Mortality odds increase in older, financially stressed patients following a heart attack
Severe financial strain is associated with an elevated risk of death six months after an acute myocardial infarction (AMI), according to a new study published in JAMA Internal Medicine.
Researchers analyzed data from more than 2,800 adults older than 75 years of age who were discharged from a hospital following an AMI. All information was gathered from SILVER-AMI (Comprehensive Evaluation of Risk Factors in Older Patients with Acute Myocardial Infarction) for care that occurred between 2013 and 2017. Data analysis was conducted between 2020-2021.
The authors found that compared with patients with no financial burden, older patients with financial strain had higher rates of chronic disease and geriatric vulnerability.
In addition, within 180-days of charge, 134 of 1,864 (7.2%) older patients with no financial pressure died compared with 74 of 796 (9.2%) of patients with moderate strain, and 32 of 191 (16.8%) of those patients reporting severe financial strain.
Overall, severe financial stress was associated with a 61% rise in 180-day mortality risk compared with patient with no strain.
Meanwhile, moderate financial strain was not linked with mortality, according to the authors.
“Screening for financial strain during admissions provides an opportunity for clinicians to probe for resource needs in an actionable way,” lead author Jason R. Falvey, PhD, with the departments of physical therapy and rehabilitation science and epidemiology and public health, University of Maryland School of Medicine, and colleagues wrote. “A positive screen could guide targeted referrals for community supports, such as transportation services, assistance with prescription drug co-payments, or durable medical equipment.”
The authors concluded that these interventions should be paired with state and local policy changes such as housing support to improve outcomes for financially strained older patients who are recovering from an AMI.
Read the full study here.