Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study
Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unkno...
Ausführliche Beschreibung
Autor*in: |
Govier, Diana J. [verfasserIn] Bui, David P. [verfasserIn] Hauschildt, Katrina E. [verfasserIn] Eaton, Tammy L. [verfasserIn] McCready, Holly [verfasserIn] Smith, Valerie A. [verfasserIn] Osborne, Thomas F. [verfasserIn] Bowling, C. Barrett [verfasserIn] Boyko, Edward J. [verfasserIn] Ioannou, George N. [verfasserIn] Maciejewski, Matthew L. [verfasserIn] O’Hare, Ann M. [verfasserIn] Viglianti, Elizabeth M. [verfasserIn] Bohnert, Amy S. B. [verfasserIn] Hynes, Denise M. [verfasserIn] Iwashyna, Theodore J. [verfasserIn] |
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E-Artikel |
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Englisch |
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2024 |
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Anmerkung: |
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 |
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Übergeordnetes Werk: |
Enthalten in: BMC health services research - BioMed Central, 2001, 24(2024), 1 vom: 19. Aug. |
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Übergeordnetes Werk: |
volume:24 ; year:2024 ; number:1 ; day:19 ; month:08 |
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DOI / URN: |
10.1186/s12913-024-11421-1 |
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Katalog-ID: |
SPR057018316 |
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245 | 1 | 0 | |a Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study |
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520 | |a Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. | ||
650 | 4 | |a COVID-19 |7 (dpeaa)DE-He213 | |
650 | 4 | |a SARS-CoV-2 |7 (dpeaa)DE-He213 | |
650 | 4 | |a Financial hardship |7 (dpeaa)DE-He213 | |
650 | 4 | |a Veterans |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cohort study |7 (dpeaa)DE-He213 | |
650 | 4 | |a Survey |7 (dpeaa)DE-He213 | |
650 | 4 | |a Emulated target trial |7 (dpeaa)DE-He213 | |
700 | 1 | |a Bui, David P. |e verfasserin |4 aut | |
700 | 1 | |a Hauschildt, Katrina E. |e verfasserin |4 aut | |
700 | 1 | |a Eaton, Tammy L. |e verfasserin |4 aut | |
700 | 1 | |a McCready, Holly |e verfasserin |4 aut | |
700 | 1 | |a Smith, Valerie A. |e verfasserin |4 aut | |
700 | 1 | |a Osborne, Thomas F. |e verfasserin |4 aut | |
700 | 1 | |a Bowling, C. Barrett |e verfasserin |4 aut | |
700 | 1 | |a Boyko, Edward J. |e verfasserin |4 aut | |
700 | 1 | |a Ioannou, George N. |e verfasserin |4 aut | |
700 | 1 | |a Maciejewski, Matthew L. |e verfasserin |4 aut | |
700 | 1 | |a O’Hare, Ann M. |e verfasserin |4 aut | |
700 | 1 | |a Viglianti, Elizabeth M. |e verfasserin |4 aut | |
700 | 1 | |a Bohnert, Amy S. B. |e verfasserin |4 aut | |
700 | 1 | |a Hynes, Denise M. |e verfasserin |4 aut | |
700 | 1 | |a Iwashyna, Theodore J. |e verfasserin |4 aut | |
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10.1186/s12913-024-11421-1 doi (DE-627)SPR057018316 (SPR)s12913-024-11421-1-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Govier, Diana J. verfasserin aut Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Financial hardship (dpeaa)DE-He213 Veterans (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Survey (dpeaa)DE-He213 Emulated target trial (dpeaa)DE-He213 Bui, David P. verfasserin aut Hauschildt, Katrina E. verfasserin aut Eaton, Tammy L. verfasserin aut McCready, Holly verfasserin aut Smith, Valerie A. verfasserin aut Osborne, Thomas F. verfasserin aut Bowling, C. Barrett verfasserin aut Boyko, Edward J. verfasserin aut Ioannou, George N. verfasserin aut Maciejewski, Matthew L. verfasserin aut O’Hare, Ann M. verfasserin aut Viglianti, Elizabeth M. verfasserin aut Bohnert, Amy S. B. verfasserin aut Hynes, Denise M. verfasserin aut Iwashyna, Theodore J. verfasserin aut Enthalten in BMC health services research BioMed Central, 2001 24(2024), 1 vom: 19. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:24 year:2024 number:1 day:19 month:08 https://dx.doi.org/10.1186/s12913-024-11421-1 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 19 08 |
spelling |
