• Am J Manag Care · Dec 2024

    Out-of-pocket spending for cardiac rehabilitation and adherence among US adults.

    • Alexandra I Mansour, Ushapoorna Nuliyalu, Michael P Thompson, Steven Keteyian, and Devraj Sukul.
    • Johns Hopkins Hospital, 1305 Dock St, Apt 310, Baltimore, MD 21231. Email: amansou6@jhu.edu.
    • Am J Manag Care. 2024 Dec 1; 30 (12): 651657651-657.

    ObjectivesAlthough 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 DesignRetrospective analysis.MethodsCommercial 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.ResultsA 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).ConclusionAmong 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.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…