Financial Worries, Lack of Insurance Tied to MI Care Delays

Money concerns, being uninsured associated with greater likelihood of long prehospital delay
By Eric Metcalf
HealthDay Reporter

TUESDAY, April 13 (HealthDay News) -- Patients who don't have insurance, or who have insurance but have financial concerns related to accessing care, are more likely to delay seeking emergency care for acute myocardial infarction (AMI), according to research published in the April 14 issue of the Journal of the American Medical Association.

Kim G. Smolderen, Ph.D., of Tilburg University in the Netherlands, and colleagues analyzed data from 3,721 patients with AMI enrolled over several years at 24 American hospitals. The participants were grouped as having either insurance without financial concerns, insurance with financial concerns about accessing care, or no insurance.

The researchers found that 61.7 percent were insured without financial concerns, 18.5 percent were insured but had financial concerns about accessing care, and 19.8 percent were uninsured. Uninsured patients and those with financial concerns were more likely to delay seeking care during their AMI. Nearly half of the uninsured patients (48.6 percent) and 44.6 percent of insured patients with financial concerns had prehospital delays of more than six hours, compared to 39.3 percent of those with insurance and no financial concerns.

"These findings underscore important consequences from inadequate health care insurance coverage for the substantial number of individuals in the United States experiencing AMIs. The data also suggest that efforts to reduce prehospital delay times may have limited impact without first ensuring that access to health insurance is improved and financial concerns are addressed in patients who seek emergency care," the authors write.

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