290 Insurability of patients with congenital heart disease in France

Abstract

Improvements in the treatment of children with congenital heart disease (CHD) have led to the majority of these patients reaching adulthood. There is little data on their ability to obtain a mortgage or a consumer loan. We supposed that the majority of adults with CHD would be denied insurance or offered higher rates independently on the prognosis of their heart disease. to investigate the outcome of mortgage and loan application of adults at different severities. four hundred and seventy six adult CHD patients underwent a questionnaire-based interview by phone. One hundred and forty two replied. CHD patients were classified into three categories based on severity according the Bethesda conference. Comparison was made between different severities of CHD. ninety (64%) patients had applied for loans or mortgages, among them; seventeen have not reported their heart disease to the insurance. Thirteen patients have been refused and 39 asked to pay extra. This concerned significantly more patients classified significant and complex according the severity of their CHD (p<0.0001 and p = 0.003, respectively compared with mild). No difference was observed between patients classified significant and complex. Age, sex, other diseases, cardiovascular risk factors and duration of the loan had no influence on loan applications. adults with CHD are significantly more likely to have difficulty obtaining a mortgage or a loan independently of severity of CHD. Despite a better ability to obtain a loan for CHD with mild severity, refusal rates are the same in significant and complex CHD. This suggests that the label CHD may have a negative impact despite the improvement in the management of adults with CHD whose life expectancy is increasing.