Incremental Healthcare Expenditures Associated with Thyroid Disorders among Individuals with Diabetes

Objective. To estimate incremental healthcare expenditures associated with thyroid disorders among individuals with diabetes.Research Design and Methods. Cross-sectional study design with data on adults over 20 years of age with diabetes (N=4,490) from two years (2007 and 2009) of the Medical Expenditure Panel Survey (MEPS) was used. Ordinary least square regressions on log-transformed total expenditures and type of healthcare expenditures (inpatient, emergency room, outpatient, prescription drug, and other) were performed to estimate the incremental expenditures associated with thyroid disorders after controlling for demographic, socioeconomic, health status, lifestyle risk factors, macrovascular comorbid conditions (MCCs), and chronic conditions (CCs).Results. Among individuals with diabetes, those with thyroid disorders had significantly greater average annual total healthcare expenditures ($15,182) than those without thyroid disorders ($11,093). Individuals with thyroid disorders had 34.3% greater total healthcare expenditures compared to those without thyroid disorders, after controlling for demographic, socio-economic, and perceived health status. Furthermore, controlling for CCs and MCCs, this increase in expenditures was reduced to 21.4%.Conclusions. Among individuals with diabetes, thyroid disorders were associated with greater healthcare expenditures; such excess expenditures may be due to CCs and MCCs. Comanagement of CCs and reducing MCCs may be a pathway to reduce high healthcare expenditures.

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Healthcare Expenditures Associated with Comorbid Anxiety and Depression among Adults with Migraine

10.21203/rs.2.19619/v1 ◽

2019 ◽

Author(s):

Monira Alwhaibi ◽

Abdulkarim M. Meraya ◽

Yazed AlRuthia

Keyword(s):

Medical Expenditure Panel Survey ◽

Cross Sectional Study ◽

Medical Expenditure ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Comorbid Depression ◽

Healthcare Expenditures ◽

Cross Sectional ◽

Comorbid Anxiety ◽

Anxiety Screening

Abstract Objective. To examine direct healthcare expenditures among adults with migraine alone or with comorbid anxiety and/or depression. Methods. This was a retrospective cross-sectional study using the 2012, 2014, and 2016 Medical Expenditure Panel Survey data. Adult patients aged ≥22 years with migraine headache were included in the study. The direct healthcare expenditures of four migraine groups (migraine alone, migraine and anxiety, migraine and depression, migraine and both conditions) were compared. Results. There were 1,556 patients met the inclusion criteria and were eventually enrolled in the study. Approximately, 50% of the study sample had migraine with comorbid depression and/or anxiety (16.1% have depression, 12.3% have anxiety disorder, and 13.9% have both). The mean total healthcare expenditures of adults with migraine alone ($6,461) were significantly lower than those with comorbid depression and anxiety ($11,102), comorbid anxiety ($10,817), and comorbid depression ($14,577). Migraine with comorbid anxiety and depression was significantly associated with incremental costs of $1,027 in outpatient’s and $662 emergency room healthcare expenditures, compared to the migraine alone group after controlling for a multitude of covariates. Besides, migraine with comorbid anxiety and/or depression was significantly associated with incremental costs of prescription drug, compared to the migraine alone group. Conclusions. The healthcare expenditures associated with migraine with comorbid depression and/or anxiety are significantly higher than those without mental health comorbidities. Therefore, regular depression and anxiety screening for patients with migraine may help in reducing the healthcare expenditures associated with depression and/or anxiety comorbidities as well as in improving the quality of care.

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The Humanistic and Economic Burden Associated with Anxiety and Depression among Adults with Comorbid Diabetes and Hypertension

Journal of Diabetes Research ◽

10.1155/2018/4842520 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Kimberly Wallace ◽

Xiaohui Zhao ◽

Ranjita Misra ◽

Usha Sambamoorthi

Keyword(s):

