2022
Subjective Financial Hardship due to Medical Bills Among Patients With Heart Failure in the United States: The 2014–2018 Medical Expenditure Panel Survey
Ali HR, Valero-Elizondo J, Wang SY, Cainzos-Achirica M, Bhimaraj A, Khan SU, Khan MS, Mossialos E, Khera R, Nasir K. Subjective Financial Hardship due to Medical Bills Among Patients With Heart Failure in the United States: The 2014–2018 Medical Expenditure Panel Survey. Journal Of Cardiac Failure 2022, 28: 1424-1433. PMID: 35839928, DOI: 10.1016/j.cardfail.2022.06.009.Peer-Reviewed Original ResearchMeasures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US
Wang SY, Valero-Elizondo J, Cainzos-Achirica M, Desai NR, Nasir K, Khera R. Measures of Financial Hardship From Health Care Expenses Among Families With a Member With Atherosclerotic Cardiovascular Disease in the US. JAMA Health Forum 2022, 3: e221962. PMID: 35977226, PMCID: PMC9308060, DOI: 10.1001/jamahealthforum.2022.1962.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAtherosclerosisCardiovascular DiseasesCross-Sectional StudiesFemaleFinancial StressHealth ExpendituresHumansIncomeMaleYoung AdultConceptsFinancial hardshipFinancial burdenPocket medical expensesMedical Expenditure Panel SurveyHealth care expensesHigher incomePanel SurveyHealth careCare expensesFinancial consequencesHealth care costsForgone carePublic insuranceMedical billsSubstantial financial burdenMedical expensesIncomeDisparate measuresHardshipCare costsRepresentative surveySubjective measuresComprehensive frameworkExpenseInsuranceCost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018.
Taha MB, Valero-Elizondo J, Yahya T, Caraballo C, Khera R, Patel KV, Ali HJR, Sharma G, Mossialos E, Cainzos-Achirica M, Nasir K. Cost-Related Medication Nonadherence in Adults With Diabetes in the United States: The National Health Interview Survey 2013-2018. Diabetes Care 2022, 45: 594-603. PMID: 35015860, DOI: 10.2337/dc21-1757.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedComorbidityDiabetes MellitusFemaleHealth ExpendituresHumansMedication AdherenceSurveys and QuestionnairesUnited StatesConceptsCost-related medication nonadherenceNational Health Interview SurveyLack of insuranceMedication nonadherenceNational Health Interview Survey 2013Duration of diabetesHigher comorbidity burdenSelf-reported diabetesHealth Interview SurveyWorse health outcomesHealth-related expendituresComorbidity burdenInsulin useCurrent smokingLess medicationMedication adherenceFemale sexWeighted prevalenceHigher oddsAge subgroupsSkipping dosesDiabetesHealth outcomesElderly adultsNHIS participants
2021
Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States
Lago‐Hernandez C, Nguyen NH, Khera R, Loomba R, Asrani SK, Singh S. Financial Hardship From Medical Bills Among Adults With Chronic Liver Diseases: National Estimates From the United States. Hepatology 2021, 74: 1509-1522. PMID: 33772833, DOI: 10.1002/hep.31835.Peer-Reviewed Original ResearchConceptsChronic liver diseaseForgone Medical Care Associated With Increased Health Care Costs Among the U.S. Heart Failure Population
Thomas A, Valero-Elizondo J, Khera R, Warraich HJ, Reinhardt SW, Ali HJ, Nasir K, Desai NR. Forgone Medical Care Associated With Increased Health Care Costs Among the U.S. Heart Failure Population. JACC Heart Failure 2021, 9: 710-719. PMID: 34391737, DOI: 10.1016/j.jchf.2021.05.010.Peer-Reviewed Original ResearchMeSH KeywordsAgedEmergency Service, HospitalHealth Care CostsHealth ExpendituresHeart FailureHumansPrevalenceUnited StatesConceptsHeart failureHealth care utilizationHealth care costsHealth care expendituresCare utilizationCare costsMedical careMore emergency department visitsTotal health care costsCare expendituresAnnual health careAnnual inpatient costsPrevalence of patientsEmergency department visitsMedical Expenditure Panel SurveyOverall health care spendingHF patientsElderly patientsCare AssociatedDepartment visitsFailure populationInpatient costsHealth care spendingLeading causePatientsFinancial Hardship Among Nonelderly Adults With CKD in the United States
