The financial implications of unexpected major healthcare expenses for common cardiovascular conditions and procedures are addressed in two new studies presented at the American Heart Association's annual meeting, in Anaheim, California.
The studies found that one in eight heart attack patients, one in eight stroke patients, and one in nine coronary artery bypass grafting patients were uninsured. The study included patients ages 18 to 65 years. Those uninsured patients had a nearly 80% chance of then being faced with a catastrophic health expense, defined as a hospitalization bill that exceeded 40% of their annual household income, minus food expenses.
The survey findings are based on data from the National Inpatient Sample. “For the uninsured patients, we constructed a microsimulation model to estimate patient income based on the median income of their residential zip code,” says Rohan Khera, MD, lead researcher of one study and a cardiology fellow at the University of Texas Southwestern Medical Center in Dallas.
Based on prior studies, this income was assumed to follow a gamma probability distribution, according to Khera. “In addition, data from the Bureau of Labor Statistics was used to estimate income. The hospitalization bills were then compared against income left after food expenses to assess the probability of a catastrophic health expense.”
During the years of the studies, the median hospital bill for heart attacks was $53,384 and $31,218 for strokes. Heart bypass surgeries costs ranged from $85,891 to $177,546.
The studies highlight the need to understand the financial toxicity of lacking health insurance coverage, Khera says.
“The studies show that a sizable number of patients with these major medical problems lack health insurance coverage, a situation expected to become more common with legislative actions aimed at scaling back provisions of the Affordable Care Act,” he says. “The financial impact of lacking insurance coverage should not be underestimated. Uninsured individuals and healthcare systems may increasingly become involved in lengthy collection efforts, and patients may be at risk for financial catastrophe—including bankruptcy.”