TY - JOUR
T1 - The household economic burden for acute coronary syndrome survivors in Australia
AU - Hyun, Karice K.
AU - Essue, Beverley M.
AU - Woodward, Mark
AU - Jan, Stephen
AU - Brieger, David
AU - Chew, Derek
AU - Nallaiah, Kellie
AU - Howell, Tegwen
AU - Briffa, Tom
AU - Ranasinghe, Isuru
AU - Astley, Carolyn
AU - Redfern, Julie
N1 - Funding Information:
The SNAPSHOT ACS study was supported in part by: The Cardiac Society of Australia and New Zealand (CSANZ), the National Heart Foundation of Australia (NHF), the Agency for Clinical Innovation (NSW), the Victorian Cardiac Clinical Network, the Queensland Cardiac Clinical Network, the Cardiovascular Health Network, Department of Health, WA, Department of Health and its Cardiovascular Health Network, South Australian Health. The study was endorsed by the Australian Commission for Quality and Safety in Health Care and supported with in-kind support from each of the participating hospitals and their respective State and Territory Departments of Health. The follow-up linkage was supported by NSW Cardiovascular Research Network. None of these institutions had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; or decision to submit the article for publication.
Publisher Copyright:
© 2016 The Author(s).
PY - 2016/11/8
Y1 - 2016/11/8
N2 - Background: Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. Methods: Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship. Results: Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614) in Australian dollars was A$258.06 (median: A$126.50) per month. The average spending for medical services was A$120.18 (SD: A$310.35) and medications was A$66.25 (SD: A$80.78). In total, 350 (51 %) of patients reported experiencing economic hardship, 78 (12 %) were unable to pay for medical services and 81 (12 %) could not pay for medication. Younger age (18-59 vs ≥80 years (OR): 1.89), no private health insurance (OR: 2.04), pensioner concession card (OR: 1.80), residing in more disadvantaged area (group 1 vs 5 (OR): 1.77), history of CVD (OR: 1.47) and higher out-of-pocket expenses (group 4 vs 1 (OR): 4.57) were more likely to experience hardship. Conclusion: Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients.
AB - Background: Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. Methods: Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship. Results: Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614) in Australian dollars was A$258.06 (median: A$126.50) per month. The average spending for medical services was A$120.18 (SD: A$310.35) and medications was A$66.25 (SD: A$80.78). In total, 350 (51 %) of patients reported experiencing economic hardship, 78 (12 %) were unable to pay for medical services and 81 (12 %) could not pay for medication. Younger age (18-59 vs ≥80 years (OR): 1.89), no private health insurance (OR: 2.04), pensioner concession card (OR: 1.80), residing in more disadvantaged area (group 1 vs 5 (OR): 1.77), history of CVD (OR: 1.47) and higher out-of-pocket expenses (group 4 vs 1 (OR): 4.57) were more likely to experience hardship. Conclusion: Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients.
KW - Acute coronary syndrome
KW - Financial burden
KW - Household economic hardship
KW - Out-of-pocket expenditure
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U2 - 10.1186/s12913-016-1887-3
DO - 10.1186/s12913-016-1887-3
M3 - Article
C2 - 27825335
AN - SCOPUS:84994651163
VL - 16
SP - 1
EP - 8
JO - BMC Health Services Research
JF - BMC Health Services Research
SN - 1472-6963
IS - 1
M1 - 636
ER -