Perceived Financial Insecurity Impacts Healthcare Decision-Making Among Patients With Sinusitis

Objectives/Hypothesis: The economic burden of sinusitis is significant, and socioeconomic factors can impact patient decision-making. The purpose of this study was to examine the impact of perceived financial insecurity on healthcare decision-making and treatment compliance among sinusitis patients. Study Design: Cross-sectional study using the 2018 National Health Interview Survey. Methods: Survey responses to nine questions regarding financial stressors and nine questions regarding cost-saving healthcare actions were recorded, which included seeking lower cost medication, medication noncompliance, and avoiding care visits due to costs. Results: There was a total weighted sample size of 28.9 million patients who self-reported a diagnosis of sinusitis (12% of the U.S. population). Sinusitis patients who reported cost-saving actions had an increased severity of perceived financial insecurity than those without cost-saving actions (P <.001). Sinusitis patients with perceived financial insecurity had the highest odds of at least one cost-saving action (odds ratio [OR] = 5.94, 95% CI = 5.911–5.970, P <.001), followed by lack of health insurance (OR = 5.13, 95% CI = 5.107–5.159, P <.001), and poor self-reported health status (OR = 2.81, 95% CI = 2.792–2.822, P <.001). Increasing the number of financial stressors increased the odds of at least one cost-saving action (P <.001). Across all financial stressors, the most commonly performed cost-saving action was asking for lower cost medication. Conclusions: Perceived financial insecurity is associated with cost-saving healthcare actions among sinusitis patients, including treatment noncompliance. Interventions to assess financial insecurity among sinusitis patients may facilitate shared decision-making for optimal, individualized treatment plans that may lead to improved outcomes and quality of life. Level of Evidence: NA Laryngoscope, 131:2403–2412, 2021.