Patients' annual income adequacy, insurance premiums and out-of-pocket expenses related to heart failure care

Piamjariyakul, Ubolrat; Yadrich, Donna Macan; Russell, Christy; Myer, Jane; Prinyarux, Chanawee; Vacek, James L.; Ellerbeck, Edward F.; Smith, Carol E.

doi:10.1016/j.hrtlng.2014.05.013

Cited by 19 publications

(18 citation statements)

References 24 publications

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“…[ 9 – 11 ] Regarding the economic burdens of cardiovascular disease, the focus was on other, more traditional cardiovascular disorders, such as acute or chronic heart failure or perioperative myocardial infarction. [ 12 – 15 ]…”

Section: Introductionmentioning

confidence: 99%

Analysis of hospitalization expenditures and influencing factors for inpatients with coronary heart disease in a tier-3 hospital in Xi’an, China

Ding

Zhang

et al. 2017

Medicine

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BackgroundThe medical costs for inpatients with coronary heart disease (CHD) have risen to unprecedented levels, putting tremendous financial pressure on their families and the entire society. The objective of this study was to examine the actual direct medical costs of inpatients with CHD and to analyze the influencing factors of those costs, to provide advice on the prevention and control of high medical costs of patients with CHD.MethodsA retrospective descriptive analysis of hospitalization expenditures data examined 10,301 inpatients with coronary heart disease of a tier-3 hospital in Xi’an from January 1, 2015 to December 31, 2015. The data included demographic information, the average length of stay, and different types of expenses incurred during the hospitalization period. The difference between different groups was analyzed using a univariate analysis, and the influencing factors of hospitalization expenditures were explored by the multiple linear stepwise regression analysis.ResultsThe average age of these patients was 60.0 years old, the average length of stay was 4.0 days, and the majority were males (7172, 69.6%). The average hospitalization expenses were $6791.38 (3294.16–9, 732.59), and the top 3 expenses were medical consumables, operation fees, and drugs. The influencing factors of hospitalization expenditures included the length of stay, the number of times of admission, the type of medical insurance schemes, whether have a surgery or not, the gender, the age, and the marriage status.ConclusionThe inpatients with CHD in this tier-3 hospital were mostly over 45 years old. The average medical cost of males was much higher than that of females. Our findings suggest that the solution for tremendous hospitalization expenditures should be that more attention is paid to controlling the high expense of medical consumables and that the traditional method of reducing medical expenses by shortening the length of stay is still important in nowadays. Furthermore, the type of medical insurance schemes has different impacts on medical expenses. Reducing or controlling high hospitalization expenditures is a complicated process that needs multifaceted cooperation.

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Section: Introductionmentioning

confidence: 99%

Analysis of hospitalization expenditures and influencing factors for inpatients with coronary heart disease in a tier-3 hospital in Xi’an, China

Ding

Zhang

et al. 2017

Medicine

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“…And the cost is certainly less than the charges for an ER visit or rehospitalization that could be avoided by patients with HF home care skills or out-of-pocket costs for HF care reported by families. 65 …”

Section: Discussionmentioning

confidence: 99%

Nurse-Led Multidisciplinary Heart Failure Group Clinic Appointments

Smith

Piamjariyakul

Dalton

et al. 2015

Journal of Cardiovascular Nursing

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Background The Self-Management and Care of Heart Failure through Group Clinics Trial (SMAC-HF) evaluated the effects of multidisciplinary group clinic appointments on self-care skills and rehospitalizations in high risk heart failure (HF) patients. Objective The purpose of this article is to: (1) describe key SMAC-HF group clinic interactive learning strategies; (2) describe resources and materials used in the group clinic appointment; and (3) present results supporting this patient-centered group intervention. Methods This clinical trial included 198 HF patients (randomized to either group clinical appointments or to standard care). Data were collected from 72 group clinic appointments via patients’: (1) group clinic session evaluations; (2) HF Self-Care Behaviors Skills; (3) HF related discouragement and quality of life scores and (4) HF related reshopitalizations during the 12 month follow-up. Also the costs of delivery of the group clinical appointments were tabulated. Results Overall, patients rated group appointments as 4.8 out of 5 on the “helpfulness” in managing HF score. The statistical model showed a 33% decrease in the rate of rehospitalizations (incidence rate ratio (IRR) = 0.67) associated with the intervention over the 12-month follow-up period when compared with control patients (χ2(1) = 3.9, p = 0.04). The total cost for implementing five group appointments was $243.58 per patient. Conclusion The intervention was associated with improvements in HF self-care knowledge and home care behavior skills and managing their for HF care. In turn, better self-care was associated with reductions in HF related hospitalizations.

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“…4 Each patient’s out-of-pocket HF health care cost curve allows for the identification of the family’s cost burden and needs for social services referral. This type of graph is a powerful visual tool to help the HF population with low health literacy and the inability to read or fully understand health information.…”

Section: Synthesis Of the Literature And Preliminary Studiesmentioning

confidence: 99%

“…This results in unwanted care, high health care costs, and family out-of-pocket expenses. 4,19 The overwhelming number of patients do not want extraordinary futile care, 20 yet most African American patients do not have an advance directive, professional guidance, or discussions of EOL options specific to HF decline. 11,12,21 …”

Section: Synthesis Of the Literature And Preliminary Studiesmentioning

confidence: 99%

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Designing and Testing an End-of-Life Discussion Intervention for African American Patients With Heart Failure and Their Families

Piamjariyakul

Smith

Werkowitch

et al. 2016

J Hosp Palliat Nurs

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There is an escalating prevalence of heart failure (HF) with high mortality. Compared with other races, African Americans face a higher incidence of HF at earlier age of onset, with more rapid progression, and with increased family care burden and greater care costs and disparity in health care services at the end of life (EOL). Concomitant out-of-pocket HF costs and care demands indicate the need for early discussion of palliative and EOL care needs. We therefore developed and pilot tested a culturally sensitive intervention specific to the needs of African American HF patients and their families at the EOL. Our pilot study findings encompass patient and caregiver perspectives and align with the state of EOL science. The ultimate long-term goal of this intervention strategy is to translate into practice the preferred, culturally sensitive, and most cost-efficient EOL care recommendations for HF patients and families.

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Patients' annual income adequacy, insurance premiums and out-of-pocket expenses related to heart failure care

Cited by 19 publications

References 24 publications

Analysis of hospitalization expenditures and influencing factors for inpatients with coronary heart disease in a tier-3 hospital in Xi’an, China

Analysis of hospitalization expenditures and influencing factors for inpatients with coronary heart disease in a tier-3 hospital in Xi’an, China

Nurse-Led Multidisciplinary Heart Failure Group Clinic Appointments

Designing and Testing an End-of-Life Discussion Intervention for African American Patients With Heart Failure and Their Families

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