Predicting Health Care Use and Quality of Life in Women With Heart Disease

Heart disease is the leading cause of death and disability for women in the United States.  Compared to men, women with cardiac conditions are at higher risk for functional impairments and reduced quality of life (QOL).  While in recent years more studies have examined the unique challenges of women with heart disease, critical unanswered questions remain regarding the factors that put women at risk for decline in functional status and greater health care use (HCU).  The Center is undertaking a study guided by an empirically-based, multi-component framework to examine the relative importance of sociodemographic, clinical, and intrapersonal factors that place women with heart disease at higher risk for negative outcomes over time. 

The study draws on an extensive longitudinal data set from a clinical trial funded by the Heart Division of NHLBI, entitled "The Effect of Heart Disease Education on Older Women."  Data from over 1200 women, age 60 and over, with heart disease are available for analysis.  The longitudinal study design employed three data sources over 18 months: telephone-administered interviews, objective measurements of physical functioning, and HCU from hospital billing records.  

The current analysis provides a unique opportunity for an in-depth exploration of questions that are directly relevant to the clinical management of women with heart disease.  Specifically, we are using data at multiple time points to examine: 1) the relative impact of demographic characteristics, clinical factors, and intrapersonal measures in predicting HCU and QOL; 2) the extent to which symptom attribution and bothersomeness influence HCU and QOL; 3) how perceived severity of the heart condition and its importance relative to other comorbid conditions affect subsequent health behaviors, HCU, and QOL; and 4) the manner in which specific components of behavioral self-regulation processes impact heart disease management and outcomes.

Taken together these findings can significantly expand understanding of the collective importance of clinical, psychosocial, perceptual, and behavioral factors as they influence quality of life and health care use in women with heart disease.  It is hoped that findings can lead to targeted assessment in the clinical setting and guide the development of behavioral interventions directed toward enhancing women's well-being and reducing need for health services.

For more information, contact Associate Director Nancy Janz at nkjanz@umich.edu