between cost sharing, income, and care seeking and financial stress. Of the respondents, 25.9%, 21.7%, and 18.2%of children received public subsidies, were commercially insured with household incomes at or below 250 percent of the federal poverty level (FPL), and had higher cost-sharing levels of all services, respectively. Children with asthma were classified based on current receipt of a subsidy or potential eligibility for Affordable Care Act low-income cost sharing or premium subsidies, as well as cost-sharing levels for drugs, office visits, and emergency department visits.
The researchers found that, after adjustment, parents at or below 250% of the FPL were less likely to delay or avoid taking their children to a physician's office or emergency department because of cost (odds ratios, 0.07 and 0.05, respectively), if they had lower versus higher cost-sharing levels. Furthermore, the likelihood of foregoing children's care was lower for high-income parents and those whose children were receiving public subsidies compared with those at or below 250% of the FPL with higher cost-sharing levels. To pay for their children's asthma care, 15.6% of parents borrowed money or cut back on necessities.
"Cost-related barriers to care among children with asthma were concentrated among low-income families with higher cost-sharing levels," the authors write.
One author disclosed financial ties to Merck.