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A Scoping Review of Behavioral Interventions Addressing Medical Financial Hardship.

Minal R Patel1,2, Reshma Jagsi2,3,4, Kenneth Resnicow1,2

  • 1Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

Population Health Management
|May 14, 2021
PubMed
Summary

Interventions to reduce medical financial hardship show limited success in lowering out-of-pocket costs. While some improvements in behavior and care use were noted, consistent positive effects are lacking.

Keywords:
financial toxicityhealth careinterventionsmedical financial hardship

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Area of Science:

  • Health Services Research
  • Health Economics
  • Qualitative Research

Background:

  • Medical financial hardship is a growing concern in healthcare delivery.
  • Existing interventions to mitigate financial strain lack comprehensive review.
  • Understanding intervention content and outcomes is crucial for effective strategies.

Purpose of the Study:

  • To conduct a systematic scoping review of interventions addressing medical financial hardship.
  • To examine the content, targets, and outcomes of these interventions.
  • To identify gaps and inform future research in this emerging field.

Main Methods:

  • Systematic scoping review following PRISMA guidelines.
  • Searched PubMed, Scopus, and CINAHL (1980-2020) and reviewed reference lists.
  • Included studies focused on mitigating out-of-pocket expenses with evaluation components.

Main Results:

  • Twelve studies met inclusion criteria, revealing variation in intervention targets and outcome measures.
  • No studies reported significant reductions in out-of-pocket expenses or improved health status.
  • Observed positive changes in behavioral outcomes, some psychosocial outcomes, and healthcare utilization.

Conclusions:

  • Few rigorous studies exist on medical financial hardship interventions.
  • Current interventions lack consistent positive effects and require conceptual clarity.
  • Future research needs rigorous designs, aligned outcome measurement, and consensus on outcomes.