Title: Pain and poverty: Disparities by poverty level in the experience of pain-related interference

Pain Medicine ◽  
2021 ◽  
Author(s):  
Jessica M Keralis
Keyword(s):  
Logistic Regression ◽  
Medical Expenditure Panel Survey ◽  
Social Determinant ◽  
Medical Expenditure ◽  
Health Policies ◽  
Panel Survey ◽  
Poverty Level ◽  
Policy Makers ◽  
The Relationship ◽  
Social Determinant Of Health

Abstract Objective To assess the relationship between poverty and pain-related interference. Subjects Data on a sample of 108,259 adults aged 18 and older from the Household Component of the Medical Expenditure Panel Survey (MEPS) from 2013-2017 were analyzed. Methods I assess the odds of reporting any pain-related interference, as well as increasing levels of pain-related interference, using binary and ordinal logistic regression, respectively. Results After controlling for covariates, the analysis showed a significant association between poverty and pain-related interference, with more severe levels of poverty associated with increased odds of reporting any pain-related interference as well as increased levels of pain-related interference. However, Hispanics were less likely to report any pain-related interference overall, and more severe levels of poverty were associated with decreased odds of reporting pain among Hispanics. Conclusion Policy makers should regard poverty as a social determinant of health, taking poverty and socioeconomic status into consideration when designing health policies.

scholarly journals Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Monira Alwhaibi ◽  
Arijita Deb ◽  
Usha Sambamoorthi
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Migraine Headache ◽  
Medical Expenditure Panel Survey ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Lower Percentage ◽  
Panel Survey ◽  
Cross Sectional ◽  
The Relationship

Objective. To examine the association between the cardiovascular (CV) risk factors and triptans use among adults with migraine. Methods. A retrospective cross-sectional study design was used. Data were derived from 2009–2013 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults (age > 21 years) with migraine headache (N = 1,652). Multivariable logistic regression was used to examine the relationship between CV risk factors and triptans use. Results. Overall, 21% adults with migraine headache used triptans. Nearly two-thirds (61%) of adults with migraine had at least one CV risk factor. A significantly lower percentage of adults with CV risk (18.1%) used triptans compared to those without CV risk factors (25.5%). After controlling for demographic, socioeconomic status, access to care, and health status, adults with no CV risk factors were more likely to use triptans as compared to those with one CV risk factor (AOR = 1.83, 95% CI = 1.17–2.87). There were no statistically significant differences in triptans use between those with two or more CV risk factors and those with one CV risk factor. Conclusion. An overwhelming majority of adults with migraine had a contraindication to triptans based on their CV risk factors. The use of triptans among adults with migraine and multiple CV risk factors warrants further investigation.

scholarly journals Coverage, Financial Burden, and the Patient Protection and Affordable Care Act for Patients With Cancer

2019 ◽  
Vol 15 (12) ◽  
pp. e1035-e1049 ◽  
Author(s):  
Joel E. Segel ◽  
Jeah Jung
Keyword(s):  
Affordable Care Act ◽  
Family Income ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Medical Expenditure ◽  
Lower Income ◽  
Panel Survey ◽  
Poverty Level ◽  
Patients With Cancer ◽  
Patient Protection

PURPOSE: Evidence suggests coverage has improved significantly for patients with cancer, particularly in the lower-income population, after the implementation of the Affordable Care Act (ACA). Yet no study has examined changes in type of coverage or the resulting effect on spending and financial burden. METHODS: Using 2011 to 2015 Medical Expenditure Panel Survey data, we examine changes in type of coverage, spending, and financial burden among lower-income (< 400% of federal poverty level [FPL]) individuals diagnosed with cancer after the ACA. To better understand the changes, we compare this sample to the lower-income patients without cancer and patients with cancer with a higher income (≥ 400% of FPL). All analyses were conducted in 2018. RESULTS: In adjusted analyses, we found a decline in months uninsured (−0.78 months; P = .001) and an increase in months with Medicaid coverage (0.40 months; P = .059) among the lower-income patients with cancer. This change is similar to the lower-income patients without cancer. We found an increase in total expenditures ($3,020; P = .071) but a modest decline in the fraction of family income spent on health (−0.014; P = 0.099), although neither is statistically significant. For the higher income patients with cancer, we observed significant increases in both out-of-pocket premiums and medical financial burden. CONCLUSION: After the ACA, lower-income people diagnosed with cancer experienced significant gains in coverage largely through Medicaid at rates similar to lower-income patients without cancer, but patients with cancer with incomes 400% or greater of FPL faced a higher financial burden.

scholarly journals Modeling the Conditional Dependence between Discrete and Continuous Random Variables with Applications in Insurance

Mathematics ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 45
Author(s):  
Emilio Gómez-Déniz ◽  
Enrique Calderín-Ojeda
Keyword(s):  
Structural Model ◽  
Medical Expenditure Panel Survey ◽  
Health Care Use ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Conditional Distributions ◽  
Conditional Dependence ◽  
Outpatient Visits ◽  
Conditional Expectations ◽  
The U.S

We jointly model amount of expenditure for outpatient visits and number of outpatient visits by considering both dependence and simultaneity by proposing a bivariate structural model that describes both variables, specified in terms of their conditional distributions. For that reason, we assume that the conditional expectation of expenditure for outpatient visits with respect to the number of outpatient visits and also, the number of outpatient visits expectation with respect to the expenditure for outpatient visits is related by taking a linear relationship for these conditional expectations. Furthermore, one of the conditional distributions obtained in our study is used to derive Bayesian premiums which take into account both the number of claims and the size of the correspondent claims. Our proposal is illustrated with a numerical example based on data of health care use taken from Medical Expenditure Panel Survey (MEPS), conducted by the U.S. Agency of Health Research and Quality.

scholarly journals Are There Racial Disparities in Psychotropic Drug Use and Expenditures in a Nationally Representative Sample of Men in the United States? Evidence From the Medical Expenditure Panel Survey

2013 ◽  
Vol 8 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Geraldine Pierre ◽  
Roland J. Thorpe ◽  
Gniesha Y. Dinwiddie ◽  
Darrell J. Gaskin
Keyword(s):  
United States ◽  
Drug Use ◽  
Racial Disparities ◽  
Psychotropic Drug ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Psychotropic Drug Use ◽  
Nationally Representative

This article sought to determine whether racial disparities exist in psychotropic drug use and expenditures in a nationally representative sample of men in the United States. Data were extracted from the 2000-2009 Medical Expenditure Panel Survey, a longitudinal survey that covers the U.S. civilian noninstitutionalized population. Full-Year Consolidated, Medical Conditions, and Prescribed Medicines data files were merged across 10 years of data. The sample of interest was limited to adult males aged 18 to 64 years, who reported their race as White, Black, Hispanic, or Asian. This study employed a pooled cross-sectional design and a two-part probit generalized linear model for analyses. Minority men reported a lower probability of psychotropic drug use (Black = −4.3%, 95% confidence interval [CI] = [−5.5, −3.0]; Hispanic = −3.8%, 95% CI = [−5.1, −2.6]; Asian = −4.5%, 95% CI = [−6.2, −2.7]) compared with White men. After controlling for demographic, socioeconomic, and health status variables, there were no statistically significant race differences in drug expenditures. Consistent with previous literature, racial and ethnic disparities in the use of psychotropic drugs present problems of access to mental health care and services.

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