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Financially burdened patients more likely to die after coronary revascularization

WASHINGTON, D.C., May 16 Heart patients who had angioplasty or bypass surgery and felt burdened by medical costs were more than twice as likely to die within a year of their procedure as patients who didn't have trouble paying for healthcare, according to a study presented today at the American Heart Association's 5th annual Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

Many studies have found an association between socioeconomic status and cardiovascular death, but they had not analyzed how patients' perceptions of economic burden affect cardiovascular survival.

In this study, 2,097 patients undergoing either angioplasty or coronary artery bypass surgery participated in a survey in 1999 to 2000 to examine recovery and health status outcomes, including symptoms, physical function and quality of life, said lead author Carole J. Decker, R.N., Ph.D.

Participants were asked, "Have your medical costs been an economic burden to you over the past year?"

They responded using a five-point scale, and researchers classified patients who said they were "somewhat" to "severely" burdened as "burdened." Those reporting less burden were classified as "non-burdened."

They found that 547 patients (26 percent) perceived themselves as economically burdened. Those who reported feeling burdened tended to be slightly younger -- average age 64.1 years versus 66.5 in the non-burdened group. Thirty-four percent of the burdened group was female, versus 27 percent of the non-burdened group. People in the burdened group were more likely to have received angioplasty versus surgery to unblock arteries, and they also tended to have other diseases such as diabetes, congestive heart failure, high blood pressure, chronic obstructive pulmonary disease (COPD) or a previous heart attack.

The burdened group had a 5.9 percent mortality rate one year later, compared with 3.5 percent for the non-burdened group.

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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
17-May-2004


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