title: Patient-reported economic burden and the health status of heart failure patients.
abstract: BACKGROUND
  Heart failure (HF) guidelines recommend treatment with multiple medications to improve survival, functioning, and quality of life. Yet, HF treatments can be costly, resulting in significant economic burden for some patients. To date, there are few data on the impact of patients' perceived difficulties in affording medical care on their health outcomes.
  
  
  RESULTS
  Comprehensive clinical data, health status, and the perceived economic burden of 539 HF outpatients from 13 centers were assessed at baseline and 1 year later. Health status was quantified with the Kansas City Cardiomyopathy Questionnaire overall summary score. Cross-sectional and longitudinal (1-year) analyses were conducted comparing the health status of patients with and without self-reported economic burden. Patients with economic burden had significantly lower health status scores at both baseline and 1 year later. Although baseline perceptions of economic burden were associated with poorer health status, patients' perceived difficulty affording medical care at 1 year was a more important determinant of lower 1-year health status.
  
  
  CONCLUSIONS
  HF patients reporting difficulty affording their medical care had lower perceived health status than those reporting little to no economic burden. More research is needed to further evaluate this association and to determine whether addressing perceived economic difficulties affording health care can improve HF patients' health status.
authors.affiliation: University of Missouri-Kansas City and Mid America Heart Institute of Saint Luke's Hospital, Kansas City, Missouri, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Conard
authors.forename: Paul
authors.initials: P
authors.lastname: Heidenreich
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
authors.forename: John
authors.initials: J
authors.lastname: Spertus
mesh_terms: D000368:Aged; D002303:Cardiac Output, Low / Q000191:economics* / Q000503:physiopathology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010361:Patients; D011795:Surveys and Questionnaires