Personal Bankruptcy After Traumatic Brain or Spinal Cord Injury: The Role of Medical Debt |
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Authors: | Annemarie Relyea-Chew William Hollingworth Leighton Chan Bryan A Comstock Karen A Overstreet Jeffrey G Jarvik |
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Institution: | a Department of Radiology, University of Washington, Seattle, WA b Department of Medicine, University of Washington, Seattle, WA c Department of Health Services, University of Washington, Seattle, WA d Department of Neurological Surgery, University of Washington, Seattle, WA e Department of Center for Cost and Outcomes Research, University of Washington, Seattle, WA f Department of Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA g Department of Social Medicine, University of Bristol, Bristol, UK h Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, MD i U.S. Bankruptcy Court, Western District of Washington, Seattle, WA |
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Abstract: | Relyea-Chew A, Hollingworth W, Chan L, Comstock BA, Overstreet KA, Jarvik JG. Personal bankruptcy after traumatic brain or spinal cord injury: the role of medical debt.ObjectiveTo estimate the prevalence of medical debt among traumatic brain injury (TBI) and spinal cord injury (SCI) patients who discharged their debts through bankruptcy.DesignA cross-sectional comparison of bankruptcy filings of injured versus randomly selected bankruptcy petitioners.SettingPatients hospitalized with SCI or TBI (1996-2002) and personal bankruptcy petitioners (2001-2004) in western Washington State.ParticipantsSubjects (N=186) who filed for bankruptcy, comprised of 93 patients with previous SCI or TBI and 93 randomly selected bankruptcy petitioners.InterventionsNot applicable.Main Outcome MeasuresMedical and nonmedical debt, assets, income, expenses, and employment recorded in the bankruptcy petition.ResultsFive percent of randomly selected petitioners and 26% of petitioners with TBI or SCI had substantial medical debt (debt that accounted for more than 20% of all unsecured debts). SCI and TBI petitioners had fewer assets and were more likely to be receiving government income assistance at the time of bankruptcy than controls. SCI and TBI patients with a higher blood alcohol content at injury were more likely to have substantial medical debts (odds ratio=2.70; 95% confidence interval, 1.04-7.00).ConclusionsMedical debt plays an important role in some bankruptcies after TBI or SCI. We discuss policy options for reducing financial distress after serious injury. |
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Keywords: | Brain injuries Health care costs Insurance health Rehabilitation Spinal cord injuries |
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