Worrying About Health Costs Raises Death Rate

'Burdened' attitude toward money linked to poorer outcomes in heart patients

MONDAY, May 17, 2004 (HealthDayNews) -- Worrying about the cost of medical care appears to increase the risk of dying after a cardiac procedure, a study finds.

People who answered "yes" when asked, "Have your medical costs been an economic burden over the past year?" were much more likely to die in the 12 months after angioplasty to open heart arteries or bypass surgery, said a May 16 report at an American Heart Association scientific forum in Washington, D.C.

There have been "lots of other studies" showing that money and socioeconomic status have a strong influence on medical results, said report presenter Carole J. Decker, project manager of cardiovascular outcomes at the Mid America Heart Institute of Saint Luke's Hospital in Kansas City, Mo.

But this is the first study to ask the question about a patient's attitude toward medical costs, she said.

More than a quarter of the 2,097 patients asked the question described themselves as "slightly" to "severely" burdened, Decker said.

The one-year death rate for those people was 5.9 percent, compared to 3.5 percent for those who described themselves as unburdened, she said.

There was the inevitable correlation between economic status and poor outcomes that has been found in many other studies, Decker said, but also some surprises.

"For the most part, patients who had lower incomes reported themselves as burdened," she said. "But one patient had an income over $100,000 a year and said his medical costs were a burden."

Another part of the study not reported at the meeting found generally poorer outcomes in terms of frequency of symptoms and self-reported physical limitations among patients who described themselves as worried about medical costs, Decker said.

A next step in the study will be to get a clearer picture of the link between attitude toward medical costs and health, she said. Perhaps worries about money prevented people from seeking medical care or from taking medications they needed, she noted. Overall, the patients with money worries were in poorer health and more likely to have conditions such as diabetes, congestive heart failure and high blood pressure.

More studies at other hospitals are needed to verify the results, Decker added. If the relationship holds up, it could help identify patients who need special help, such as social services or more aggressive action by their doctors.

"We also need to better understand what the actual burden is," she said. "Is it medication, transportation to health care, time away from work? Only then can society take steps to decrease the burden and possibly impact these patients survival."

More information

A government report about socioeconomic effects on medicine is available from the U.S. Department of Health and Human Services. Meanwhile, the American Heart Association has several pages on a healthier heart lifestyle.

SOURCES: Carole J. Decker, R.N., Ph.D., project manager, cardiovascular outcomes, Mid America Heart Institute, Saint Luke's Hospital, Kansas City, Mo.; May 16, 2004, presentation, American Heart Association annual scientific forum, Washington, D.C.
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