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Type: Journal article
Title: Sex differences in financial barriers and the relationship to recovery after acute myocardial infarction
Author: Beckman, A.L.
Bucholz, E.M.
Zhang, W.
Xu, X.
Dreyer, R.P.
Strait, K.M.
Spertus, J.A.
Krumholz, H.M.
Spatz, E.S.
Citation: Journal of the American Heart Association, 2016; 5(10):e003923-1-e003923-15
Publisher: Wiley
Issue Date: 2016
ISSN: 2047-9980
Statement of
Adam L. Beckman, Emily M. Bucholz, Weiwei Zhang, Xiao Xu, Rachel P. Dreyer, Kelly M. Strait, John A. Spertus, Harlan M. Krumholz, Erica S. Spatz
Abstract: Background-Financial barriers to health care are associated with worse outcomes following acute myocardial infarction (AMI). Yet, it is unknown whether the prevalence of financial barriers and their relationship with post-AMI outcomes vary by sex among young adults. Methods and Results-We assessed sex differences in patient-reported financial barriers among adults aged <55 years with AMI using data from the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study. We examined the prevalence of financial barriers and their association with health status 12 months post-AMI. Among 3437 patients, more women than men reported financial barriers to medications (22.3% vs 17.2%; P=0.001), but rates of financial barriers to services were similar (31.3% vs 28.9%; P=0.152). In multivariable linear regression models adjusting for baseline health, psychosocial status, and clinical characteristics, compared with no financial barriers, women and men with financial barriers to services and medications had worse mental functional status (Short Form-12 mental health score: mean difference [MD]=-3.28 and -3.35, respectively), greater depressive symptomatology (Patient Health Questionnaire-9: MD, 2.18 and 2.16), lower quality of life (Seattle Angina Questionnaire-Quality of Life: MD, -4.98 and -7.66), and higher perceived stress (Perceived Stress Score: MD, 3.76 and 3.90; all P<0.05). There was no interaction between sex and financial barriers. Conclusions-Financial barriers to care are common in young patients with AMI and associated with worse health outcomes 1 year post-AMI. Whereas women experienced more financial barriers than men, the association did not vary by sex. These findings emphasize the importance of addressing financial barriers to recovery post-AMI in young adults.
Keywords: Epidemiology; myocardial infarction; risk factors; women
Rights: © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
DOI: 10.1161/JAHA.116.003923
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