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Financial barriers to health care and outcomes after acute myocardial infarction
Ali R Rahimi1, John A Spertus, Kimberly J Reid
1Department of Medicine,Yale University School of Medicine, New Haven, Conn 06520-8088, USA. harlan.krumholz@yale.edu
JAMA
|March 16, 2007
Summary
Financial barriers to health care and medications significantly worsen recovery after acute myocardial infarction (AMI). Patients face more angina, lower quality of life, and increased rehospitalization risks, highlighting a critical gap in post-AMI care.
Area of Science:
- Cardiology
- Health Services Research
- Health Economics
Background:
- Financial barriers to healthcare and medications are prevalent but understudied in acute myocardial infarction (AMI) patients.
- Understanding these barriers is crucial for improving patient outcomes post-AMI.
Purpose of the Study:
- To determine the prevalence of financial barriers to healthcare services and medications in AMI survivors.
- To assess the association between these financial barriers and subsequent healthcare outcomes over 12 months.
Main Methods:
- The Prospective Registry Evaluating Myocardial Infarction: Event and Recovery (PREMIER) study enrolled 2498 patients post-AMI.
- Data collected included self-reported financial barriers, health status (SAQ, SF-12), and rehospitalization rates over 12 months.
Main Results:
- 18.1% reported financial barriers to healthcare services; 12.9% to medications. Many were insured.
- Financial barriers were linked to lower quality of life (SAQ scores) and increased all-cause and cardiac rehospitalization rates at 1-year follow-up.
- Patients with medication barriers also reported more angina, poorer quality of life, and higher rehospitalization rates.
Conclusions:
- Financial barriers to healthcare services and medications negatively impact recovery following acute myocardial infarction.
- These barriers are associated with increased angina, diminished quality of life, and a higher risk of rehospitalization.
- Addressing financial constraints is essential for improving long-term outcomes in AMI patients.
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