Acquah I, Valero-Elizondo J, Javed Z, Ibrahim HN, Patel KV, Ryoo Ali HJ, Menser T, Khera R, Cainzos-Achirica M, Nasir K. Financial Hardship Among Nonelderly Adults With CKD in the United States. American Journal Of Kidney Diseases 2021, 78: 658-668. PMID: 34144103, DOI: 10.1053/j.ajkd.2021.04.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultCross-Sectional StudiesFinancial StressHealth ExpendituresHumansMedication AdherenceRenal Insufficiency, ChronicUnited StatesConceptsChronic kidney diseaseLack of insuranceMedical billsDiagnosis of CKDMultivariable logistic regression modelNational Health Interview SurveyHealth Interview SurveyFinancial hardshipLogistic regression modelsClinical characteristicsClinical factorsCKD diagnosisKidney diseaseUS populationAbstractTextStudy designInterview SurveyRepresentative estimatesDiagnosisRegression modelsRepresentative sampleAdultsOutcomesStrong determinantAMPOut‐of‐pocket Annual Health Expenditures and Financial Toxicity from Healthcare Costs in Patients with Heart Failure in the United States
Wang SY, Valero‐Elizondo J, Ali H, Pandey A, Cainzos‐Achirica M, Krumholz HM, Nasir K, Khera R. Out‐of‐pocket Annual Health Expenditures and Financial Toxicity from Healthcare Costs in Patients with Heart Failure in the United States. Journal Of The American Heart Association 2021, 10: e022164. PMID: 33998273, PMCID: PMC8483501, DOI: 10.1161/jaha.121.022164.Peer-Reviewed Original ResearchConceptsGreater risk-adjusted oddsRisk-adjusted oddsHeart failureMedical Expenditure Panel SurveyCatastrophic financial burdenPocket healthcare expensesHigh financial burdenFinancial toxicityHealthcare expensesFinancial burdenHealthcare costsCatastrophic burdenMajor public health burdenLow-income familiesBackground Heart failurePublic health burdenInsurance premiumsPanel SurveyPocket healthcare costsAnnual health expenditureWorld Health OrganizationConclusions PatientsHealth insurance premiumsPocket healthcare expenditureHealth burdenProjected 30- day out-of-pocket costs and total spending on pancreatic enzyme replacement therapy under Medicare Part D
Gupta A, Premnath N, Sedhom R, Beg MS, Khera R, Laheru DA, Dusetzina SB. Projected 30- day out-of-pocket costs and total spending on pancreatic enzyme replacement therapy under Medicare Part D. Pancreatology 2021, 21: 1009-1010. PMID: 34006458, DOI: 10.1016/j.pan.2021.05.002.Peer-Reviewed Original ResearchFinancial burden, distress, and toxicity in cardiovascular disease
Slavin SD, Khera R, Zafar SY, Nasir K, Warraich HJ. Financial burden, distress, and toxicity in cardiovascular disease. American Heart Journal 2021, 238: 75-84. PMID: 33961830, DOI: 10.1016/j.ahj.2021.04.011.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseFinancial burdenCommunity Health Worker IntegrationHigh-risk individualsComparative effectiveness studiesNon-medical needsHigh-cost interventionsHigh-cost treatmentsCVD managementEffectiveness studiesHealth systemPsychological distressInsurance coverageHealthcare policyBurdenDistressDiseaseSystem navigationInterventionCommunity-based initiativesPatientsPhysicians
2020
National Estimates of Financial Hardship From Medical Bills and Cost-related Medication Nonadherence in Patients With Inflammatory Bowel Diseases in the United States
