The household economic burden for acute coronary syndrome survivors in Australia

Karice Hyun, Beverley Essue, Mark Woodward, Stephen Jan, David Brieger, Derek Chew, Kellie Nallaiah, Tegwen Howell, Tom Briffa, Isuru Ranasinghe, Carolyn Astley, Julie Redfern

    Research output: Contribution to journalArticlepeer-review

    3 Citations (Scopus)


    Background: Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. Methods: Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship. Results: Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614) in Australian dollars was A$258.06 (median: A$126.50) per month. The average spending for medical services was A$120.18 (SD: A$310.35) and medications was A$66.25 (SD: A$80.78). In total, 350 (51 %) of patients reported experiencing economic hardship, 78 (12 %) were unable to pay for medical services and 81 (12 %) could not pay for medication. Younger age (18-59 vs ≥80 years (OR): 1.89), no private health insurance (OR: 2.04), pensioner concession card (OR: 1.80), residing in more disadvantaged area (group 1 vs 5 (OR): 1.77), history of CVD (OR: 1.47) and higher out-of-pocket expenses (group 4 vs 1 (OR): 4.57) were more likely to experience hardship. Conclusion: Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients.

    Original languageEnglish
    Article number636
    Pages (from-to)1-8
    Number of pages8
    JournalBMC Health Services Research
    Issue number1
    Publication statusPublished - 8 Nov 2016


    • Acute coronary syndrome
    • Financial burden
    • Household economic hardship
    • Out-of-pocket expenditure


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