IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0232716.html
   My bibliography  Save this article

Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals

Author

Listed:
  • Jacqueline Warth
  • Marie-Therese Puth
  • Ulrike Zier
  • Niklas Beckmann
  • Johannes Porz
  • Judith Tillmann
  • Klaus Weckbecker
  • Hans Bosma
  • Birgitta Weltermann
  • Eva Münster

Abstract

Background: About every tenth household across Europe is unable to meet payment obligations and living expenses on an ongoing basis and is thus considered over-indebted. Previous research suggests that over-indebtedness reflects a potential cause and consequence of psychosomatic health problems and limited access to care. However, it is unclear whether those affected discuss their financial problems with general practitioners. Therefore, this study examined patient-physician communication about financial problems in general practice among over-indebted individuals. Methods: We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017. We assessed the prevalence of patient-physician communication about financial problems and its association with patient characteristics using descriptive statistics and logistic regression analysis. Of 699 individuals who returned the questionnaire (response rate:50.2%), we included 598 respondents enrolled in statutory health insurance with complete outcome data in the analyses. Results: Conversations about financial problems with general practitioners were reported by 22.6% (n = 135) of respondents. Individuals with a high educational level were less likely to report such conversations than those with medium educational level (aOR 0.11; 95%CI 0.01–0.83) after adjustment for other sociodemographic characteristics, health status and measures of financial distress. Those without a migrant background(aOR 2.09; 95%CI 1.32–3.32), the chronically ill(aOR 1.90; 95%CI 1.16–3.13) and individuals who reported high financial distress(aOR 2.15; 95%CI 1.22–3.78) and cutting on necessities to pay for medications(aOR 1.86; 95%CI 1.12–3.09) were more likely to discuss financial problems than their counterparts. Conclusions: Few over-indebted individuals discussed financial problems with their general practitioner. Patients’ health status, coping strategies and perception of financial distress might contribute to variations in disclosure of financial problems. Thus, enhancing communication and screening by routine assessment of financial problems in clinical practice can help to identify vulnerable patients and promote access to health care and social services and well-being for all.

