Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/130265
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dc.contributor.author | Shah, S.J. | - |
dc.contributor.author | Krumholz, H.M. | - |
dc.contributor.author | Reid, K.J. | - |
dc.contributor.author | Rathore, S.S. | - |
dc.contributor.author | Mandawat, A. | - |
dc.contributor.author | Spertus, J.A. | - |
dc.contributor.author | Ross, J.S. | - |
dc.contributor.editor | Fielding, R. | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | PLoS One, 2012; 7(10):e47420-1-e47420-10 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.uri | http://hdl.handle.net/2440/130265 | - |
dc.description.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. | - |
dc.description.statementofresponsibility | Sachin J. Shah, Harlan M. Krumholz, Kimberly J. Reid, Saif S. Rathore, Aditya Mandawat, John A. Spertus, Joseph S. Ross | - |
dc.language.iso | en | - |
dc.publisher | Public Library Science | - |
dc.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. | - |
dc.source.uri | http://dx.doi.org/10.1371/journal.pone.0047420 | - |
dc.subject | Humans | - |
dc.subject | Myocardial Infarction | - |
dc.subject | Treatment Outcome | - |
dc.subject | Hospitalization | - |
dc.subject | Registries | - |
dc.subject | Risk Factors | - |
dc.subject | Prospective Studies | - |
dc.subject | Stress, Psychological | - |
dc.subject | Quality of Life | - |
dc.subject | Adult | - |
dc.subject | Aged | - |
dc.subject | Middle Aged | - |
dc.subject | Income | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.subject | Surveys and Questionnaires | - |
dc.title | Financial stress and outcomes after acute myocardial infarction | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1371/journal.pone.0047420 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Spertus, J.A. [0000-0002-2839-2611] | - |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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