Chronic heart disease poses high financial burden to low-income families

July 3, 2018, Yale University
Credit: CC0 Public Domain

The financial burdens of long-term care for a family member with atherosclerotic cardiovascular disease (ASCVD) disproportionately affect low-income American families, even those who have insurance, found researchers at Yale University's Center for Outcomes Research and Evaluation (CORE) and the University of Texas. The study appears in the July 3 issue of JAMA Cardiology.

Using the data from the cross-sectional Medical Expenditure Panel Survey from January 2006 through December 2015, researchers found that one in four with a member with ASCVD experience a high financial burden from the out-of-pocket healthcare costs associated with treating the chronic condition. Low-income families were also three times as likely to experience this high financial burden than middle- or high-income families with a member with ASCVD.

Additionally, 1 in 10 low-income families in the survey experienced a "catastrophic" financial burden (defined as 40% of their annual post-subsistence income), which was nine times more frequent for low-income than middle- and high-income families. For families of someone with ASCVD of any income level, the two categories of greatest healthcare spending were insurance premiums and prescription medications.

"It's sobering to realize that the way we finance medical care places nearly one in four low-income families and millions of Americans with in a position of significant ," said Khurram Nasir, M.D., senior author, a faculty member in the Section of Cardiovascular Medicine and at Yale CORE.

"Unfortunately, private insurance—which one would expect to cushion from financial risk—actually further exacerbated the out-of-pocket costs, including medical premiums, copayments, deductibles, and essential medications," said Nasir. "This was especially true for self-purchased private insurance, which may provide less comprehensive and equitable coverage than that afforded by most employer-based group healthcare insurance. In comparison, those covered via public insurances, especially among low-income families, were the least likely to suffer from financial hardships at the level."

Nasir said that these findings will certainly influence the way he approaches the "difficult conversations about the management costs of cardiovascular disease" with his own patients, but that he hopes "the provision of appropriate support services for the neediest members of our society becomes an integral component of our cardiovascular disease management programs."

"There are many people who are not only suffering from the disruption, pain, and suffering associated with an acute illness or chronic condition but also dealing with the financial toxicity of the associated healthcare costs to them and their families," explained Harlan Krumholz, director of Yale CORE. "We're doing this research to put some numbers to this issue so that it can't be ignored. These numbers will influence the policy debates about healthcare, for when people say 'We're doing well enough,' or 'Things have gotten better,' we can show with these numbers that, no, we're not nearly where we need to be."

To Krumholz's call for change, Nasir added: "These findings may further support calls from many quarters for consideration of a more progressive social and national health insurance program such as Medicare/Medicaid for all instead of the existing, regressive private model of premiums and out-of-pocket payments. Something like Medicare/Medicaid for all may likely be the most practical solution to limit income inequalities in financing , especially among those suffering from chronic diseases."

Explore further: Out-of-pocket expenses for chronic heart disease care inflict heavy financial burdens for low-income families

More information: JAMA Cardiology (2018). DOI: 10.1001/jamacardio.2018.1813

Related Stories

Out-of-pocket expenses for chronic heart disease care inflict heavy financial burdens for low-income families

April 6, 2018
Cumulative out-of-pocket expenses for the treatment of chronic heart disease led to significant financial burdens for low-income families, even for those with health insurance, according to preliminary research presented ...

Medicaid expansion leaves more money in recipients' pockets

May 15, 2018
Medicaid expansion under the Affordable Care Act reduced out-of-pocket medical expenses, allowing the poorest Americans to allocate their money for other life necessities, according to a new University of Michigan study.

Obamacare helping poor families the most

January 23, 2018
(HealthDay)—Poor families have benefited the most from Obamacare, spending less on both out-of-pocket care and health insurance premiums, a new study shows.

Out-of-pocket costs exceed what many insured cancer patients expect to pay

August 10, 2017
A third of insured people with cancer end up paying more out-of-pocket than they expected, despite having health coverage, researchers at the Duke Cancer Institute have found.

Health care financing system deepens poverty and income inequality

January 18, 2018
Households' payments for medical premiums, copayments and deductibles pushed more than 7 million Americans into poverty in 2014, according to a study appearing in the American Journal of Public Health. Such payments also ...

Medical bills pricey for Americans, even with private insurance

November 13, 2014
(HealthDay)—Many Americans may believe that private insurance can keep major medical bills at bay. But a new survey finds that one-fifth of people with private plans still spend at least 5 percent of their income on out-of-pocket ...

Recommended for you

Southern diet could be deadly for people with heart disease

July 12, 2018
People with a history of heart disease who eat a traditional Southern diet are more likely to die than those who follow a Mediterranean dietary pattern, according to new research.

Late-life high blood pressure may harm the brain, study says

July 11, 2018
Decades ago, hundreds of nuns and priests made an extraordinary decision: They agreed to donate their brains upon death to science, hoping to help solve mysteries about Alzheimer's and other diseases. Now, a study that used ...

Multivitamins do not promote cardiovascular health

July 10, 2018
Taking multivitamin and mineral supplements does not prevent heart attacks, strokes or cardiovascular death, according to a new analysis of 18 studies published in Circulation: Cardiovascular Quality and Outcomes, an American ...

Mobile health devices diagnose hidden heart condition in at-risk populations

July 10, 2018
Wearable mobile health devices improved the rate of diagnosis of a dangerous and often hidden heart condition called atrial fibrillation (AFib), according to a first of its kind, home-based clinical study conducted in part ...

Chronic heart disease poses high financial burden to low-income families

July 3, 2018
The financial burdens of long-term care for a family member with atherosclerotic cardiovascular disease (ASCVD) disproportionately affect low-income American families, even those who have insurance, found researchers at Yale ...

Women with high blood pressure during pregnancy more likely to develop CVD risk factors

July 2, 2018
Preeclampsia and gestational hypertension are common pregnancy complications involving high blood pressure that develops for the first time during pregnancy and returns to normal after delivery. Previous studies have shown ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.