Abstract Background Chronic obstructive pulmonary disease (COPD) imposes a substantial medical and financial burden. Individuals with serious, progressive illnesses, such as COPD, often face “financial toxicity, ” the distress or hardship arising from medical expenses. This financial strain may lead to delayed care, medication non-adherence, worsening disease outcomes, including poor quality of life. Methods We analyzed publicly available data from the National Institutes of Health (NIH) All of Us Research Program, which integrates survey responses and electronic health records. Financial hardship was assessed using items from the Healthcare Access and Utilization Survey among participants with a COPD diagnosis. Sociodemographic and health-related characteristics were summarized using frequencies and proportions for categorical variables and means with standard deviations (SD) for continuous variables. Between-group differences were assessed using chi-square tests and t-tests, excluding “Don’t Know”, “Prefer not to answer”, and “Skip” responses. Results A total of 8, 629 participants with COPD were included (mean age 65 SD = 11 years; 76% White; 5% Hispanic; 58% female). Tobacco use was reported by 72%, and a history of alcohol use by 95%. Nearly half (48%) reported an annual income below 50, 000, and 23% had a high school education or less. Eighteen percent reported being unable to afford dental care, and 16% could not afford prescription medications. Delayed care due to transportation barriers or out-of-pocket costs was reported by approximately 12%. Cost-coping behaviors included requesting lower-cost prescriptions (22%), delaying prescription fills (13%), and reducing or skipping medications (10% for both). Approximately 40% were worried about being able to pay their bills in case of illness or accident. Compared to those not worried, the “worried” group was younger, more likely female, Hispanic, lower income (50, 000), and less likely to have a college or advanced degree (p 0. 0001 for all comparisons). Among those worried about paying their bills, a higher proportion reported cost-coping behaviors and inability to obtain needed medical care (Figure 1). Conclusions Individuals with COPD experience substantial financial strain and often adopt cost-coping strategies that may compromise care. Those expressing concern about paying bills are at even greater risk for these behaviors. Future work will incorporate validated financial toxicity instruments to better characterize financial hardship and its consequences for patients with COPD and their families, with the goal of informing strategies to reduce financial barriers and improve health outcomes. This abstract is funded by: None
Choate et al. (Fri,) studied this question.