Approximately one in six patients with heart failure (HF) delay medical care or go without it altogether, according to new data published in JACC: Heart Failure. More than half of those patients said the delay was due to financial reasons.
The team tracked 259,594 participants from the Medical Expenditure Panel Survey who provided data from 2004 to 2015. Of that group, 2,050 had a diagnosis of HF.
Overall, Thomas et al. found that 16% of HF patients said that they skipped or delayed care. Ten percent of patients 65 years old or older skipped or delayed care, and that number was 27% for patients under the age of 65.
Fifty-five percent of all patients with HF cited financial obstacles as the main reason for delaying care compared with 60% of nonelderly patients. Among elderly patients, 54% said nonfinancial reasons were the main cause for delaying or forgoing care.
The majority of HF patients who waived or delayed care were nonelderly (60.5%), from low-income households (55.2%) and reported a higher burden of comorbidities (59.3%).
According to the authors, the study is the first to define the link between forgone/delayed care in the HF population and health care use or costs. In their analysis, the annual total healthcare expenses for adult patients with HF who reported forgoing or delaying care was $8,027 higher than those who did not forgo or delay care.
Elderly patients who reported forgone or delayed care were also associated with more emergency department visits (43% vs. 58%) as well as higher yearly inpatient costs and higher total healthcare costs
“Forgone/delayed care was associated with significantly higher health care spending in the overall HF population, especially among the elderly, and may be contributing to the rising costs of HF over time,” wrote lead author Alexander Thomas, MD, with the department of internal medicine at Yale University School of Medicine, and colleagues. “Efforts to address the underlying causes of forgone/delayed care, targeted at the demographic groups identified to be most at risk, may help to improve patient outcomes while also reducing costs."
Read the entire study here.