Abstract 213: Interplay of Health-Related Quality of Life, Cardiovascular Disease and Healthcare Costs: 2012 Medical Expenditure Panel Survey

Abstract

Background: Cardiovascular disease (CVD), the leading cause of of death in the United States, has deleterious impact on health-related quality of life (HRQL). In this study we aim to examine the interplay of CVD, HRQL and healthcare costs. Methods: Adults aged 40 in the 2012 Medical Expenditures Panel Survey (MEPS) were examined. Their HRQL were determined using responses to the Short Form 12 (SF-12) Physical and Mental Component Scale (PCS-12 and MCS-12 respectively), and Visual Analogue Scale (VAS) questionnaires. ICD-9 diagnosis of CVD (410, 413, 414, 428, 433, 434, 435, 436, 437, 427, 440, 443, or 447) was used to classify them. The two-part econometric model was used to estimate the per capita health expenditure and, linear regressions to estimate the mean change in HRQL by CVD status. Results: An estimated 139.4 million adults (59+/-27 years; 52% female) were investigated. 13.4% had CVD, and cost $245 billion in healthcare. In adjusted analysis, participants with CVD spent an average of $8,104 (95% CI: $7,465 - 8,744) in health care vs. $5,550 (95% CI: $5,101 - 6,000) among those without it. The mean HRQL scores are statistically significantly reduced across all measuring scale by CVD, and by modifiable risk factors among Non-CVD participants. In adjusted analyses, both in the general population and among those with CVD, people with better HRQL spent less on health care. For instance, participants with CVD who perceived their health to be “very good” had -$13,347 (95% CI: -$17,129 to -9,565) average lower health care expenditure versus those who perceived their health to be “poor” (p<0.001). Conclusion: CVD significantly increases healthcare expenditures and lowers HRQL. However, those with better HRQL tend to spend less on health care, irrespective of CVD status. Measures directed at improving HRQL may significantly improve healthcare cost.