Closeup image of older adult patient in bed being checked by doctor with stethoscope; Credit: Getty Images

Severe financial strain is linked to a higher risk of death within six months of being discharged from the hospital after a heart attack, a new investigation finds.

Between 5% and 7% of all older U.S. adults have substantial difficulty meeting monthly monetary needs, according to the researchers. To examine whether the strain from these problems affects long-term outcomes after acute myocardial infarction, they asked participants in the Comprehensive Evaluation of Risk Factors in Older Patients with AMI — or SILVER-AMI — cohort study about their level of financial stability.

Among patients who reported having too little money to make ends meet each month, nearly 17% died within six months of their hospital stay. This was compared to 9% for those who reported having just enough money and 7.2% for those who had more than enough money. 

After accounting for other contributors to mortality such as comorbidities and conditions tied to aging, the findings amounted to a 61% higher mortality risk for the least financially stable patients when compared to those who reported no financial strain.

Although the study did not show a causal relationship, prior research has linked poverty defined by measures such as eligibility for Medicaid to poor health outcomes, the researchers noted. 

Financial strain may make it harder for patients to access transportation to medical appointments or to afford copays for medication for example, said Alexandra Hajduk, Ph.D., MPH, of Yale University. Missed doses and appointments along with chronic stress could contribute to worsened health outcomes, she theorized.

The results are “a call to the clinical world that we need to pay attention to patients’ financial status,” Hajduk said.

She and her colleagues suggest that older adults be asked about their financial strain to identify at-risk patients, perhaps connecting these patients to social services at discharge.

The study was published in JAMA Internal Medicine.