Medical and economic costs of psychologic distress in patients with coronary artery disease

T. G. Allison, D. E. Williams, T. D. Miller, Christi Ann Patten, Kent R Bailey, R. W. Squires, G. T. Gau

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Objective: To determine the effect of psychologic distress, measured with a commonly used screening questionnaire, on 6-month morbidity and rehospitalization costs in coronary patients. Design: Psychologic distress was determined by screening with the Symptom Checklist-90 - Revised (SCL-90- R) self-report inventory during the second week of cardiac rehabilitation. Costs associated with cardiovascular rehospitalization during a 6-month follow-up period were recorded, and differences between 'distressed' and 'nondistressed' patients were analyzed statistically. Material and Methods: The study cohort consisted of 381 patients (311 men and 70 women) referred for cardiac rehabilitation after an index hospitalization for unstable angina, myocardial infarction, coronary angioplasty, or coronary bypass procedure. Patients with SCL-90-R scores above the 90th percentile for outpatient adults were considered distressed (N = 41); patients with scores below this level were considered nondistressed (N = 340). Results: The 6- month follow-up was complete in all but 1 of the 381 patients. Distressed patients had significantly higher rates of cardiovascular rehospitalization, any recurrent events, and recurrent 'hard events' (cardiac death, myocardial infarction, or cardiac arrest and resuscitation) within 6 months after dismissal from their index hospitalization in comparison with nondistressed patients. Adjustment for oilier factors associated with a risk of early rehospitalization and recurrent events did not reduce the strength or significance of the association between psychologic distress and early cardiovascular rehospitalization or recurrent events. The mean rehospitalization costs were significantly higher in the distressed than in the nondistressed patients ($9,504 versus $2,146). Conclusion: These data add support to the hypothesis that psychologic distress adversely affects the prognosis in coronary patients, confirm the added morbidity and rehospitalization costs attributable to psychologic distress, and suggest the potential for improving the prognosis in selected coronary patients by identification and appropriate treatment of psychologic distress.

Original languageEnglish (US)
Pages (from-to)734-742
Number of pages9
JournalMayo Clinic Proceedings
Volume70
Issue number8
StatePublished - 1995

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Medical Economics
Coronary Artery Disease
Costs and Cost Analysis
Hospitalization
Myocardial Infarction
Morbidity
Unstable Angina
Heart Arrest
Checklist
Angioplasty
Resuscitation
Self Report
Cohort Studies
Outpatients

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Allison, T. G., Williams, D. E., Miller, T. D., Patten, C. A., Bailey, K. R., Squires, R. W., & Gau, G. T. (1995). Medical and economic costs of psychologic distress in patients with coronary artery disease. Mayo Clinic Proceedings, 70(8), 734-742.

Medical and economic costs of psychologic distress in patients with coronary artery disease. / Allison, T. G.; Williams, D. E.; Miller, T. D.; Patten, Christi Ann; Bailey, Kent R; Squires, R. W.; Gau, G. T.

In: Mayo Clinic Proceedings, Vol. 70, No. 8, 1995, p. 734-742.

Research output: Contribution to journalArticle

Allison, TG, Williams, DE, Miller, TD, Patten, CA, Bailey, KR, Squires, RW & Gau, GT 1995, 'Medical and economic costs of psychologic distress in patients with coronary artery disease', Mayo Clinic Proceedings, vol. 70, no. 8, pp. 734-742.
Allison, T. G. ; Williams, D. E. ; Miller, T. D. ; Patten, Christi Ann ; Bailey, Kent R ; Squires, R. W. ; Gau, G. T. / Medical and economic costs of psychologic distress in patients with coronary artery disease. In: Mayo Clinic Proceedings. 1995 ; Vol. 70, No. 8. pp. 734-742.
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