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Financial burden, distress, and toxicity in cardiovascular disease
Samuel D Slavin1, Rohan Khera2, S Yousuf Zafar3
1Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Insights
Financial distress from cardiovascular disease (CVD) impacts patients psychologically and financially. Reducing this burden requires policy changes, health system adjustments, physician involvement, and community support.
Area of Science:
- Health Economics
- Cardiology
- Public Health Policy
Background:
- Cardiovascular disease (CVD) imposes significant financial burdens and distress on patients.
- This distress manifests in psychological distress, non-adherence to care due to cost, and tradeoffs with essential non-medical needs.
Purpose of the Study:
- To propose actionable strategies for mitigating financial distress among individuals with cardiovascular disease.
- To identify key research areas for further investigation into CVD financial burden.
Main Methods:
- The study outlines a multi-pronged approach involving policy, health system, physician, and community interventions.
- It also suggests research avenues focusing on policy impact, comparative effectiveness, and intervention studies.
Main Results:
- Four key strategies are proposed: expanding insurance coverage, optimizing health system expenditures, promoting shared decision-making, and enhancing community support.
- Research is needed to analyze policy effects, compare cost-effective CVD management, and evaluate interventions for financial burden reduction.
Conclusions:
- Addressing financial distress in CVD necessitates a collaborative effort across policy, healthcare delivery, clinical practice, and community support systems.
- Further research is crucial to develop and implement effective interventions that alleviate the financial impact of cardiovascular disease on patients.
Abstract:
Cardiovascular disease (CVD) is a major source of financial burden and distress, which has 3 main domains: (1) psychological distress; (2) cost-related care non-adherence or medical care deferral, and (3) tradeoffs with basic non-medical needs. We propose 4 ways to reduce financial distress in CVD: (1) policymakers can expand insurance coverage and curtail underinsurance; (2) health systems can limit expenditure on low-benefit, high-cost treatments while developing services for high-risk individuals; (3) physicians can engage in shared-decision-making for high-cost interventions, and (4) community-based initiatives can support patients with system navigation and financial coping. Avenues for research include (1) analysis of how healthcare policies affect financial burden; (2) comparative effectiveness studies examining high and low-cost strategies for CVD management; and (3) studying interventions to reduce financial burden, financial coaching, and community health worker integration.
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