Nguyen NH, Khera R, Dulai PS, Boland BS, Ohno-Machado L, Sandborn WJ, Singh S. National Estimates of Financial Hardship From Medical Bills and Cost-related Medication Nonadherence in Patients With Inflammatory Bowel Diseases in the United States. Inflammatory Bowel Diseases 2020, 27: 1068-1078. PMID: 33051681, PMCID: PMC8205631, DOI: 10.1093/ibd/izaa266.Peer-Reviewed Original ResearchConceptsCost-related medication nonadherenceInflammatory bowel diseaseBowel diseaseMedication nonadherenceFinancial toxicityMedical billsSelf-reported inflammatory bowel diseaseSubstantial health care needsUnplanned health care utilizationNational estimatesNational Health Interview SurveyHigh ED utilizationEmergency department utilizationHealth care utilizationHealth Interview SurveyTimes higher oddsHealth care needsCost-reducing behaviorsFinancial hardshipValue-based careED utilizationCare utilizationNational burdenHigher oddsHealth care affordabilityFinancial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions
Khera R, Valero-Elizondo J, Nasir K. Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions. Journal Of The American Heart Association 2020, 9: e017793. PMID: 32924728, PMCID: PMC7792407, DOI: 10.1161/jaha.120.017793.Peer-Reviewed Original ResearchMeSH KeywordsAtherosclerosisCardiovascular DiseasesCost of IllnessFinancial StressHealth ExpendituresHumansQuality of LifeUnited StatesConceptsAtherosclerotic cardiovascular diseaseFinancial toxicitySubstantial economic impactCost sharingHigh deductiblesNational expenditureEconomic impactPolicy circlesPocket costsFinancial impactHealthcare expendituresHealth careASCVD patientsWell tradeoffCardiovascular diseaseExpenditureNecessary medical careFinancial Hardship After Traumatic Injury: Risk Factors and Drivers of Out-of-Pocket Health Expenses
O'Neill KM, Jean RA, Gross CP, Becher RD, Khera R, Elizondo JV, Nasir K. Financial Hardship After Traumatic Injury: Risk Factors and Drivers of Out-of-Pocket Health Expenses. Journal Of Surgical Research 2020, 256: 1-12. PMID: 32663705, DOI: 10.1016/j.jss.2020.05.095.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChildChild, PreschoolCost of IllnessCross-Sectional StudiesFamilyFemaleFinancial StressHealth ExpendituresHospitalizationHumansInfantInfant, NewbornInsurance, HealthMaleMiddle AgedPrescription DrugsRetrospective StudiesRisk FactorsSocioeconomic FactorsUnited StatesWounds and InjuriesYoung AdultConceptsTraumatic injuryOOP expensesPocket health expensesExcess financial burdenHealth expensesInpatient costsCatastrophic medical expensesFinancial burdenMultivariable logistic regression analysisMedical expensesHealth care factorsCostly medical conditionsCross-sectional studyMedical Expenditure Panel SurveyLogistic regression analysisPrescription drug costsFinancial hardshipHealth care systemFamily membersTrauma-related disordersPrimary outcomeCare factorsEmergency roomRisk factorsDrug costsCumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States
Mszar R, Grandhi GR, Valero‐Elizondo J, Caraballo C, Khera R, Desai N, Virani SS, Blankstein R, Blaha MJ, Nasir K. Cumulative Burden of Financial Hardship From Medical Bills Across the Spectrum of Diabetes Mellitus and Atherosclerotic Cardiovascular Disease Among Non‐Elderly Adults in the United States. Journal Of The American Heart Association 2020, 9: e015523. PMID: 32394783, PMCID: PMC7660844, DOI: 10.1161/jaha.119.015523.Peer-Reviewed Original ResearchConceptsAtherosclerotic cardiovascular diseaseDiabetes mellitusNon-elderly adultsMedical billsCardiovascular diseaseBackground Atherosclerotic cardiovascular diseaseNational Health Interview SurveyEffective public health policiesThird of deathsTreatment-related expensesHealth Interview SurveyHigher relative oddsLogistic regression analysisFinancial hardshipPublic health policyASCVD statusPatient populationStudy populationHigh riskRelative oddsWeighted populationCumulative burdenHealth policyInterview SurveyStrong associationBurden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States
