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Comment & Response
January 2017

A Perspective on Out-of-Pocket Spending—Reply

Author Affiliations
  • 1University of Michigan, Ann Arbor
JAMA Intern Med. 2017;177(1):140. doi:10.1001/jamainternmed.2016.7717

In Reply We thank Drs Frost and Barrett for their thoughtful commentary and for highlighting the broader context of our Original Investigation.1 Understanding the out-of-pocket spending associated with inpatient hospitalizations is critical. The costs associated with such care can be high and, as Drs Frost and Barrett note, patients are often unable to shop around for less costly hospital care. With average out-of-pocket spending of over $1000 per hospitalization, these visits may have a substantial financial impact on patients.1 Our findings are particularly striking when you consider that a May 2016 Federal Reserve survey2 found that 46% of Americans would have difficulty paying an emergency expense of $400 or more.

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