Insurance concerns may delay heart attack patients from seeking treatment
Patients without health insurance, and those who are insured but fear the cost of medical care, are more likely to delay seeking life-saving treatment when having a heart attack.
For the estimated 3.5 million American adults who don't have health insurance,
Energy saving lamps and the millions more who have it but worry that illness might ruin them financially, the signs of an impending heart attack do not set in motion the kind of rapid, lifesaving response that medical professionals urge, finds a study conducted at 24 urban hospitals across the nation.
Instead, when uninsured or financially insecure adults feel stabbing chest pain, burning in the shoulder and jaw or extreme pressure across the midsection, they are more likely than the reliably insured to consider the economic consequences of a false alarm, and put off getting help.
That delay, established in a study published Tuesday in the Journal of the American Medical Assn., may be a costly decision for the nation as well as for those who put off seeking care. Long-standing research shows that the longer a heart attack victim delays treatment, the greater the risk of dying.
The new study included only subjects who survived, but its authors speculated that delayed care contributed to the death of many others, helping drive the estimated 45,000 annual U.S. fatalities attributed to lack of health insurance. And patients who delay getting medical attention for a heart attack are more likely to be rehospitalized for heart problems, to experience heart failure and ongoing chest pains called angina, and to have generally poorer health.
The result: a human and financial toll on which the study's researchers are currently collecting data that they expect to tally next.
Just two weeks after the passage of landmark legislation overhauling healthcare, one of the study's lead authors said its findings underscore the need to go beyond the goal of broadening access to health insurance.
Policy makers must now focus on reassuring Americans they will be able to afford care when they need it, said Dr. Paul Chan -- especially if insurance companies raise premiums or shift costs to those already on their rolls.
"I think it's a wake-up call," said Chan, a cardiologist with St. Luke's Mid America Heart Institute in Kansas City, Mo. "The affordability of care despite having insurance is going to be an increasingly larger problem as the lack of insurance becomes less of an issue."
Chan and researchers from across the country and Europe interviewed and combed through the case files of 3,721 patients hospitalized for acute myocardial infarction between April 2005 and the end of 2008. Researchers found that 36.6% with insurance got themselves to a hospital's emergency department within two hours of the onset of symptoms.
Energy saving lamps Among uninsured patients, 27.5% arrived at a hospital within two hours.
