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Health and Health Care Utilization Effects of Medical Debt Forgiveness

28. april 2026 opdateret af: Wesley Yin, University of California, Los Angeles
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.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

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.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

15008

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • California
      • Los Angeles, California, Forenede Stater, 90095
        • Wesley Yin

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

The study population is a probability sample drawn from population of individuals who owe medical debt held by FFAM, a debt collection agency.

Beskrivelse

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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Treatment
Subjects in this "treatment" group had their medical debt forgiven by a non-profit charity, RIP Medical Debt. This protocol will administer a survey to measure subjects' health care utilization, mental health, and subjective well-being.
Andet: Medical debt forgiveness
A non-profit charity, RIP Medical Debt, bought and retired medical debt for individuals that were assigned to the treatment group.
Control
No intervention was given to subjects in this "control" group. This protocol will administer a survey to measure subjects' health care utilization, mental health, and subjective well-being.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
8-item Patient Health Questionnaire (PHQ-8) Depression Scale
Tidsramme: An average of 12 months after the intervention.
Scores on the 8-item Patient Health Questionnaire depression scale range from 0 to 24, with higher scores indicating greater severity of depression.
An average of 12 months after the intervention.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Received Needed Health Care
Tidsramme: An average of 12 months after the intervention.
Binary response to: "If you needed medical care in the last 12 months, did you get ALL the medical care you needed?" (Health Care Utilization domain)
An average of 12 months after the intervention.
Received Needed Rx
Tidsramme: An average of 12 months after the intervention.
Binary response to: "If you needed prescription medications in the last 12 months, did you get all the prescription medications you needed?" (Health Care Utilization domain)
An average of 12 months after the intervention.
7-item Generalized Anxiety Disorder (GAD7) Scale
Tidsramme: An average of 12 months after the intervention.
Scores on the 7-item Generalized Anxiety Disorder Scale range from 0 to 21, with higher scores indicating greater severity of anxiety (Mental Health Domain).
An average of 12 months after the intervention.
Stress
Tidsramme: An average of 12 months after the intervention.
Binary response to: "Stress means a situation in which a person feels tense, restless, nervous or anxious or is unable to sleep at night because his/her mind is troubled all the time. Do you feel this kind of stress these days?" (Mental Health Domain)
An average of 12 months after the intervention.
General Health
Tidsramme: An average of 12 months after the intervention.
Response to: "In general, would you say your health is: Excellent, Very Good, Good, Fair, or Poor?" (General Health Domain)
An average of 12 months after the intervention.
Happiness
Tidsramme: An average of 12 months after the intervention.
Response to: "Taken all together, how would you say things are these days - would you say that you are Very Happy, Pretty Happy, or Not Too Happy?" (Subjective Wellbeing Domain)
An average of 12 months after the intervention.
Problems paying other bills
Tidsramme: An average of 12 months after the intervention.
Response to: "Besides medical bills, have you had problems paying other types of bills in the past 12 months?" (Financial Stress Domain)
An average of 12 months after the intervention.
Changes in spending due to medical debt
Tidsramme: An average of 12 months after the intervention.
Indexed response to: "As a result of medical bills have you cut back on spending in the past 12 months on i) basic necessities (like food, heat or housing, or other basic household items), ii) Big-ticket items (like cars, furniture, or appliances); iii) business investments?" (Financial Stress Domain)
An average of 12 months after the intervention.
Changes in borrowing due to medical debt
Tidsramme: An average of 12 months after the intervention.
Indexed response to: "As a result of medical bills, in the past 12 months, have you i) Increased your credit card debt, or charge card debt? ii) Borrowed money from a payday lender?; iii) Borrowed from friends and family?; iv) Used up all or most of your savings?; v) Increased debt on other lines of credit?" (Financial Stress Domain)
An average of 12 months after the intervention.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of California, Los Angeles

Samarbejdspartnere

National Institutes of Health (NIH)
Stanford University
Abdul Latif Jameel Poverty Action Lab
National Opinion Research Center

Efterforskere

  • Ledende efterforsker: Wesley Yin, PhD, University of California, Los Angeles

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

9. november 2020

Primær færdiggørelse (Faktiske)

31. december 2021

Studieafslutning (Faktiske)

31. december 2021

Datoer for studieregistrering

Først indsendt

27. marts 2021

Først indsendt, der opfyldte QC-kriterier

4. april 2021

Først opslået (Faktiske)

8. april 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

30. april 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

28. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IRB#20-001700

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

We will make de-identified and restricted data available to the research community through portals such as the publicly accessible Inter-University Consortium for Political and Social Research (hosted by the University of Michigan). We will preserve the confidentiality of study participants and protect personal health information by stripping the data of personally identifying information and purging it of all personal health information, and any information that is sufficiently fine so that it could identify individuals. We will follow standard protocols, such as converting specific dates to relative dates or date intervals, and aggregating small cells. This will allow us to maximize the data available to researchers while strictly preserving confidentiality and privacy.

IPD-delingstidsramme

De-identified and confidential IPD will be made available by the on-line publication date of published research.

IPD-delingsadgangskriterier

Access will be limited to researchers for non-commercial uses. Users will also need to certify that no attempt will be made to re-identify participants from the de-identified data.

IPD-deling Understøttende informationstype

  • SAP
  • ICF
  • ANALYTIC_CODE

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Betingelser

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