Risk of Burdensome Health Care Spending Over Time in the US

How does the risk of incurring burdensome health care spending accrue over time for individuals in the US?In this cohort study, analysis of 4-year longitudinal national survey data including 12 645 individuals, risk of burdensome out-of-pocket (OOP) costs for individuals in the US rose year after year: while 6.5% of adults experience cost burdens after 1 year, 17.4% experienced cost burdens over 4 years. Lower income, lack of insurance, hospitalizations, chronic disease, and death were each associated with higher risks of facing heavy cost burdens.The US health care system imposes OOP cost burdens on a much higher share of the population than suggested by cross-sectional analyses; policies that reduce such costs could improve the well-being of individuals in the US.

Corresponding Author: Adam Gaffney, MD, MPH, 1493 Cambridge St, Cambridge, MA 02139 (agaffney@challiance.org).

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