Heart failure (HF) has become a major public health problem among the elderly. Concern for quality of life (QOL) and health care of heart failure patients is growing. To assess the magnitude of problem with affordability in receiving HF drug treatment and its impact on the patients' QOL, we conducted a 3-month follow-up study among all new outpatients referred to an academic heart failure clinic between 4/97 - 8/99. SF-12 was used to measure QOL. Of 154 patients who completed follow-up, 66% were male; 60% were NYHA class 3-4; median age was 54 yrs. Primary payor was private insurance in 71% patients, Medicare in 25% patients, and Medicaid in 12% patients. After 3 months treatment, 22% of the patients reported having trouble paying for drug treatment; this percentage was 33% in patients with Medicare, 21% with private insurance, and 12% with Medicaid. At baseline, no difference was found in QOL scores between those with and without this financial barrier. At 3 months, however, the patients' mental component scale (MCS) score was significantly lower in those with the financial barrier than those without (43.4 vs 48.0, P=.03), while the physical component scale score was similar between two groups (34.5 vs 33.7, P=.70). The association between MCS score and the financial barrier remained significant after controlling for sex, age, NYHA class, and comorbidity by the multiple linear regression analysis. Our study demonstrates a decreased QOL, independent of disease severity, perceived by heart failure patients who had problem with affordability.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Understand the magnitude of access problem due to affordability of care among patients with heart failure; 2. Recognize the impact of financial barrier to drug treatment on the quality of life among patients with chronic diseases; 3. Evaluate and discuss the current health care financing and delivery system
Keywords: Access to Care, Chronic Diseases
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.