Associations between Difficulty Paying Medical Bills and Forgone Medical and Prescription Drug Care.


Journal Article

Problems paying medical bills have been reported to be associated with increased stress, bankruptcy, and forgone medical care. Using the Behavioral Model for Vulnerable Populations developed by Gelberg et al as a framework, as well as data from the 2010 Ohio Family Health Survey, this study examined the relationships between difficulty paying medical bills and forgone medical and prescription drug care. Logistic regression was used to examine associations between difficulty paying medical bills and predisposing, enabling, need (health status), and health behaviors (forgoing medical care). Difficulty paying medical bills increased the effect of lack of health insurance in predicting forgone medical care and had a conditional effect on the association between education and forgone prescription drug care. Those who had less than a bachelor's degree were more likely to forgo prescription drug care than those with a bachelor's degree, but only if they had difficulty paying medical bills. Difficulty paying medical bills also accounted for the relationships between several population characteristics (eg, age, income, home ownership, health status) in predicting forgone medical and prescription drug care. Policies to cap out-of-pocket medical expenses may mitigate health disparities by addressing the impact of difficulty paying medical bills on forgone care.

Full Text

Duke Authors

Cited Authors

  • Baughman, KR; Burke, RC; Hewit, MS; Sudano, JJ; Meeker, J; Hull, SK

Published Date

  • October 2015

Published In

Volume / Issue

  • 18 / 5

Start / End Page

  • 358 - 366

PubMed ID

  • 25856468

Pubmed Central ID

  • 25856468

Electronic International Standard Serial Number (EISSN)

  • 1942-7905

Digital Object Identifier (DOI)

  • 10.1089/pop.2014.0128


  • eng

Conference Location

  • United States