Abstract
Association between Non-dietary Cardiovascular Health and Health Expenditures related to Acute Coronary Syndrome and Comorbidities in the US between 2008-2018.
APHA 2022 Annual Meeting and Expo
Association between Non-dietary Cardiovascular Health and Health Expenditures related to Acute Coronary Syndrome in the US between 2008-2018.
Abstract
Continuing Education (CE) Credit Objectives:
•Measuring Cardiovascular health scores
•Assessing the relative changes in costs of Acute Coronary Syndrome based on Cardiovascular Health
Background:
Acute coronary syndrome (ACS) causes the most deaths in the United States and accounts for the highest amount of healthcare spending. The relationships between the modifiable cardiovascular risk factors and non-modifiable risk factors (Life’s simple seven) and expenditures related to the acutely ill (ACS) are largely unknown.
Aim:
Considering the substantial economic effects of ACS, the objective of this retrospective study was to analyze the effects of adherence to the American Heart Association’s Life Simple 7 components on health care expenditures in a socioeconomically diverse cohort of patients with and without ACS.
Methods:
We pooled the 10 years of MEPS data from 2008 to 2016, & 2018 using descriptive statistics to summarize frequency distributions with corresponding weighted proportions by ACS vs non-ACS status. Since our sample has both positive and a few negative or zero costs (about 4% of our sample) for some participants, we will use a Two-Part econometric Model. First, we ran a linear probability model to determine the specifications for the first stage of a Two-Part Model. This essentially determined the likelihood of having a positive expenditure, addressing a potential selection effect bias. Then, multivariable regression models contingent on the fact of a non-zero expenditure, while accounting for age, sex, race/ethnicity, level of income, education levels, and Charlson Comorbidity Index will be used to explore the associations of cardiovascular health (CVH) status with log natural of total healthcare expenditures.
Results:
Diabetes mellitus had the most impact on expenditure, followed by hypertension. Inadequate physical activity and having a non-standard body mass index had the least impact on expenditures. Improvements in CVH tend to reduce total health care expenditures to a greater degree percentage-wise among non-ACS subjects compared to ACS groups. Though, subjects with an ACS diagnosis tended to have about twice as big of expenditures as similar subjects without an ACS diagnosis.
Public Health Implications:
These findings will emphasize the role of preventative health care in minimizing ACS risk factors and reducing long-term healthcare spending.
Keywords and Abbreviations:
CVD: Cardiovascular Disease, ACS; Acute coronary syndrome, CVH; Cardiovascular Health.