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Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

The household economic burden for acute coronary syndrome survivors in Australia

Authors: Karice K. Hyun, Beverley M. Essue, Mark Woodward, Stephen Jan, David Brieger, Derek Chew, Kellie Nallaiah, Tegwen Howell, Tom Briffa, Isuru Ranasinghe, Carolyn Astley, Julie Redfern

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship.

Methods

Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship.

Results

Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614) in Australian dollars was A$258.06 (median: A$126.50) per month. The average spending for medical services was A$120.18 (SD: A$310.35) and medications was A$66.25 (SD: A$80.78). In total, 350 (51 %) of patients reported experiencing economic hardship, 78 (12 %) were unable to pay for medical services and 81 (12 %) could not pay for medication. Younger age (18–59 vs ≥80 years (OR): 1.89), no private health insurance (OR: 2.04), pensioner concession card (OR: 1.80), residing in more disadvantaged area (group 1 vs 5 (OR): 1.77), history of CVD (OR: 1.47) and higher out-of-pocket expenses (group 4 vs 1 (OR): 4.57) were more likely to experience hardship.

Conclusion

Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients.
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Literature
1.
go back to reference Aroney CN, Aylward P, Kelly A-M, et al. Guidelines for the management of acute coronary syndromes 2006. Med J Aust. 2006;184(8 Suppl):S9–S29. Aroney CN, Aylward P, Kelly A-M, et al. Guidelines for the management of acute coronary syndromes 2006. Med J Aust. 2006;184(8 Suppl):S9–S29.
2.
7.
go back to reference Hall J. Australian Health Care—The Challenge of Reform in a Fragmented System. NEJM. 2015;373(6):493–7.CrossRefPubMed Hall J. Australian Health Care—The Challenge of Reform in a Fragmented System. NEJM. 2015;373(6):493–7.CrossRefPubMed
9.
go back to reference Scott IA, Lindsay KA, Harden HE. Utilisation of outpatient cardiac rehabilitation in Queensland. Med J Aust. 2003;179(7):341–5.PubMed Scott IA, Lindsay KA, Harden HE. Utilisation of outpatient cardiac rehabilitation in Queensland. Med J Aust. 2003;179(7):341–5.PubMed
10.
go back to reference Melloni C, Alexander KP, Ou FS, et al. Predictors of early discontinuation of evidence-based medicine after acute coronary syndrome. Am J Cardiol. 2009;104(2):175–81.CrossRefPubMed Melloni C, Alexander KP, Ou FS, et al. Predictors of early discontinuation of evidence-based medicine after acute coronary syndrome. Am J Cardiol. 2009;104(2):175–81.CrossRefPubMed
12.
go back to reference Essue B, Kelly P, Roberts M, et al. We can’t afford my chronic illness! The out-of-pocket burden associated with managing chronic obstructive pulmonary disease in western Sydney, Australia. J Health Serv Res Policy. 2011;16(4):226–31.CrossRefPubMed Essue B, Kelly P, Roberts M, et al. We can’t afford my chronic illness! The out-of-pocket burden associated with managing chronic obstructive pulmonary disease in western Sydney, Australia. J Health Serv Res Policy. 2011;16(4):226–31.CrossRefPubMed
13.
go back to reference Essue BM, Wong G, Chapman J, et al. How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study. BMC Nephrol. 2013;14:5.CrossRefPubMedPubMedCentral Essue BM, Wong G, Chapman J, et al. How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study. BMC Nephrol. 2013;14:5.CrossRefPubMedPubMedCentral
14.
go back to reference Baroletti S, Dell’Orfano H. Medication adherence in cardiovascular disease. Circulation. 2010;121(12):1455–8.CrossRefPubMed Baroletti S, Dell’Orfano H. Medication adherence in cardiovascular disease. Circulation. 2010;121(12):1455–8.CrossRefPubMed
15.
go back to reference Chew DP, French J, Briffa TG, et al. Acute coronary syndrome care across Australia and New Zealand: the SNAPSHOT ACS study. Med J Aust. 2013;199(3):185–91.CrossRefPubMed Chew DP, French J, Briffa TG, et al. Acute coronary syndrome care across Australia and New Zealand: the SNAPSHOT ACS study. Med J Aust. 2013;199(3):185–91.CrossRefPubMed
16.
go back to reference Fox KA, Dabbous OH, Goldberg RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333(7578):1091.CrossRefPubMedPubMedCentral Fox KA, Dabbous OH, Goldberg RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333(7578):1091.CrossRefPubMedPubMedCentral
17.
go back to reference Bassand J-P, Hamm CW, Ardissino D, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007;28:1598–660.CrossRefPubMed Bassand J-P, Hamm CW, Ardissino D, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007;28:1598–660.CrossRefPubMed
19.
go back to reference Fenn KM, Evans SB, McCorkle R, et al. Impact of Financial Burden of Cancer on Survivors’ Quality of Life. J Oncol Pract. 2014;10(5):332–8.CrossRefPubMed Fenn KM, Evans SB, McCorkle R, et al. Impact of Financial Burden of Cancer on Survivors’ Quality of Life. J Oncol Pract. 2014;10(5):332–8.CrossRefPubMed
21.
go back to reference Australian Institute of Health and Welfare. Health expenditure Australia 2010-11. Health and welfare expenditure series no. 47. Canberra: AIHW; 2012. AIHW Cat. No.: HWE 56. Australian Institute of Health and Welfare. Health expenditure Australia 2010-11. Health and welfare expenditure series no. 47. Canberra: AIHW; 2012. AIHW Cat. No.: HWE 56.
24.
go back to reference Gordon L, Ferguson M, Chambers SK, et al. Fuel, beds, meals and meds: Out-of-pocket expenses for patients with cancer in rural Queensland. Cancer Counc Aust. 2009;33(3):1–7. Gordon L, Ferguson M, Chambers SK, et al. Fuel, beds, meals and meds: Out-of-pocket expenses for patients with cancer in rural Queensland. Cancer Counc Aust. 2009;33(3):1–7.
25.
go back to reference Redfern J, Hyun K, Chew DP, et al. Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: results from a large prospective audit in Australia and New Zealand. Heart. 2014;100(16):1281–8.CrossRefPubMedPubMedCentral Redfern J, Hyun K, Chew DP, et al. Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: results from a large prospective audit in Australia and New Zealand. Heart. 2014;100(16):1281–8.CrossRefPubMedPubMedCentral
28.
go back to reference Jan S, Essue BM, Leeder SR. Falling through the cracks: the hidden economic burden of chronic illness and disability on Australian households. Med J Aust. 2012;196(1):29–31.CrossRefPubMed Jan S, Essue BM, Leeder SR. Falling through the cracks: the hidden economic burden of chronic illness and disability on Australian households. Med J Aust. 2012;196(1):29–31.CrossRefPubMed
Metadata
Title
The household economic burden for acute coronary syndrome survivors in Australia
Authors
Karice K. Hyun
Beverley M. Essue
Mark Woodward
Stephen Jan
David Brieger
Derek Chew
Kellie Nallaiah
Tegwen Howell
Tom Briffa
Isuru Ranasinghe
Carolyn Astley
Julie Redfern
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1887-3

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