Caraballo C, Valero-Elizondo J, Khera R, Mahajan S, Grandhi GR, Virani SS, Mszar R, Krumholz HM, Nasir K. Burden and Consequences of Financial Hardship From Medical Bills Among Nonelderly Adults With Diabetes Mellitus in the United States. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006139. PMID: 32069093, DOI: 10.1161/circoutcomes.119.006139.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsBlack or African AmericanComorbidityCost of IllnessCross-Sectional StudiesDiabetes MellitusFemaleFinancing, PersonalFood SupplyHealth Care CostsHealth Care SurveysHealth ExpendituresHealth Services AccessibilityHumansIncomeMaleMedically UninsuredMiddle AgedPatient ComplianceRisk AssessmentRisk FactorsUnited StatesYoung AdultConceptsDiabetes mellitusMedical billsHigher oddsMedical careNational Health Interview Survey dataHealth Interview Survey dataCost-related medication nonadherenceHigher comorbidity burdenCost-related nonadherenceSelf-reported diagnosisNon-Hispanic blacksInterview Survey dataFinancial hardshipMedication nonadherenceMean ageNonmedical needsHigh prevalenceMellitusMultivariate analysisPocket expenditureFood insecurityNonadherenceHigh financial distressPatientsAdults
2019
Financial Hardship From Medical Bills Among Nonelderly U.S. Adults With Atherosclerotic Cardiovascular Disease
Valero-Elizondo J, Khera R, Saxena A, Grandhi GR, Virani SS, Butler J, Samad Z, Desai NR, Krumholz HM, Nasir K. Financial Hardship From Medical Bills Among Nonelderly U.S. Adults With Atherosclerotic Cardiovascular Disease. Journal Of The American College Of Cardiology 2019, 73: 727-732. PMID: 30765039, DOI: 10.1016/j.jacc.2018.12.004.Peer-Reviewed Original Research
2018
Association of Out-of-Pocket Annual Health Expenditures With Financial Hardship in Low-Income Adults With Atherosclerotic Cardiovascular Disease in the United States
Khera R, Valero-Elizondo J, Okunrintemi V, Saxena A, Das SR, de Lemos JA, Krumholz HM, Nasir K. Association of Out-of-Pocket Annual Health Expenditures With Financial Hardship in Low-Income Adults With Atherosclerotic Cardiovascular Disease in the United States. JAMA Cardiology 2018, 3: 729-738. PMID: 29971325, PMCID: PMC6143078, DOI: 10.1001/jamacardio.2018.1813.Peer-Reviewed Original ResearchConceptsCatastrophic financial burdenLow-income familiesPocket health care expensesHigh financial burdenMedical Expenditure Panel SurveyHealth care expensesFamily incomeFinancial burdenPanel SurveyHealth expensesMean annual family incomePocket expensesCare expensesFinancial hardshipAtherosclerotic cardiovascular diseaseLow incomePocket health expensesAssociation of OutAnnual family incomeFederal poverty limitHigh-income familiesAnnual health expenditureLow-income adultsInsurance premiumsHealth expenditureTrends in Use and Expenditures of Brand-name Atorvastatin After Introduction of Generic Atorvastatin
Warraich HJ, Salami JA, Khera R, Valero-Elizondo J, Okunrintemi V, Nasir K. Trends in Use and Expenditures of Brand-name Atorvastatin After Introduction of Generic Atorvastatin. JAMA Internal Medicine 2018, 178: 719-721. PMID: 29525818, PMCID: PMC5885171, DOI: 10.1001/jamainternmed.2018.0990.Peer-Reviewed Original Research
2017
Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States
Khera R, Hong JC, Saxena A, Arrieta A, Virani SS, Blankstein R, de Lemos JA, Krumholz HM, Nasir K. Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States. Circulation 2017, 137: 408-410. PMID: 29133601, PMCID: PMC5780190, DOI: 10.1161/circulationaha.117.030128.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultFemaleHealth Care CostsHealth ExpendituresHealth Services AccessibilityHospital ChargesHospital CostsHumansIncomeMaleMedically UninsuredMiddle AgedMyocardial InfarctionPatient Protection and Affordable Care ActProcess Assessment, Health CareStrokeTime FactorsUnited StatesYoung Adult