Age-specific differences in patient reported outcomes among adults with atherosclerotic cardiovascular disease: Medical expenditure panel survey 2006–2015

Okunrintemi, Victor; Benson, Eve-Marie A.; Derbal, Ouassim; Miedema, Michael D.; Blumenthal, Roger S.; Tibuakuu, Martin; Ogunmoroti, Oluseye; Khan, Safi U.; Mamas, Mamas A.; Gulati, Martha; Michos, Erin D.

Abstract

Objective
The prevalence of atherosclerotic cardiovascular disease (ASCVD) in younger adults has increased over the past decade. However, it is less well established whether patient reported outcomes differ between younger and older adults with ASCVD. We sought to evaluate age-specific differences in patient reported outcomes among adults with ASCVD.

Methods
This was a retrospective cross-sectional survey study. We used data from the 2006–2015 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of the United States population. Adults ≥18 years with a diagnosis of ASCVD, ascertained by ICD9 codes or self-reported data, were included. Logistic regression was used to compare self-reported patient-clinician communication, patient satisfaction, perception of health, emergency department (ED) visits, and use of preventive medications (aspirin and statins) by age category [Young: 18–44, Middle: 45–64, Older: ≥65 years]. We used two-part econometric modeling to evaluate age-specific annual healthcare expenditure.

Results
There were 21,353 participants included. Over 9000 (42.6%-weighted) of the participants were young or middle aged, representing ~9.9 million adults aged <65 years with ASCVD nationwide. Compared with older adults, middle-aged and young adults with ASCVD were more likely to report poor patient-clinician communication [OR 1.73 (95% CI 1.28–2.33) and 2.49 (1.76–3.51), respectively], poor healthcare satisfaction, and poor perception of health status, have increased ED utilization and were also less likely to be using aspirin and statins. The mean annual healthcare expenditure was highest among middle-aged adults [$10,798 (95% CI, $10,012 to $11,583)].

Conclusion
Compared with older adults, younger adults with ASCVD were more likely to report poor patient experience and poor health status and less likely to be using preventive medications. More effort needs to be geared towards understanding the age-specific differences in healthcare quality and delivery to improve outcomes among high-risk young adults with ASCVD.

Citation

Okunrintemi, V., Benson, E.-M. A., Derbal, O., Miedema, M. D., Blumenthal, R. S., Tibuakuu, M., Ogunmoroti, O., Khan, S. U., Mamas, M. A., Gulati, M., & Michos, E. D. (2020). Age-specific differences in patient reported outcomes among adults with atherosclerotic cardiovascular disease: Medical expenditure panel survey 2006–2015. American Journal of Preventive Cardiology, 3, Article 100083. https://doi.org/10.1016/j.ajpc.2020.100083

• Journal Article Type: Article
• Acceptance Date: Aug 20, 2020
• Online Publication Date: Aug 27, 2020
• Publication Date: 2020-09
• Deposit Date: Jun 20, 2023
• Journal: American Journal of Preventive Cardiology
• Print ISSN: 2666-6677
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Article Number: 100083
• DOI: https://doi.org/10.1016/j.ajpc.2020.100083
• Keywords: General Medicine
• Public URL: https://keele-repository.worktribe.com/output/490267
• Additional Information: This article is maintained by: Elsevier; Article Title: Age-specific differences in patient reported outcomes among adults with atherosclerotic cardiovascular disease: Medical expenditure panel survey 2006–2015; Journal Title: American Journal of Preventive Cardiology; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.ajpc.2020.100083; Content Type: article; Copyright: © 2020 The Authors. Published by Elsevier B.V.