Uninsured heart attack, stroke patients face ‘catastrophic’ costs
DALLAS – Nov. 15, 2017 – Heart attack and stroke patients without medical insurance face “devastating” health care costs that can bankrupt them, research from UT Southwestern and other centers shows.
“Many patients with large medical bills may have had to declare bankruptcy, sell their home, and be hounded by medical bill collectors as they struggled to juggle rent or mortgage payments while paying for utilities and food,” said Dr. Rohan Khera, a Cardiology Division fellow at UT Southwestern Medical Center and co-first author of the paper, “Medical expenses are the leading cause of bankruptcy in the United States.”
For uninsured patients hospitalized with acute myocardial infarction (heart attack), the median cost for their stay totaled $53,384 in 2012, according to the research. Uninsured stroke patients had a median bill of $31,218.
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Recent UTSW findings:
Patients without calcium buildup in the coronary arteries had significantly lower risk of future heart attack or stroke despite other high risk factors such as diabetes, high blood pressure, or bad cholesterol levels.
Modest weight gains – even among those who aren’t overweight – can cause dangerous changes to the heart, but small amounts of weight loss can improve the condition.
Based on the likely annual incomes of the uninsured patients, which were modeled on the median incomes of their residential zip codes, the researchers estimated that 85 percent of the heart attack patients and 75 percent of the stroke patients faced hospital bills greater than 40 percent of the income they had left after buying food.
About 60 percent of the uninsured heart attack patients had bills higher than their annual income, after allowing for the purchase of food, according to the paper.
“The potentially devastating financial impact of these events on the uninsured is considerable,” according to the paper, which pointed out that more than 1 in 8 of heart attack and stroke patients were without insurance before the Affordable Care Act (ACA).
The research, published in the journal Circulation, looked at thousands of patients hospitalized for acute myocardial infarction (heart attack) or stroke between 2008 and 2012, the year before Americans began signing up for subsidized insurance on exchanges created under the federal Affordable Care Act (ACA).
The patients studied ranged from age 18 to 64 (federal Medicare insurance is available to those 65 and older). More than 39,000 hospitalizations for heart attack and more than 29,000 hospitalizations for stroke were analyzed.
Information for the paper came from the National Inpatient Sample, a large database developed by the federal Agency for Healthcare Research and Quality.
Collaborators included cardiologist Dr. James de Lemos, Professor of Internal Medicine and holder of the Sweetheart Ball‐Kern Wildenthal, M.D., Ph.D. Distinguished Chair in Cardiology and Medical Director for the Dallas Heart Study, and researchers were from Baptist Health South Florida, Johns Hopkins Bloomberg School of Public Health, Florida International University, Michael E. DeBakey VA Medical Center, Brigham and Women’s Hospital, and Yale New Haven Hospital.
About UT Southwestern Medical Center
UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 22 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The faculty of more than 2,700 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in about 80 specialties to more than 100,000 hospitalized patients, 600,000 emergency room cases, and oversee approximately 2.2 million outpatient visits a year.