Experiences of Financial Stress and Supports in Caregivers During Pediatric Hospital Admission

Author:

Nadarajah Ajantha1,Lazor Tanya23,Meserve Allison4,Buchanan Francine5,Birken Catherine256,van den Heuvel Meta256

Affiliation:

1. aFaculty of Medicine

2. bDepartment of Paediatrics, University of Toronto, Toronto, Canada

3. cDepartment of Social Work

4. dProsper Canada, Toronto, Canada

5. eDivision of Paediatrics

6. fChild Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada

Abstract

BACKGROUND AND OBJECTIVE In Canada and the United States, ∼1 in 5 children live in poverty, contributing to poor health outcomes. Families with children with chronic illness may experience additional financial stress related to hospitalization. This study aimed to capture experiences of financial needs and supports among caregivers with a child admitted to a tertiary care pediatric hospital to inform hospital-based financial services to reduce financial stress in families. METHODS We recruited caregivers of children admitted to the general inpatient ward of an academic pediatric center using purposive sampling with no exclusion criteria. Individual, semistructured, in-depth interviews with participants were conducted. Data collected included socio-demographics, financial needs, and experiences with financial supports. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed on NVivo software using a modified-grounded theory approach and summative content analysis. RESULTS Fifteen caregivers of diverse backgrounds were interviewed, including non-English speakers (n = 4). Three themes and associated subthemes (in parentheses) were identified: (1) financial stress expressed by participants (acute admission-related and chronic financial stress), (2) challenges associated with accessing and utilizing financial supports (caregiver factors, systemic hospital factors, and systemic government factors), and (3) ideas for financial services at the pediatric hospital (services that will provide acute- and chronic financial assistance including education about financial supports and benefits). CONCLUSIONS Our study highlighted acute and chronic financial needs as well as challenges in accessing financial support. Participants were interested in the healthcare system gaining a comprehensive understanding of their financial circumstances and accessing financial services in a hospital setting.

Publisher

American Academy of Pediatrics (AAP)

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