Psychological Distress in Adults With Myocardial Infarction: Implications for Health Care Utilization and Expenditure

Myocardial infarction (MI) poses a major financial burden on the U.S. health care system, but its impact on medical expenses and health care utilization when coupled with psychological distress remains unknown.

The study aims to investigate the association between psychological distress and healthcare utilization and medical expenditures in adults with a history of MI.

We analyzed the 2017-2021 Medical Expenditure Panel Survey to identify 44,716 adults with a history of MI. Psychological distress was measured using the Kessler (K6) questionnaire, with a score of ≥13 indicating clinically significant distress. Differences in medical expenditures and health care utilization between patients with MI with and without psychological distress were assessed using weighted generalized linear and negative binomial regression models. Expenditures, medical visits, and prescribed medications are reported as means and 95% CI.

Among 9,773,458 weighted adults, 970,049 experienced psychological distress. Adults with MI and psychological distress were younger, more likely to be female (51.1% vs 37.5%; P < 0.001), less educated (11.1 vs 12.5 years; P < 0.001), lower income, and were more likely to have public insurance, compared to those without psychological distress. Adults with psychological distress and a history of MI had higher average medical expenses ($31,577 vs $15,830; P < 0.001) and greater health care utilization including office visits (8.3 vs 5.7; P = 0.01), inpatient visits (0.6 vs 0.3; P < 0.001), emergency room visits (0.7 vs 0.3; P < 0.001), and prescribed medications including refills (42.3 vs 28; P < 0.001).

Psychological distress is correlated with increased medical expenditures and health care utilization in patients with MI. This research highlights the need for interventions addressing psychological needs in patients with MI.