85% of uninsured patients hospitalised for acute MI face catastrophic costs


Catastrophic health expensesAcute myocardial infarction (MI) and stroke patients without medical insurance in the USA face “devastating” and catastrophic health expenses that can bankrupt them, new research shows. The study by Rohan Khera (University of Texas Southwestern Medical Centre, Dallas, USA) et al was presented at this year’s American Heart Association (AHA) Scientific Sessions (11-15 November, Anaheim, USA) and published in Circulation.

“Many patients with large medical bills may have had to declare bankruptcy, sell their home, and be hounded by medical bill collectors as they struggled to juggle rent or mortgage payments while paying for utilities and food,” said Khera, co-first author of the paper, adding, “Medical expenses are the leading cause of bankruptcy in the United States.”

For uninsured patients hospitalised with acute myocardial infarction (MI), the median cost for their stay totaled US$53,384 in 2012, the study found. Uninsured stroke patients had a median bill of US$31,218.

“These individuals are likely to encounter continued financial difficulties because of missed work, disability, and outpatient healthcare needs, putting them at risk for financial catastrophe, including bankruptcy”, Khera et al stated in their study. “Because many of these patients will have additional hospitalisations and health expenditures, they may easily exceed their annual income while being deprived of work during the illness.”

Catastrophic health expenses for the uninsured accounted for 85% of those hospitalised after acute MI (95% confidence interval, 84–85) and 75% after stroke (95% confidence interval, 74–75). Any hospitalisation expenses that exceeded 40% of annual income after eliminating the cost of food were classed as catastrophic health expenses.

A study published earlier this year in the Journal of the American Heart Association (JAHA) found that sudden catastrophic loss of heart function, or cardiac arrest, occurred significantly less among adults who acquired health insurance via the Affordable Care Act (ACA), commonly known as Obamacare.

“Health insurance allows people to engage in regular medical care, which is crucial for the prevention of cardiovascular disease and the diagnosis and treatment of conditions that can cause cardiac arrest”, lead study author Eric Stecker (Oregon Health and Science University’s Knight Cardiovascular Institute in Portland, USA) said at the time.


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