Financial Burden in Adults With Chronic Illness in Switzerland: A Secondary Analysis of Qualitative Interviews Using Natural Language Processing and Topic Modeling

Abstract

Background Chronic illness may cause a financial burden that affects patients, their caregivers, and families. While international research, mostly from the United States, has largely focused on cancer-related financial hardship, less is known about whether financial distress due to other chronic illnesses exists, specifically in countries that have universal health insurance coverage, such as Switzerland. Objective This study aims to provide insights into how financial burden is discussed by individuals living with chronic illness in Switzerland. Methods Based on a natural language processing (NLP) approach, alongside topic modeling, a secondary analysis of 180 qualitative interviews of individuals living with chronic illness (dementia, chronic pain, multiple sclerosis, Parkinson disease, and rare diseases) from the Swiss Database of Individual Patient Experiences was conducted. Results Key categories identified were money issues, disability insurance, general insurance concerns, and work and loss of income. Individuals living with dementia and Parkinson disease appear to be more concerned with money issues, whereas people living with chronic pain, multiple sclerosis, and rare diseases are more burdened by insurance-related concerns, specifically disability insurance-related challenges. Bureaucratic hurdles and employment instability appear to contribute to the financial burden of people living with chronic illness in Switzerland. Conclusions Financial burden is a complex issue among individuals living with chronic illness in Switzerland. Our findings indicate that effectively addressing this burden requires a comprehensive and context-sensitive strategy. Targeted interventions should consider factors such as insurance eligibility, employment flexibility, and the mitigation of out-of-pocket costs to improve financial stability and quality of life for affected individuals.