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The following is a summary of “Percentage of Patients Experiencing Financial Strain Depends on the Screening Measure: Evidence From a Cross-Sectional Survey of Adult Members of an Integrated Healthcare Delivery System,” published in the September 2024 issue of the Primary Care by Tucher et al.

Currently, there is no universally accepted method to screen for financial strain on healthcare systems, providers, and patients. It poses significant challenges for both the patients and the healthcare system. So, a study evaluated the performance of three single-item screeners compared to a composite measure of financial strain as a “gold standard.”

Researchers analyzed data from a 2021 survey of Kaiser Permanente Northern California health plan members. The study included 2,734 non-Medicaid insured adults who answered all questions related to financial strain. The effectiveness of three general single-item screeners and one screener specific to medical and dental care was compared to the composite measure. Kappa statistics were used to assess the agreement between these screeners and the composite measure, with analyses performed across different age groups, income levels, and racial/ethnic subgroups.

Results showed that among 947 adults aged 35 to 65, 30.7% reported having just enough or not enough money to make ends meet, 23.3% had difficulty paying for basics, 18.8% struggled with at least one type of expense, 20.5% had delayed or reduced medical or dental care, and 41.5% experienced financial strain according to the composite measure. The figures for 1,787 adults aged 66 to 85 were 22.7%, 19.4%, 12.9%, 19.8%, and 34.4%, respectively.

Across the entire sample, the screener asking if individuals had trouble making ends meet identified a higher percentage of financial strain than other screeners and showed better performance than the composite measure. The effectiveness of the screeners decreased with higher income levels, and middle-aged adults were more likely to experience financial strain than older adults, as indicated by both the composite and single-item screeners.

The study concluded that as financial strain screening becomes a standard component of healthcare, it is crucial to assess the effectiveness of different brief screeners. The screener focused on making ends meet, which was the most effective way to identify financial strain. Understanding how these tools perform across diverse patient populations can enhance their utility and improve financial strain detection in healthcare settings.

Source: journals.sagepub.com/doi/10.1177/21501319241277408