Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Barriers to Healthcare Access After an ACS

Am J Cardiol; ePub 2018 Jul 15; Erskine, et al

After hospital discharge for an acute coronary syndrome (ACS), financial and other barriers to healthcare access may be associated with clinically meaningful declines in health-related quality of life, a recent study found. Patients from a large cohort of ACS survivors were classified as having any financial barriers, no usual source of care (USOC), or transportation barriers to healthcare. The primary outcomes included clinically meaningful declines in generic physical and mental health-related quality of life (HRQOL) and in disease-specific HRQOL between 1 and 6 months after discharge. Researchers found:

  • Among 1,053 ACS survivors, 29.0% had a financial barrier, 14.2% had no USOC, and 8.7% had a transportation barrier.
  • Patients with a financial barrier had greater risk of experiencing a decline in generic physical and mental HRQOL at 6 months.
  • Patients with ≥2 access barriers had greater risks of decline in generic physical and mental HRQOL compared to those without any healthcare barriers.


Erskine NA, Gandek B, Tran HV, et al. Barriers to healthcare access and to improvements in health-related quality of life after an acute coronary syndrome (from TRACE-CORE). [Published online ahead of print July 15, 2018]. Am J Cardiol. doi:10.1016/j.amjcard.2018.06.043.

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