Effect of Difficulty Affording Health Care on Health Status After Coronary Revascularization

Background— An objective of the United States’ Healthy People 2010 Initiative is to eliminate disparities based on socioeconomic status. We assessed the effect of difficulty affording health care on the health status (symptoms, function, and quality of life) of patients treated with percutaneous coronary intervention or CABG. Methods and Results— A consecutive, single-center cohort of 480 patients undergoing coronary revascularization received the Seattle Angina Questionnaire at the time of their procedure and at subsequent monthly intervals for 6 months. At baseline, patients who reported somewhat of a burden to a severe burden in affording health care had significantly lower scores on the Seattle Angina Questionnaire (mean±SD) with respect to angina (55±29 versus 68±25, P<0.0001), physical limitation (55±26 versus72±24, P<0.0001), and quality of life (46±22 versus 56±22, P<0.0001) than those who did not perceive healthcare costs to be burdensome. Although both groups of patients improved after revascula...