Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income

J Health Care Poor Underserved. 2010 May;21(2):691-703. doi: 10.1353/hpu.0.0309.


Introduction: High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden.

Methods: The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics.

Results: Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios.

Conclusion: Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.

MeSH terms

  • Adult
  • Aged
  • Delivery of Health Care / economics
  • Delivery of Health Care / statistics & numerical data
  • Family*
  • Female
  • Financing, Personal / statistics & numerical data*
  • Health Expenditures / statistics & numerical data*
  • Health Status
  • Health Surveys
  • Humans
  • Income / statistics & numerical data*
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Assessment
  • Rural Population / statistics & numerical data