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Health care-related transportation insecurity is associated with adverse health outcomes among adults with chronic liver disease.


ABSTRACT:

Background

Health care-related transportation insecurity (delayed or forgone medical care due to transportation barriers) is being increasingly recognized as a social risk factor affecting health outcomes. We estimated the national burden and adverse outcomes of health care-related transportation insecurity among US adults with chronic liver disease (CLD).

Methods

Using the U.S. National Health Interview Survey from 2014 to 2018, we identified adults with self-reported CLD. We used complex weighted survey analysis to obtain national estimates of health care-related transportation insecurity. We examined the associations between health care-related transportation insecurity and health care-related financial insecurity, food insecurity, self-reported health status, work productivity, health care use, and mortality.

Results

Of the 3643 (representing 5.2 million) US adults with CLD, 267 [representing 307,628 (6%; 95% CI: 5%-7%)] reported health care-related transportation insecurity. Adults with CLD experiencing health care-related transportation insecurity had 3.5 times higher odds of cost-related medication nonadherence [aOR, 3.5; (2.4-5.0)], 3.5 times higher odds of food insecurity [aOR, 3.5; (2.4-5.3)], 2.5 times higher odds of worsening self-reported health status over the past year [aOR, 2.5; (1.7-3.7)], 3.1 times higher odds of being unable to work due to poor health over the past year [aOR, 3.1; (2.0-4.9)], and 1.7 times higher odds of being in a higher-risk category group for number of hospitalizations annually [aOR, 1.7; (1.2-2.5)]. Health care-related transportation insecurity was independently associated with mortality after controlling for age, income, insurance status, comorbidity burden, financial insecurity, and food insecurity [aHR, 1.7; (1.4-2.0)].

Conclusions

Health care-related transportation insecurity is a critical social risk factor that is associated with health care-related financial insecurity, food insecurity, poorer self-reported health status and work productivity, and increased health care use and mortality among US adults with CLD. Efforts to screen for and reduce health care-related transportation insecurity are warranted.

SUBMITTER: Ufere NN 

PROVIDER: S-EPMC10786597 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Health care-related transportation insecurity is associated with adverse health outcomes among adults with chronic liver disease.

Ufere Nneka N NN   Lago-Hernandez Carlos C   Alejandro-Soto Alysa A   Walker Tiana T   Li Lucinda L   Schoener Kimberly K   Keegan Eileen E   Gonzalez Carolina C   Bethea Emily E   Singh Siddharth S   El-Jawahri Areej A   Nephew Lauren L   Jones Patricia P   Serper Marina M  

Hepatology communications 20240111 1


<h4>Background</h4>Health care-related transportation insecurity (delayed or forgone medical care due to transportation barriers) is being increasingly recognized as a social risk factor affecting health outcomes. We estimated the national burden and adverse outcomes of health care-related transportation insecurity among US adults with chronic liver disease (CLD).<h4>Methods</h4>Using the U.S. National Health Interview Survey from 2014 to 2018, we identified adults with self-reported CLD. We use  ...[more]

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