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Individual income, mortality and healthcare resource use in patients with chronic heart failure living in a universal healthcare system: A population-based study in Catalonia, Spain
Journal article   Peer reviewed

Individual income, mortality and healthcare resource use in patients with chronic heart failure living in a universal healthcare system: A population-based study in Catalonia, Spain

Miguel Cainzos-Achirica, Cristina Capdevila, Emili Vela, Montse Cleries, Usama Bilal, Ana Garcia-Altes, Cristina Enjuanes, Alberto Garay, Sergi Yun, Nuria Farre, …
International journal of cardiology, v 277, pp 250-257
15 Feb 2019
DOI: https://doi.org/10.1016/j.ijcard.2018.10.099
PMID: 30413306
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Health disparities Heart failure Income Mortality Socioeconomic status Universal coverage
To evaluate the associations between individual income, all-cause mortality and use of healthcare resources in a very large population of chronic heart failure (CHF) patients living in Catalonia (Spain), where access to public healthcare is granted by law. We used 2016 data from the Catalan Health Surveillance System, a large, exhaustive, administrative healthcare database which includes information on medical diagnoses, healthcare resource use, and individual income for all Catalan residents (N = 7,638,524). Individual annual income was categorized as high (>100,000€), medium (18,000–100,000€), low (<18,000€), and very low (welfare support). Among 155,883 CHF patients, lower individual income was associated with a shorter life expectancy at age 50 (life expectancy for high income patients 22.2 years, for very low income patients 12.8), and were independently associated with higher all-cause mortality adjusting for age, sex, comorbidities, and duration of the CHF diagnosis (odds ratio very low vs. medium income 1.21 [95% CI 1.11, 1.33]). Also, in patients with lower income levels the burden of public healthcare resource use was displaced towards urgent hospitalizations and frequent emergency department visits, as opposed to regular, specialized CHF ambulatory-based care. In a very large population of CHF patients with access to universal healthcare, lower income was independently associated with higher mortality and with lower use of ambulatory-based healthcare resources. Our findings suggest that CHF patients may benefit from systematic assessment of their socioeconomic status, as this may aid the identification of vulnerable subgroups who may benefit from tailored health education and management. •In CHF patients with access to universal healthcare, lower income was associated with shorter life expectancy•Lower income was also independently associated with higher all-cause mortality•In low income patients, the burden of healthcare resource use was displaced towards urgent hospitalizations and ED visits•CHF patients may benefit from systematic assessment of their socioeconomic status

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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