title: Loan applications in adult patients with congenital heart disease: a French study.
abstract: BACKGROUND
  Improvements in the treatment of children with congenital heart disease have led to most of these patients reaching adulthood. Despite the increase in lifespan, very little is known about their quality of life - in particular, their ability to obtain a mortgage or consumer loan.
  
  
  OBJECTIVE
  To investigate the outcome of mortgage and loan applications made by adults with differential severities of congenital heart disease.
  
  
  METHODS
  Four hundred and seventy-six patients were invited to participate in a questionnaire-based interview by phone. Of these patients, one hundred and forty-two responded. Respondents were classified into three categories ('significant', 'complex' and 'mild') based on congenital heart disease severity according to the Bethesda conference.
  
  
  RESULTS
  Ninety patients (64%) had applied for loans; 17 (16.5%) did not report their heart disease to the insurance company, 13 were refused insurance and 39 were asked to pay surplus fees. The imposed fees concerned patients classified in the 'significant' and 'complex' groups (P<0.0001 and P<0.003, respectively, compared with those classified in the 'mild' group). Age, sex, other diseases, cardiovascular risk factors and duration of the loan had no influence on loan application outcomes.
  
  
  CONCLUSIONS
  Adults with congenital heart disease are considerably more likely to have difficulty obtaining a mortgage or loan, independent of their congenital heart disease severity. Moreover, despite an increased obtainment of a loan in patients classified as 'mild', the refusal rates were identical for patients classified as having 'significant' or 'complex' congenital heart disease, although their prognosis is different.
authors.affiliation: Adult congenital heart disease unit, department of cardiology, Georges-Pompidou European hospital, 20, rue Leblanc, 75015 Paris, France. magalie.ladouceur@egp.aphp.fr
authors.forename: Magalie
authors.initials: M
authors.lastname: Ladouceur
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dugardin
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Gourdin
authors.forename: Daniel
authors.initials: D
authors.lastname: Sidi
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
authors.forename: Laurence
authors.initials: L
authors.lastname: Iserin
mesh_terms: D000328:Adult; D000465:Algorithms; D005260:Female; D005378:Financial Support; D005602:France; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007343:Insurance Carriers; D015273:Insurance Selection Bias; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires