Table 3. Association Between No Insurance on Catastrophic Health Spending, Distress Financing, or Both From 2114 ACS QUIK Respondents Who Completed Microeconomic Surveys.
| Model | Catastrophic Health Spending | Distress Financing | Catastrophic Health Spending or Distress Financinga | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Respondents, No./Total No. | RR (95% CI) | Respondents, No./Total No. | RR (95% CI) | Respondents, No./Total No. | RR (95% CI) | ||||
| No Cluster Effect | Study Effectb | No Cluster Effect | Study Effect | No Cluster Effect | Study Effect | ||||
| Unadjustedc | 644/1196 | 1.45 (1.25-1.70) | 1.22 (1.03-1.43) | 171/2114 | 3.11 (1.88-5.16) | 2.80 (1.50-5.22) | 772/1311 | 1.48 (1.28-1.70) | 1.23 (1.06-1.43) |
| Adjusted | |||||||||
| Model 1d | 644/1196 | 1.49 (1.28-1.74) | 1.24 (1.07-1.43) | 171/2114 | 3.14 (1.89-5.21) | 2.87 (1.49-5.54) | 772/1311 | 1.50 (1.31-1.73) | 1.25 (1.09-1.44) |
| Model 2e | 644/1196 | 1.49 (1.28-1.73) | NDf | 170/2112 | 3.36 (1.99-5.67) | 3.05 (1.45-6.44) | 771/1310 | 1.51 (1.31-1.74) | 1.23 (1.11-1.36) |
Abbreviations: ACS QUIK, Acute Coronary Syndrome Quality Improvement in Kerala; ND, not determinable; RR, risk ratio.
Among 918 participants who were missing information to calculate catastrophic health spending, 115 provided a response for distress financing.
Study-level effects included ACS QUIK intervention and a random effect for hospital cluster.
Unadjusted model reference is insurance.
Adjusted model 1 is further adjusted for Global Registry of Acute Coronary Events risk score variables (age, sex, ST-segment elevation myocardial infarction or non–ST-segment elevation myocardial infarction status, systolic blood pressure, and heart rate). In-hospital heart failure, cardiogenic shock, and cardiac arrest were not included owing to collinearity and a small number of events.
Adjusted model 2 is further adjusted for baseline household income.
Binomial regression model did not converge.