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This study investigates the association between overall nonmedical out-of-pocket expenses (NOPEs), their components, and perceived financial distress among families with children facing a pediatric critical illness. A single-site cross-sectional caregiver survey (September 2021–August 2022) was analyzed using ordinal logistic regression.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/association-of-financial-distress-with-nonmedical-out-of-pocket-expenses-in-those-with-critical-illness/563901/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/association-of-financial-distress-with-nonmedical-out-of-pocket-expenses-in-those-with-critical-illness/563901.png","ImageObject",300,407,{"name":92,"@type":93},"Ivy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-19","2026-10-12",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What is the study’s main objective?","Question",{"text":112,"@type":113},"To examine the association between overall nonmedical out-of-pocket expenses (NOPEs), their components, and perceived financial distress in families with children who have a critical illness.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were nonmedical out-of-pocket expenses (NOPEs) defined and measured?",{"text":117,"@type":113},"NOPEs included costs of transportation, food, childcare, and housing, reported as proportions of weekly income. Food was also analyzed separately as a NOPE component.",{"name":119,"@type":110,"acceptedAnswer":120},"What statistical method was used to assess the relationship between NOPEs and perceived financial distress?",{"text":121,"@type":113},"Ordinal logistic regression was used to evaluate the relationship between NOPEs (overall and component-level) and perceived financial distress.",{"name":123,"@type":110,"acceptedAnswer":124},"What key findings were reported about perceived financial distress?",{"text":125,"@type":113},"Families reporting high distress spent a much higher proportion of income on NOPEs (including food) than families with average or low distress, with increased odds of financial distress associated with higher NOPE proportions.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},563901,1792392984,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","Author Manuscr ipt Author Manuscr ipt Author Manuscr ipt Author Manuscript  \n\n| | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Hosp Pediatr. Author manuscript; available in PMC 2026 April 21. |\n| --- | --- |\n\nPublished in final edited form as:  \nHosp Pediatr. 2025 November 01; 15(11): 932–941. doi:10.1542/hpeds.2025-008381 .  \nAssociation of Financial Distress With Nonmedical Out-ofPocket Expenses in Those With Critical Illness  \nVidya S. Mahavadi, MD 1 , David Aaby, MS2 , Erin Paquette, MD, JD, MBe3 , Anna Chorniy, PhD4 , Carolyn Foster, MD, MS5 , Denise M. Goodman, MD, MS3  \n1 Division of Critical Care Medicine, Department of Pediatrics, Valley Children’s Hospital, Madera, California  \n2 Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois  \n3 Division of Critical Care Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois  \n4Center for Child Health Services Research, Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York  \n5 Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois  \nAbstract  \nOBJECTIVE: Financial distress related to critical illness worsens clinical outcomes and is affected by objective financial difficulty or subjective perception of financial distress. Sources of financial distress include nonmedical out-of-pocket expenses (NOPEs; eg, food), but their impact on perceived financial distress is poorly understood, especially in pediatric critical care. We examine the association among overall NOPEs, their components, and perceived financial distress in families with children who have a critical illness.  \nMETHODS: This was a single-site cross-sectional survey (conducted from September 2021 to August2022) of caregivers of children admitted to the pediatric intensive care unit (PICU) .  \nPerceived financial condition was measured by the InCharge Financial Distress/Financial Well-  \nAddress correspondence to: Vidya Mahavadi, MD, Division of Pediatric Critical Care Medicine, Valley Children’s Hospital, 9300 Valley Children’s Place, Madera, [CA 93636. vsmahavadi@gmail.com](CA 93636. vsmahavadi@gmail.com).  \nDr Mahavadi conceptualized and designed the study, designed the data collection instruments, collected data, drafted the initial manuscript, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. Mr Aaby carried out the initial and subsequent analyses, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr Paquette conceptualized and designed the study, critically reviewed and revised the manuscript for important intellectual content, and approved the final manuscript as submitted. Dr Chorniy conceptualized and designed the study, critically reviewed and revised the manuscript for important intellectual content, and approved the final manuscript as submitted. Dr Foster conceptualized and designed the study, critically reviewed and revised the manuscript for important intellectual content, and approved the final manuscript as submitted. Dr Goodman conceptualized and designed the study, designed the data collection instruments, collected data, drafted the initial manuscript, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.  \nCONFLICT OF INTEREST DISCLOSURES: Dr Goodman is the associate editor of The Journal of Pediatrics and Elsevier, medical editor of the American Board of Pediatrics Subboard of Pediatric Critical Care Medicine, and editor of a textbook with McGraw-Hill, for which she receives royalties. Dr Paquette is on the editorial board of Pediatric Critical Care Medicine. The other authors have no conflicts of interest t","cbCaihgiae7BwJOA","https://ap.wps.com/l/cbCaihgiae7BwJOA","pdf",403181,17,"English","# Abstract\n## Objective\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What is the study’s main objective?\",\"answer\":\"To examine the association between overall nonmedical out-of-pocket expenses (NOPEs), their components, and perceived financial distress in families with children who have a critical illness.\"},{\"question\":\"How were nonmedical out-of-pocket expenses (NOPEs) defined and measured?\",\"answer\":\"NOPEs included costs of transportation, food, childcare, and housing, reported as proportions of weekly income. Food was also analyzed separately as a NOPE component.\"},{\"question\":\"What statistical method was used to assess the relationship between NOPEs and perceived financial distress?\",\"answer\":\"Ordinal logistic regression was used to evaluate the relationship between NOPEs (overall and component-level) and perceived financial distress.\"},{\"question\":\"What key findings were reported about perceived financial distress?\",\"answer\":\"Families reporting high distress spent a much higher proportion of income on NOPEs (including food) than families with average or low distress, with increased odds of financial distress associated with higher NOPE proportions.\"}]","Association of Financial Distress With Nonmedical Out-ofPocket Expenses in Those With Critical Illness | PDF",1791839195,43]