Table 3.
Adjusted Frequency of Care-Seeking Cost Responses by Subsidy, Income, and Cost-Sharing Levelsa
| Switch to Cheaper Medication | Cost-Related Nonadherence to Drug Treatment Regimen | Delay/Avoid Office Visit | Delay/Avoid ED Visit | |||||
|---|---|---|---|---|---|---|---|---|
| Higher Cost Sharing | Lower Cost Sharing | Higher Cost Sharing | Lower Cost Sharing | Higher Cost Sharing | Lower Cost Sharing | Higher Cost Sharing | Lower Cost Sharing | |
| Public Subsidies | ||||||||
| Medicaid (≤100% of the FPL) | ||||||||
| Adjusted % of participants | NA | 2.4 | NA | 5.6 | NA | 6.9 | NA | 0.4 |
| OR (95% CI) | 0.75 (0.05–11.88) | 0.31 (0.06–1.55) | 0.14 (0.03–0.58) | 0.01 (0.003–0.06) | ||||
| CHIP (101%–250% of the FPL) | ||||||||
| Adjusted % of participants | NA | 2.2 | NA | 9.7 | NA | 8.9 | NA | 4.9 |
| OR (95% CI) | 0.66 (0.04–10.80) | 0.59 (0.17–2.07) | 0.18 (0.05–0.72) | 0.20 (0.04–1.06) | ||||
| Commercially Insured | ||||||||
| ≤250% of the FPL | ||||||||
| Adjusted % of participants | 3.2 | 1.6 | 14.8 | 8.0 | 31.6 | 3.8 | 19.4 | 1.2 |
| OR (95% CI) | 1 [Ref] | 0.50 (0.03–7.38) | 1 [Ref] | 0.47 (0.12–1.80) | 1 [Ref] | 0.07 (0.01–0.39) | 1 [Ref] | 0.05 (0.01–0.25) |
| 250%–400% of the FPL | ||||||||
| Adjusted % of participants | 0.9 | 0.2 | 15.8 | 12.6 | 10.1 | 0.2 | 7.8 | 4.6 |
| OR (95% CI) | 0.34 (0.02–4.95) | 0.06 (0.004–0.99) | 1.12 (0.15–8.65) | 0.81 (0.15–4.33) | 0.21 (0.04–1.21) | 0.003 (0.0003–0.03) | 0.33 (0.05–2.25) | 0.19 (0.02–1.70) |
| >400% of the FPL | ||||||||
| Adjusted % of participants | 7.2 | 2.4 | 7.1 | 8.0 | 6.3 | 5.2 | 6.4 | 2.6 |
| OR (95% CI) | 2.49 (0.22–28.67) | 0.73 (0.29–18.00) | 0.41 (0.09–1.83) | 0.49 (0.11–2.11) | 0.12 (0.02–0.76) | 0.10 (0.03–0.38) | 0.26 (0.05–1.47) | 0.10 (0.02–0.49) |
Abbreviations: CHIP, Children’s Health Insurance Program; ED, emergency department; FPL, federal poverty level; NA, not applicable; OR, odds ratio; Ref, reference.
a
Logistic regression model was adjusted for patient characteristics and weighted for sampling proportions. Boldface values are significantly different from the reference group at P < .05. Medicaid and CHIP income limits are for children and adolescents aged 6 to 18 years.