Abstract 18418: Favorable Cardiovascular Risk Profile is Associated With Lower Out-of-Pocket Health Care Financial Burden: Medical Expenditure Panel Survey (2010-2013)
Introduction: The AHA 2020 Strategic Impact Goals emphasize the importance of preventing atherosclerotic cardiovascular disease (ASCVD) and optimizing CV modifiable risk factors (CRF) to reduce morbidity, mortality and economic burden. We sought to quantify the impact of favorable CRF profile on out of pocket (OOP) medical spending among those with and without ASCVD in US adult population between 18-64 years of age.
Methods: The study population was derived from 2010-13 Medical Expenditure Panel Survey. ASCVD diagnoses (coronary artery disease, peripheral arterial disease, stroke) and CRF (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity & obesity) were ascertained by ICD9CM codes and self-report. CRF profile was categorized as “Optimal”, “Average” and “Poor”, (0-1, 2-3 & ≥4 CRF respectively). OOP expenditures were self-reported payments for coinsurance, copayments, deductibles, and medically-related items and services not covered by insurance. High financial burden (HFB) was defined as OOP/family income ratio > 10%.
Results: The final study sample consisted of 73,492 participants (41±10.7 years). After adjusting for cofounding variables, those without ASCVD were noted to have significantly lower OOP costs than those with ASCVD ($733 vs $1033, p < 0.01). For ASCVD patients, OOP were lower for optimal and average CRF by $509 (95% CI 299, 720) and $211 (95% CI 11, 412) compared to those with a poor risk profile. Similar respective differences of $315 (95% CI 247, 343) and $235 (95% CI 174, 296) among those without ASCVD. Increased OOP spending was associated with advancing age, female gender and white ethnicity. Significantly lower financial burden was noted in the absence of ASCVD and a more favorable CRF profile across the entire spectrum of socioeconomic strata.
Conclusions: Favorable CRF profile is associated with significantly lower OOP spending and financial burden among individuals with and without established ASCVD.
Author Disclosures: J. Valero-Elizondo: None. H.J. Warraich: None. J.A. Salami: None. A. Younus: None. O. Ogunmoroti: None. E.S. Spatz: None. N. Desai: None. J.S. Rana: None. S.S. Virani: None. R. Blankstein: None. M.J. Blaha: None. K. Nasir: Consultant/Advisory Board; Modest; Quest Diagnostic, Regeneron.
- © 2016 by American Heart Association, Inc.