Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/130265
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Type: | Journal article |
Title: | Financial stress and outcomes after acute myocardial infarction |
Author: | Shah, S.J. Krumholz, H.M. Reid, K.J. Rathore, S.S. Mandawat, A. Spertus, J.A. Ross, J.S. |
Citation: | PLoS One, 2012; 7(10):e47420-1-e47420-10 |
Publisher: | Public Library Science |
Issue Date: | 2012 |
ISSN: | 1932-6203 1932-6203 |
Editor: | Fielding, R. |
Statement of Responsibility: | Sachin J. Shah, Harlan M. Krumholz, Kimberly J. Reid, Saif S. Rathore, Aditya Mandawat, John A. Spertus, Joseph S. Ross |
Abstract: | Little is known about the association between financial stress and health care outcomes. Our objective was to examine the association between self-reported financial stress during initial hospitalization and long-term outcomes after acute myocardial infarction (AMI).We used prospective registry evaluating myocardial infarction: Event and Recovery (PREMIER) data, an observational, multicenter US study of AMI patients discharged between January 2003 and June 2004. Primary outcomes were disease-specific and generic health status outcomes at 1 year (symptoms, function, and quality of life (QoL)), assessed by the Seattle Angina Questionnaire [SAQ] and Short Form [SF]-12. Secondary outcomes included 1-year rehospitalization and 4-year mortality. Hierarchical regression models accounted for patient socio-demographic, clinical, and quality of care characteristics, and access and barriers to care.Among 2344 AMI patients, 1241 (52.9%) reported no financial stress, 735 (31.4%) reported low financial stress, and 368 (15.7%) reported high financial stress. When comparing individuals reporting low financial stress to no financial stress, there were no significant differences in post-AMI outcomes. In contrast, individuals reporting high financial stress were more likely to have worse physical health (SF-12 PCS mean difference -3.24, 95% Confidence Interval [CI]: -4.82, -1.66), mental health (SF-12 MCS mean difference: -2.44, 95% CI: -3.83, -1.05), disease-specific QoL (SAQ QoL mean difference: -6.99, 95% CI: -9.59, -4.40), and be experiencing angina (SAQ Angina Relative Risk = 1.66, 95%CI: 1.19, 2.32) at 1 year post-AMI. While 1-year readmission rates were increased (Hazard Ratio = 1.50; 95%CI: 1.20, 1.86), 4-year mortality was no different.High financial stress is common and an important risk factor for worse long-term outcomes post-AMI, independent of access and barriers to care. |
Keywords: | Humans Myocardial Infarction Treatment Outcome Hospitalization Registries Risk Factors Prospective Studies Stress, Psychological Quality of Life Adult Aged Middle Aged Income Female Male Surveys and Questionnaires |
Rights: | © 2012 Shah et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
DOI: | 10.1371/journal.pone.0047420 |
Published version: | http://dx.doi.org/10.1371/journal.pone.0047420 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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