Document Type
Article
Department
Cardiology; Office of the Provost
Abstract
Background: While optimal cardiovascular risk factor (CRF) profile is associated with lower mortality, morbidity, and healthcare expenditures among individuals with atherosclerotic cardiovascular disease (ASCVD), less is known regarding its impact on financial hardship from medical bills. Therefore, we assessed whether an optimal CRF profile is associated with a lower burden of financial hardship from medical bills and a reduction in cost-related barriers to health.
Methods: We used a nationally representative sample of adults between 18 and 64 years from the National Health Interview Survey between 2013 and 2017. We assessed ASCVD status and the number of risk factors to categorize the study population into 4 mutually exclusive categories: ASCVD (irrespective of CRF profile) and non-ASCVD with poor, average, and optimal CRF profile. Adjusted logistic regression model was used to determine the association of ASCVD/CRF profile with financial hardship from medical bills and cost-related barriers to health (cost-related medication non-adherence (CRN), foregone/delayed care, and high financial distress).
Results: We included 119,388 non-elderly adults, representing 189 million individuals annually across the United States. Non-ASCVD/optimal CRF profile individuals had a lower prevalence of financial hardship and an inability paying medical bills when compared with individuals with ASCVD (24% vs 45% and 6% vs 19%, respectively). Among individuals without ASCVD and an optimal CRF profile, the prevalence of each cost-related barrier to health was <50% compared with individuals with ASCVD. Poor/low income and uninsured individuals within non-ASCVD/average CRF profile strata had a lower prevalence of financial hardship and an inability paying medical bills when compared with middle/high income and insured individuals with ASCVD. Non-ASCVD individuals with optimal CRF profile had the lowest odds of all barriers to health.
Conclusion: Optimal CRF profile is associated with a lower prevalence of financial hardship from medical bills and cost-related barriers to health despite lower income and lack of insurance.
Publication (Name of Journal)
American Journal of Preventive Cardiology
DOI
10.1016/j.ajpc.2020.100034
Recommended Citation
Grandhi, G. R.,
Valero-Elizondo, J.,
Reed Mszar, R.,
Brandt, E. J.,
Annapureddy, A.,
Khera, R.,
Saxena, A.,
Virani, S. S.,
Blankstein, R.,
Desai, N. R.
(2020). Association of cardiovascular risk factor profile and financial hardship from medical bills among non-elderly adults in the United States. American Journal of Preventive Cardiology, 2, 100034.
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Creative Commons License
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Comments
Issue and pagination are not provided by the author/publisher. This work was published before the author joined Aga Khan University.