Financial Issues Affect Post-MI Outcome

Angina, rehospitalization rates higher in patients who report barriers to health care or medication

TUESDAY, March 13 (HealthDay News) -- Myocardial infarction (MI) patients who report financial barriers to health care services or medication have significantly poorer one-year outcomes than those who do not, according to the results of a study published in the March 14 issue of the Journal of the American Medical Association. About 70 percent of patients who report financial barriers have health insurance.

Harlan M. Krumholz, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues surveyed 2,498 patients who were hospitalized for MI, 18.1 percent of whom reported financial barriers to health care services and 12.9 percent of whom reported financial barriers to medication.

After 12 months, more patients who reported financial barriers to medication had angina (34.9 percent) compared to those without financial barriers to medication (17.9 percent). Patients with financial barriers to health care were also more likely to experience all-cause rehospitalization and cardiac rehospitalization (49.3 percent and 25.7 percent, respectively) compared to those who reported no financial barriers to health care (38.1 percent and 17.7 percent, respectively). The researchers also found that patients who reported either type of financial barrier were more likely have a lower quality of life.

"The findings may be helpful to improve risk stratification of patients and to address structural issues in the health care system predisposing certain patients to worse outcomes," the authors write. "This study provides further support for improved needs assessment and discharge planning combined with a mechanism to facilitate implementation of discharge plans."

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