10.1186/s12913-024-11421-1 doi (DE-627)SPR057018316 (SPR)s12913-024-11421-1-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Govier, Diana J. verfasserin aut Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Financial hardship (dpeaa)DE-He213 Veterans (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Survey (dpeaa)DE-He213 Emulated target trial (dpeaa)DE-He213 Bui, David P. verfasserin aut Hauschildt, Katrina E. verfasserin aut Eaton, Tammy L. verfasserin aut McCready, Holly verfasserin aut Smith, Valerie A. verfasserin aut Osborne, Thomas F. verfasserin aut Bowling, C. Barrett verfasserin aut Boyko, Edward J. verfasserin aut Ioannou, George N. verfasserin aut Maciejewski, Matthew L. verfasserin aut O’Hare, Ann M. verfasserin aut Viglianti, Elizabeth M. verfasserin aut Bohnert, Amy S. B. verfasserin aut Hynes, Denise M. verfasserin aut Iwashyna, Theodore J. verfasserin aut Enthalten in BMC health services research BioMed Central, 2001 24(2024), 1 vom: 19. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:24 year:2024 number:1 day:19 month:08 https://dx.doi.org/10.1186/s12913-024-11421-1 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 19 08 |
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10.1186/s12913-024-11421-1 doi (DE-627)SPR057018316 (SPR)s12913-024-11421-1-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Govier, Diana J. verfasserin aut Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Financial hardship (dpeaa)DE-He213 Veterans (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Survey (dpeaa)DE-He213 Emulated target trial (dpeaa)DE-He213 Bui, David P. verfasserin aut Hauschildt, Katrina E. verfasserin aut Eaton, Tammy L. verfasserin aut McCready, Holly verfasserin aut Smith, Valerie A. verfasserin aut Osborne, Thomas F. verfasserin aut Bowling, C. Barrett verfasserin aut Boyko, Edward J. verfasserin aut Ioannou, George N. verfasserin aut Maciejewski, Matthew L. verfasserin aut O’Hare, Ann M. verfasserin aut Viglianti, Elizabeth M. verfasserin aut Bohnert, Amy S. B. verfasserin aut Hynes, Denise M. verfasserin aut Iwashyna, Theodore J. verfasserin aut Enthalten in BMC health services research BioMed Central, 2001 24(2024), 1 vom: 19. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:24 year:2024 number:1 day:19 month:08 https://dx.doi.org/10.1186/s12913-024-11421-1 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 19 08 |
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10.1186/s12913-024-11421-1 doi (DE-627)SPR057018316 (SPR)s12913-024-11421-1-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Govier, Diana J. verfasserin aut Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Financial hardship (dpeaa)DE-He213 Veterans (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Survey (dpeaa)DE-He213 Emulated target trial (dpeaa)DE-He213 Bui, David P. verfasserin aut Hauschildt, Katrina E. verfasserin aut Eaton, Tammy L. verfasserin aut McCready, Holly verfasserin aut Smith, Valerie A. verfasserin aut Osborne, Thomas F. verfasserin aut Bowling, C. Barrett verfasserin aut Boyko, Edward J. verfasserin aut Ioannou, George N. verfasserin aut Maciejewski, Matthew L. verfasserin aut O’Hare, Ann M. verfasserin aut Viglianti, Elizabeth M. verfasserin aut Bohnert, Amy S. B. verfasserin aut Hynes, Denise M. verfasserin aut Iwashyna, Theodore J. verfasserin aut Enthalten in BMC health services research BioMed Central, 2001 24(2024), 1 vom: 19. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:24 year:2024 number:1 day:19 month:08 https://dx.doi.org/10.1186/s12913-024-11421-1 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 19 08 |
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10.1186/s12913-024-11421-1 doi (DE-627)SPR057018316 (SPR)s12913-024-11421-1-e DE-627 ger DE-627 rakwb eng 610 VZ 44.00 bkl Govier, Diana J. verfasserin aut Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Financial hardship (dpeaa)DE-He213 Veterans (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Survey (dpeaa)DE-He213 Emulated target trial (dpeaa)DE-He213 Bui, David P. verfasserin aut Hauschildt, Katrina E. verfasserin aut Eaton, Tammy L. verfasserin aut McCready, Holly verfasserin aut Smith, Valerie A. verfasserin aut Osborne, Thomas F. verfasserin aut Bowling, C. Barrett verfasserin aut Boyko, Edward J. verfasserin aut Ioannou, George N. verfasserin aut Maciejewski, Matthew L. verfasserin aut O’Hare, Ann M. verfasserin aut Viglianti, Elizabeth M. verfasserin aut Bohnert, Amy S. B. verfasserin aut Hynes, Denise M. verfasserin aut Iwashyna, Theodore J. verfasserin aut Enthalten in BMC health services research BioMed Central, 2001 24(2024), 1 vom: 19. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:24 year:2024 number:1 day:19 month:08 https://dx.doi.org/10.1186/s12913-024-11421-1 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 VZ AR 24 2024 1 19 08 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">SPR057018316</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240820064727.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240820s2024 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12913-024-11421-1</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR057018316</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12913-024-11421-1-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.00</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Govier, Diana J.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2024</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. 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Govier, Diana J. ddc 610 bkl 44.00 misc COVID-19 misc SARS-CoV-2 misc Financial hardship misc Veterans misc Cohort study misc Survey misc Emulated target trial Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study |
