Cost of Managing Heart Failure
Financial factors also impact on the adherence to the medications prescribed in the management of heart failure. According to Seferović, (2017), adherence to medication management in heart failure is a critical aspect of improving patient outcomes as well as improving the quality of life. Low financial capabilities lead to cost-related medication non-adherence as patients are not able to afford the medications prescribed or not able to afford the medication in a timely manner for therapeutic benefits to be effectively met. Financial barriers also pose additional limitations to the cardioprotective measures that patients with heart failure are required to take. Patients may forgo healthy food so as to ensure that they are able to afford medications or even have to design priority on the medications or forgo the medications meant to manage underlying conditions such as hypertension or diabetes which impacts negatively on the patient outcomes (Dhaliwal et al.
According to Kapoor et al. , (2015), patients under the Medicare Medicaid and those with no insurance cover compared to patients with private insurance were more likely to experience in-hospital mortality and long admission periods. These patients without insurance or those insured under the Medicare Medicaid programs were also denied therapies that are listed on the heart failure guidelines. The discharge counseling and instructions on lifestyle modifications at discharge were more preferred for the patients without insurance coverage. In a research on the cost of care for heart failure, (Dhaliwal et al. Improved access to timely management of heart failure plays an essential role in preventing future cardiovascular events or the complications and deterioration in the patient's heart condition. Adequate access to patient care also leads to better management and monitoring of the heart failure leading to more appropriate medication prescription, monitoring, and adherence hence better patient outcomes.
In patients covered by Medicaid, it was established that they had better outcomes in care because they have a usual source of care which is important in chronic illness such as heart failure. Compared to uninsured, who lack a regular source of care provision, the quality of care for the uninsured due to this limitation in care access is usually problematic leading to less than optimal outcomes. Patients with better access to medical care in heart failure also tend to have higher health literacy on the care for and enhanced self-efficacy in self-management for heart failure. The financial limitation leads to limited affordability for medication hampering adherence which is critical to improving heart failure outcomes and the quality of life for heart failure patients.
Inability to pay for treatment leads to mismanagement of heart failure or the limited care and lowered quality of life. Patient Characteristics in Unmanaged Heart Failure Poorly managed heart failure can lead to a variety of outcomes which include; exacerbation of symptoms, complications including disability and mortality, readmissions and extended hospital stay. Patient characteristics in unmanaged heart failure include poor quality of life due to the symptoms of heart failure such as dyspnoea, chest pain and referred pains the limit day to day activity and their ability to meet their daily needs and activities of living. Aggravation of symptoms of heart failure may impact on the patents ability to be independent causing increased dependency for the patient and inability to work.
The existence of comorbidities with cardiac failure poses a higher patient care burden for the patients as well as their families and the community. Comorbidities increase the pill burden to patients coupled with the other care modalities in heart failure such as dietary requirements and physical and psychological care needs (Fry et al. The increased pill burden increases risks for adverse medication interactions, errors and side effects (Fry et al. These needs of care may pose difficulties in patients to coordinate their own care leading to increased need for support which places a burden of care on families and their significant other. The cost of managing heart failure is high and may impact negatively on the patient’s as well as their families who have to meet the cost or the extra costs of care not covered by insurance for the insured.
Self-care and patient education is a critical contributor to positive patient outcomes in the management of heart failure. Patient education systems ought to encompass collaborative action by the interprofessional patient care teams to ensure that the patient education is comprehensive to ensure the patients are adequately educated to understand their condition and the management plans. The effectiveness of patient education can be evaluated through client exit questionnaires which assess the patient’s knowledge and self-efficacy for self-care. Establishment of cardiac centers within the organization that allows for cardiac failure patients to access regular follow-ups in care. The patient management and care of cardiac failure are complicated and costs increased by the regular hospitalizations. , Beckerman, J. , Champagne, P. , & Brookmeyer, R. et al.
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