EMBARGOED UNTIL 3 P.M., June 11, 1997
Contact: Sarah Ellis, (303) 315-5571
When It Comes to the Heart, Money Doesn't Matter: Copayment Costs Do Not Contribute to Treatment Delays in Heart Attacks
Patients who have heart attacks, or myocardial infarction, were no more likely to delay seeking emergency treatment when an insurance copayment was required than if a copayment was not required, according to the results of a five-year study released today. The study, conducted by a University of Colorado Health Sciences Center assistant professor, appears in the June 12 issue of The New England Journal of Medicine.
"More and more managed care companies, or HMOs, have been requiring their patients to make copayments for emergency department visits as a way to reduce the inappropriate use of such services," said David Magid, MD, assistant professor in the department of preventive medicine and biometrics and in the division of emergency medicine at the CU-Health Sciences Center, and a physician investigator in clinical research at the Colorado Permanente Medical Group.
The purpose of this study was to determine whether such copayments would lead patients to delay seeking care when they had a true emergency such as a heart attack.
"We found that for patients with private insurance, modest copayments did not present a financial barrier to patients seeking emergency care," Dr. Magid said.
Of the more than 1,300 patients in the study who were treated by emergency personnel at a hospital in King County, Wash., 602 patients were required to pay a copayment, usually $25 or $50, while 729 patients had no copayment. All patients in the study were enrolled in a single HMO.
Between the two groups of patients, no significant difference was found in the time it took for those with heart attacks to arrive at the hospital for treatment, Dr. Magid and his colleagues at the University of Washington and the Seattle Veterans Affairs Medical Center found. Several other investigators contributed to the study.
Patients with heart attacks were selected for the study because they benefit from more immediate care, and without it, are at higher risk for both out-of-hospital cardiac arrest and of in-hospital mortality.
"Heart attacks are a common emergency condition, Dr. Magid said. "Those patients who seek immediate care have a much better chance for survival with the treatments that are now available. Additional studies on a range of other conditions should be conducted to further establish the safety of cost-sharing in emergency care."
Previous studies have suggested that HMO patients respond to emergency department copayments by reducing their use of less appropriate services.
The University of Colorado Health Sciences Center is one of four campuses in the University of Colorado system. Located in Denver, Colo., the campus includes schools of medicine, nursing, pharmacy, and dentistry, a graduate school and two hospitals.
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