FINANCIAL challenges faced by family surrogate decision-makers of stroke patients were highlighted in a new study that revealed that nearly half experience moderate to severe concerns about affording stroke-related medical expenses. This mixed-methods study, conducted in Nueces County, Texas, aimed to explore the prevalence, predictors, and nature of these cost concerns among a largely biethnic population.
The study involved 318 family members of 256 stroke patients, with patients averaging 75 years of age and predominantly female (52%). The ethnic composition included 58% Mexican American (MA) and 38% non-Hispanic White (NHW) individuals. Family members were primarily female (76%), with 63% identifying as MA and 32% as NHW, and an average age of 56.
Findings indicated that 46% of the patients had a family member who was either “very worried” or “moderately worried” about managing stroke-related medical costs. After adjusting for various covariates, two significant predictors of heightened cost concerns emerged:
Mexican American Ethnicity: Family members identifying as MA were more likely to express financial worries.
Lack of Insurance: Families without adequate insurance coverage faced greater financial apprehension.
Over time, these cost concerns showed a decreasing trend and were less prevalent among family members who were neither spouses nor children of the patients. Through semistructured interviews, researchers discovered that worries about postacute care expenses were most frequently mentioned. However, concerns regarding hospital costs and nonmedical expenses, such as transportation and lost wages, were also common.
This study underscores the substantial financial burden that stroke-related medical expenses can impose on families, particularly among historically marginalized ethnic groups and those lacking sufficient insurance coverage. The findings highlight the need for healthcare professionals to be cognizant of these financial stressors when discussing treatment options and discharge planning with patients and their families.
Addressing these concerns may involve connecting families with financial counseling services, exploring insurance options, and providing information on community resources. By proactively engaging in these discussions, healthcare providers can help alleviate some of the financial anxieties that accompany the already challenging journey of stroke recovery.
Reference: Becker CJ et al. Financial Concerns Are Common Among Family Surrogate Decision-Makers of Patients With Stroke. Neurol Clin Pract. 2025;15(2):e1-e8.
Anaya Malik | AMJ