Suggested Citation

  • Jacqueline Warth & Marie-Therese Puth & Ulrike Zier & Niklas Beckmann & Johannes Porz & Judith Tillmann & Klaus Weckbecker & Hans Bosma & Birgitta Weltermann & Eva Münster, 2020. "Patient-physician communication about financial problems: A cross-sectional study among over-indebted individuals," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0232716
    DOI: 10.1371/journal.pone.0232716
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232716
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0232716&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0232716?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Alley, D.E. & Lloyd, J. & Pagán, J.A. & Pollack, C.E. & Shardell, M. & Cannuscio, C., 2011. "Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years," American Journal of Public Health, American Public Health Association, vol. 101(12), pages 2293-2298.
    2. John Gathergood, 2012. "Debt and Depression: Causal Links and Social Norm Effects," Economic Journal, Royal Economic Society, vol. 122(563), pages 1094-1114, September.
    3. Jenni Blomgren & Nico Maunula & Heikki Hiilamo, 2016. "Over-indebtedness and chronic disease: a linked register-based study of Finnish men and women during 1995–2010," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(5), pages 535-544, June.
    4. Herman, P.M. & Rissi, J.J. & Walsh, M.E., 2011. "Health insurance status, medical debt, and their impact on access to care in arizona," American Journal of Public Health, American Public Health Association, vol. 101(8), pages 1437-1443.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jacqueline Warth & Niklas Beckmann & Marie-Therese Puth & Judith Tillmann & Johannes Porz & Ulrike Zier & Klaus Weckbecker & Birgitta Weltermann & Eva Münster, 2020. "Association between over-indebtedness and antidepressant use: A cross-sectional analysis," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-11, July.
    2. Benjian Wu & Yi Cui & Yushuo Jiang, 2022. "The Role of Microfinance in China’s Rural Public Health: Evidence from the Anti-Poverty Microcredit Program," IJERPH, MDPI, vol. 19(17), pages 1-22, August.
    3. Vásquez-Vera, Hugo & Palència, Laia & Magna, Ingrid & Mena, Carlos & Neira, Jaime & Borrell, Carme, 2017. "The threat of home eviction and its effects on health through the equity lens: A systematic review," Social Science & Medicine, Elsevier, vol. 175(C), pages 199-208.
    4. Naijie Guan & Alessandra Guariglia & Patrick Moore & Fangzhou Xu & Hareth Al-Janabi, 2022. "Financial stress and depression in adults: A systematic review," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-20, February.
    5. Lynn, Peter & Fumagalli, Laura & Muñoz-Bugarin, Jair, 2021. "The effect of formal debt advice on financial management and knowledge: insights from a new longitudinal study in Britain," ISER Working Paper Series 2021-09, Institute for Social and Economic Research.
    6. Jenni Blomgren & Nico Maunula & Heikki Hiilamo, 2016. "Over-indebtedness and chronic disease: a linked register-based study of Finnish men and women during 1995–2010," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(5), pages 535-544, June.
    7. Alexander C Tsai, 2015. "Home Foreclosure, Health, and Mental Health: A Systematic Review of Individual, Aggregate, and Contextual Associations," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-21, April.
    8. Lynn, Peter & Fumagalli, Laura & Muñoz-Bugarin, Jair, 2021. "Investigating the role of debt advice on borrowers’ well-being. An encouragement study on a new sample of over-indebted people in Britain," ISER Working Paper Series 2021-08, Institute for Social and Economic Research.
    9. Burlinson, Andrew & Giulietti, Monica & Law, Cherry & Liu, Hui-Hsuan, 2021. "Fuel poverty and financial distress," Energy Economics, Elsevier, vol. 102(C).
    10. Maite Blázquez & Santiago Budría, 2018. "The Effects of Over-indebtedness on Individual Health," Hacienda Pública Española / Review of Public Economics, IEF, vol. 227(4), pages 103-131, December.
    11. Mavropoulos, Antonios & Xiong, Qizhou, 2019. "Housing consumption and macroprudential policies in Europe: An ex ante evaluation," IWH Discussion Papers 17/2018, Halle Institute for Economic Research (IWH), revised 2019.
    12. David G. Blanchflower & Andrew E. Clark, 2021. "Children, unhappiness and family finances," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(2), pages 625-653, April.
    13. A. Håkansson, 2020. "Role of Gambling in Payback Failure in Consumer Credit—Data from a Large Body of Material Regarding Consumer Loan Recipients in Sweden," IJERPH, MDPI, vol. 17(8), pages 1-18, April.
    14. Liu, Jiankun & He, Xiaobin & Dong, Yinxi, 2024. "Household debt and children’s psychological well-being in China: The mediating role of parent–child relations," Children and Youth Services Review, Elsevier, vol. 157(C).
    15. Roth, Paula, 2020. "Inequality, Relative Deprivation and Financial Distress: Evidence from Swedish Register Data," Working Paper Series 1374, Research Institute of Industrial Economics.
    16. Guillem López-Casasnovas & Marc Saez, 2020. "Saved by Wealth? Income, Wealth, and Self-Perceived Health in Spain during the Financial Crisis," IJERPH, MDPI, vol. 17(19), pages 1-20, September.
    17. Hiilamo, Aapo, 2020. "Debt matters? Mental wellbeing of older adults with household debt in England," LSE Research Online Documents on Economics 106507, London School of Economics and Political Science, LSE Library.
    18. Jiajing Li & Chen Jiao & Stephen Nicholas & Jian Wang & Gong Chen & Jinghua Chang, 2020. "Impact of Medical Debt on the Financial Welfare of Middle- and Low-Income Families across China," IJERPH, MDPI, vol. 17(12), pages 1-13, June.
    19. Sachin J Shah & Harlan M Krumholz & Kimberly J Reid & Saif S Rathore & Aditya Mandawat & John A Spertus & Joseph S Ross, 2012. "Financial Stress and Outcomes after Acute Myocardial Infarction," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-10, October.
    20. Hoke, Morgan K. & Boen, Courtney E., 2021. "The health impacts of eviction: Evidence from the national longitudinal study of adolescent to adult health," Social Science & Medicine, Elsevier, vol. 273(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0232716. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.