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610 VZ 44.00 bkl Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study COVID-19 (dpeaa)DE-He213 SARS-CoV-2 (dpeaa)DE-He213 Financial hardship (dpeaa)DE-He213 Veterans (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Survey (dpeaa)DE-He213 Emulated target trial (dpeaa)DE-He213 |
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Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study |
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Govier, Diana J. Bui, David P. Hauschildt, Katrina E. Eaton, Tammy L. McCready, Holly Smith, Valerie A. Osborne, Thomas F. Bowling, C. Barrett Boyko, Edward J. Ioannou, George N. Maciejewski, Matthew L. O’Hare, Ann M. Viglianti, Elizabeth M. Bohnert, Amy S. B. Hynes, Denise M. Iwashyna, Theodore J. |
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financial hardship after covid-19 infection among us veterans: a national prospective cohort study |
title_auth |
Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study |
abstract |
Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 |
abstractGer |
Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 |
abstract_unstemmed |
Background Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. Trial registration NCT05394025, registered 05–27-2022. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024 |
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Bui, David P. Hauschildt, Katrina E. Eaton, Tammy L. McCready, Holly Smith, Valerie A. Osborne, Thomas F. Bowling, C. Barrett Boyko, Edward J. Ioannou, George N. Maciejewski, Matthew L. O’Hare, Ann M. Viglianti, Elizabeth M. Bohnert, Amy S. B. Hynes, Denise M. Iwashyna, Theodore J. |
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Whether COVID-19 is associated with financial hardship in the longer-term or among socially vulnerable populations is unknown. Therefore, we examined whether COVID-19 was associated with a range of financial hardships 18 months after initial infection among a national cohort of Veterans enrolled in the Veterans Health Administration (VHA)—the largest national integrated health system in the US. We additionally explored the association between Veteran characteristics and financial hardship during the pandemic, irrespective of COVID-19. Methods We conducted a prospective, telephone-based survey. Out of 600 Veterans with COVID-19 from October 2020 through April 2021 who were invited to participate, 194 Veterans with COVID-19 and 194 matched comparators without a history of infection participated. Financial hardship outcomes included overall health-related financial strain, two behavioral financial hardships (e.g., taking less medication than prescribed due to cost), and seven material financial hardships (e.g., using up most or all savings). Weighted generalized estimating equations were used to estimate risk ratios (RR) and 95% confidence intervals (CI) of financial hardship by COVID-19 status, and to assess the relationship between infection and Veteran age, VHA copay status, and comorbidity score, irrespective of COVID-19 status. Results Among 388 respondents, 67% reported at least one type of financial hardship since March 2020, with 21% reporting behavioral hardships and 64% material hardships; 8% reported severe-to-extreme health-related financial strain. Compared with uninfected matched comparators, Veterans with a history of COVID-19 had greater risks of severe-to-extreme health-related financial strain (RR: 4.0, CI: 1.4–11.2), taking less medication due to cost (RR: 2.9, 95% CI: 1.0–8.6), and having a loved one take time off work to care for them (RR: 1.9, CI: 1.1–3.6). Irrespective of COVID-19 status, Veterans aged < 65 years had a greater risk of most financial hardships compared with Veterans aged ≥ 65 years. Conclusions Health-related financial hardships such as taking less medication due to cost and severe-to-extreme health-related financial strain were more common among Veterans with a history of COVID-19 than among matched comparators. Strategies are needed to address health-related financial hardship after COVID-19. 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