AI Article Synopsis
- The study examined the impact of out-of-pocket (OOP) costs on adherence to cardiac rehabilitation (CR) programs among patients with cardiovascular issues.
- A retrospective analysis of nearly 44,000 beneficiaries found that those who paid more for their first CR session attended significantly fewer sessions overall.
- The results indicated that higher OOP expenses were linked to decreased participation in CR, suggesting that lowering these costs could enhance adherence rates among patients facing financial barriers.
Article Abstract
Objectives: Although cardiac rehabilitation (CR) improves cardiovascular outcomes, adherence remains low. Higher patient-incurred out-of-pocket (OOP) spending may be a barrier to CR adherence. We evaluated the association between OOP spending for the first CR session and adherence.
Study Design: Retrospective analysis.
Methods: Commercial and Medicare supplemental beneficiaries with a CR-qualifying event between 2016 and 2020 who attended at least 1 CR session within 6 months of discharge were identified in the MarketScan Commercial Database. OOP spending for the first session was categorized as zero or into 1 of 3 increasing tertiles of OOP spending. Poisson regression was used to determine the association between OOP-spending tertile and CR adherence, defined as the number of CR sessions attended within 6 months of discharge.
Results: A total of 43,992 beneficiaries attended at least 1 CR session. Of these, 35,883 (81.6%) paid $0, 2702 (6.1%) paid $0.01 to $25.39, 2704 (6.1%) paid $25.40 to $82.41, and 2703 (6.1%) paid at least $82.42 for the first session, constituting the first, second, and third OOP-spending tertiles, respectively. Compared with the zero-OOP cohort, the first-tertile cohort attended 13.5% (95% CI, 1.4%-27.1%; P = .028) more CR sessions and the second- and third-tertile cohorts attended 11.9% (95% CI, -16.4% to -7.1%; P < .001) and 30.9% (95% CI, -40.8% to -19.4%; P < .001) fewer CR sessions on average, respectively. For every additional $10 spent OOP on the first CR session, patients attended 0.41 fewer sessions on average (95% CI, -0.65 to -0.17; P < .001).
Conclusion: Among patients with OOP spending, higher spending was associated with lower CR adherence, dose dependently. Reducing OOP costs for CR may improve adherence for beneficiaries with cost sharing.
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| http://dx.doi.org/10.37765/ajmc.2024.89637 | DOI Listing |
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