Clinical trial NCT04835012: Health and Health Care Utilization Effects of Medical Debt Forgiveness
Official title: Health and Health Care Utilization Effects of Medical Debt Forgiveness
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Health Care Utilization
Depression
Anxiety
Subjective Wellbeing
Keywords: Health Care Utilization
Mental Health
Depression
Anxiety
Subjective Wellbeing
Medical Debt
Lead sponsor: University of California, Los Angeles
Sponsor class: OTHER
Collaborators: name: Stanford University
name: National Opinion Research Center
name: Abdul Latif Jameel Poverty Action Lab
name: National Institutes of Health (NIH)
First posted: 2021-04-08
Enrollment: 17000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: The study population is a probability sample drawn from population of individuals who owe medical debt held by FFAM, a debt collection agency.

Brief summary: The goal of this study is to estimate the direct, causal impact of medical debt on health care utilization, mental health, and wellbeing of patients. The investigators will conduct a survey to measure the impact of the debt forgiveness on health care use, mental health, and wellbeing. The survey will be administered to approximately 17,000 subjects of a recent medical financial intervention. In that prior intervention, a non-profit charity, RIP Medical Debt, purchased and abolished medical debt for a randomly selected about 6,000 (out of the 17,000) individuals. In this current protocol, the investigators will administer the survey, and will compare surveyed outcomes of subjects who received and did not receive the intervention.

Detailed description: This study will estimate the direct, causal impact of medical debt on health care utilization, mental health, and wellbeing of patients. To do so, the investigators will administer a survey to approximately 17,000 subjects of a recent medical financial intervention. In that intervention, a non-profit charity, RIP Medical Debt, purchased and abolished medical debt for a randomly selected about 6,000 (out of the 17,000) study subjects. In this current protocol, the investigators will compare surveyed outcomes of subjects who received and did not receive the medical debt abolishment intervention. Because debt abolishment was randomized, comparing surveyed outcomes of treated and control subjects in the cross-section will allow the study to estimate the causal impact of the medical debt abolishment. The survey will measure the effects of medical debt on three sets of outcomes: (i) health care utilization, as measured by medical care visits, prescription drug utilization and adherence, and unmet need for medical care; (ii) mental health, as measured by validated screens for depression and anxiety; and (iii) subjective wellbeing, as measured by self-reported health, forgone consumption, and financial strain. This study would be the first to provide a direct, causal connection between the rising personal debt associated with U.S. health care and the health outcomes of its recipients.

Eligibility criteria: Inclusion Criteria:

* Individuals ages 18 and over who owed medical debt to FFAM, a debt collections agency

Exclusion Criteria:

* Excluded individuals who owed less than $500 in medical debt to FFAM
* Excluded individuals with missing social security numbers

Primary outcomes:
measure: 8-item Patient Health Questionnaire (PHQ-8) Depression Scale
timeFrame: An average of 12 months after the intervention.
Secondary outcomes:
measure: Received Needed Health Care
timeFrame: An average of 12 months after the intervention.
measure: Received Needed Rx
timeFrame: An average of 12 months after the intervention.
measure: 7-item Generalized Anxiety Disorder (GAD7) Scale
timeFrame: An average of 12 months after the intervention.
measure: Stress
timeFrame: An average of 12 months after the intervention.
measure: General Health
timeFrame: An average of 12 months after the intervention.
measure: Happiness
timeFrame: An average of 12 months after the intervention.
measure: Problems paying other bills
timeFrame: An average of 12 months after the intervention.
measure: Changes in spending due to medical debt
timeFrame: An average of 12 months after the intervention.
measure: Changes in borrowing due to medical debt
timeFrame: An average of 12 months after the intervention.
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: UCLA IRB
state: California
Study officials:
affiliation: University of California, Los Angeles
name: Wesley Yin, PhD
role: PRINCIPAL_INVESTIGATOR
References: