Jun 29 2017
The new study published on June 28 in the Journal of the American Heart Association shows significant reduction in the sudden cardiac arrest incidences among adults who gained health insurance through the Affordable Care Act (ACA) and were not insured previously.
Most of the study participants got the insurance through expanded Medicaid coverage that was jointly funded by federal-state government, the health insurance program also known as Obamacare, for people in the low-income group was an expansion under federal law. The study emphasized the role of health insurance in the study outcomes.
The analysis that the investigators carried out was based on the emergency medical services in an urban Oregon county prior to and after making the insurance expansion mandatory by law.
A decrease by 17% is seen in the cardiac arrest incidences among adults in the age group of 45–64, who were not insured earlier. The adult age group of 65 and above, which had higher health insurance coverage rates constantly - before and after implementing ACA (through medicare mainly) also showed same incidence rates,
"Cardiac arrest is a devastating and under-recognized cause of premature death for both men and women age 45 and older," said Eric Stecker, M.D., M.P.H., associate professor of cardiology at Oregon Health & Science University's Knight Cardiovascular Institute in Portland, Ore., and the study's lead author. "Health insurance allows people to engage in regular medical care, which is crucial for the prevention of cardiovascular disease and the diagnosis and treatment of conditions that can cause cardiac arrest."
In the United States, more than 350,000 out-of-hospital cardiac arrests occur annually. "sudden cardiac arrest" and "heart attack” are often interchangeably used terms, there is vast difference between the two medical conditions. A block in any of the main arteries that leads to the heart, typically by plaque, will interrupt the blood flow to the muscle of the heart and result in a heart attack. An electrical impulse that disturbs the heart rhythm and stops the heart to beat is characterized as a sudden cardiac arrest. This disorder will provide small or no warning signs and usually cause immediate death in patients.
Because so few survive a sudden cardiac arrest, it is imperative that we be able to predict which patients are the most vulnerable. Effective primary prevention is the only way to make a significant impact on this problem. Fewer than 10 percent of these patients are going to make it out of the hospital alive. By the time we dial 911, it's much too late for most of them."
Senior author, Sumeet Chugh, M.D., director of the Heart Rhythm Center at the Cedars-Sinai Heart Institute in Los Angeles
The report findings are the outcomes of Oregon Sudden Unexpected Death Study, a large research enterprise. It is a comprehensive study in which cardiac deaths occurred in 16 hospitals in the metropolitan area of Poland, which is home to 2.4 million people, was assessed for many years. It provided a collection of data with distinctive, community-based information to Chugh and his team through which the causes of sudden cardiac arrest can be unveiled.
Researchers inspected the medical records from the emergency medical services in Multnomah County, Oregon, and identified individuals with out‐of‐hospital cardiac arrest (OHCA). This data was then compared with the adult population data available with the U.S. Census Bureau in the years 2011–2012 before implementing ACA and in 2014–2015 after implementing ACA.
A word of caution from the investigators was that the study did not prove the cause and effect even though it has established a strong relationship between health insurance and decreased cardiac arrest rates. The study authors mentioned that the key implications on public health is possible when large studies are carried out across more diverse patient groups that could prove these study findings.
Stecker commented that it is critical to find the benefits of health insurance more comprehensively and to cautiously think about public policies that have an effect on the numerous Americans who are not insured.
Sources:
Study identifies key immune cells that could protect the brain after cardiac arrest