Abstract 3: Patient Satisfaction and Healthcare Service Utilization Following Premature Acute Coronary Syndrome

Abstract

Objectives. Patient centered care is recognized as central to a high-quality healthcare system. Satisfaction with healthcare services may be differentially experienced among young adults suffering from heart disease. The current study examined the association between patient satisfaction with healthcare services, utilization, and clinical outcomes in patients with premature acute coronary syndrome (ACS). Methods and Results. We used data from 1033 patients (≤ 55 years) hospitalized for ACS and enrolled into the prospective cohort study, GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond PRemature Acute Coronary SYndrome). Participants were recruited between January 2009-April 2013, from 24 centers across Canada, 1 in the US, and 1 in Switzerland. Patient satisfaction with treatment and subsequent healthcare service utilization/clinical outcomes were assessed within 12 months post-index ACS through questionnaire and medical chart review. The median age of our cohort was 48 years and 30% were female. Ninety two percent of males and females reported high satisfaction with healthcare services; however, among patients with low satisfaction we observed lower social support (48% vs. 24%; p<.0001) and higher rates of depression (46% vs. 22%; p<.0001) at baseline. Multivariable Cox regressions adjusted for patient characteristics and clinical risk factors indicated lower risk of cardiac ER visits (HR=0.56; 95%CI, 0.34-0.93; P=0.01) and cardiac rehospitalization (HR=0.55; 95%CI, 0.28-1.07; P=0.08) among patients with higher satisfaction. There was no association between patient satisfaction level and risk of major adverse cardiac events (MACE) (HR=0.61; 95% CI, 0.32-1.19 P=0.15). Conclusions. Patients with lower satisfaction with healthcare services at index ACS were more likely to visit the ER and to be rehospitalized for cardiac reasons. Patient satisfaction level was not associated with risk of adverse clinical outcomes. Our results suggest that the younger ACS population may be a tangible target for reducing healthcare utilization through increased patient satisfaction.