Economic Burden ◽

Diabetes Management ◽

Medical Expenditure Panel Survey ◽

Cost Effective ◽

Cross Sectional Study ◽

Medical Expenditure ◽

Depression And Anxiety ◽

Annual Household Income ◽

Healthcare Expenditures ◽

Cross Sectional

We conducted a retrospective cross-sectional study to estimate the humanistic and economic burden associated with depression and anxiety among adults with comorbid diabetes and hypertension. Pooled data from the 2013 and 2015 Medical Expenditure Panel Survey were used to include adults (≥18 years old) who were alive and diagnosed with both diabetes and hypertension during the observation period. We assessed the humanistic burden with health-related quality of life (HRQoL) and economic burden with the total annual healthcare expenditures. Depending on the presence/absence of depression and anxiety, the study sample was divided into four groups (i.e., no depression/anxiety, depression only, anxiety only, and depression and anxiety). Multivariable regression analyses were used to evaluate the associations between the depression/anxiety categories and disease burden measures. The incremental burden associated with depression and/or anxiety was estimated with the counterfactual recycled prediction. Of the 4560 adults with comorbid diabetes and hypertension, 13.2% reported depression only, 8.7% reported anxiety only, and 7.7% reported both. Results from adjusted analyses indicated that the presence/absence of depression and anxiety was associated with significantly poorer HRQoL, especially on the mental component. Having either depression or anxiety corresponded to reduced mental component summary scores by more than four points. The reduction was as high as 10.35 points when both conditions occurred. Comparing to adults without depression or anxiety, the per-capital incremental annual healthcare expenditures were $4607 for the depression group, $2481 for the anxiety group, and $8709 for adults with both conditions. Furthermore, adults with depression and anxiety were 58% more likely to spend at least 10% of annual household income on healthcare as compared to those with neither the conditions. Our results highlight the needs for integrating cost-effective mental health services into diabetes management to improve the HRQoL and reduce healthcare costs for adults with comorbid diabetes and hypertension.

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Healthcare Expenditures Associated With Comorbid Anxiety and Depression Among Adults With Migraine

Frontiers in Neurology ◽

10.3389/fneur.2021.658697 ◽

2021 ◽

Vol 12 ◽

Author(s):

Monira Alwhaibi ◽

Abdulkarim M. Meraya ◽

Yazed AlRuthia

Keyword(s):

Medical Expenditure Panel Survey ◽

Financial Burden ◽

Cross Sectional Study ◽

Medical Expenditure ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Comorbid Depression ◽

Healthcare Expenditures ◽

Cross Sectional ◽

Comorbid Anxiety

Introduction: Depression and anxiety are common among patients with migraine and usually associated with a humanistic and financial burden. This study aims to examine the direct healthcare expenditures among adults with migraine alone or with comorbid anxiety and/or depression.Methods: This was a retrospective cross-sectional study using 2012, 2014, and 2016 Medical Expenditure Panel Survey data. Adult patients aged ≥22 years with migraine headache were included in the study. The direct healthcare expenditures of four migraine groups (migraine alone, migraine and anxiety, migraine and depression, and migraine and both conditions) were compared.Results: There were 1,556 patients who met the inclusion criteria and eventually enrolled in the study. Approximately 42% of the study sample had migraine with comorbid depression and/or anxiety (16.1% have depression, 12.3% have anxiety disorder, and 13.9% have both). The mean total healthcare expenditures of adults with migraine alone ($6,461) were significantly lower than those with comorbid depression and anxiety ($11,102), comorbid anxiety ($10,817), and comorbid depression ($14,577). Migraine with comorbid anxiety and depression was significantly associated with incremental costs of $1,027 in outpatient and $662 emergency room healthcare expenditures and prescription drug compared to the migraine alone group.Conclusions: The healthcare expenditures associated with migraine with comorbid depression and/or anxiety are significantly higher than those without mental health comorbidities. Therefore, regular depression and anxiety screening for patients with migraine may help reduce the healthcare expenditures associated with depression and/or anxiety comorbidities and improve the quality of care.

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Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise

Journal of Aging and Physical Activity ◽

10.1123/japa.2021-0301 ◽

2021 ◽

pp. 1-9

Author(s):

David R. Axon ◽

Jonathan Chien ◽

Hanh Dinh

Keyword(s):

Health Care ◽

Medical Expenditure Panel Survey ◽

Survey Design ◽

Health Care Expenditure ◽

Prescription Medication ◽

Health Care Expenditures ◽

Cross Sectional Study ◽

Medical Expenditure ◽

Cross Sectional ◽

Nationally Representative

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate–vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

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Depression treatment in individuals with cancer: a comparative analysis with cardio-metabolic conditions

Health Psychology Research ◽

10.4081/hpr.2013.632 ◽

2013 ◽

Vol 1 (1) ◽

pp. 2 ◽

Cited By ~ 2

Author(s):

Pallavi B. Rane ◽

Usha Sambamoorthi ◽

Suresh Madhavan

Keyword(s):

Medical Expenditure Panel Survey ◽

Household Survey ◽

The United States ◽

Primary Objective ◽

Medical Expenditure ◽

Depression Treatment ◽

Cross Sectional ◽

Physician Visits ◽

Lifestyle Risk Factors ◽

Metabolic Conditions

A clear picture of the current state of nationwide depression treatment practices in individuals with cancer and depression does not exist in the United States (US). Therefore, the primary objective of this study was to examine rates of any depression treatment among individuals with cancer and depression in the US. To better understand the relationship between any treatment for depression and presence of cancer, we used a comparison group of individuals with cardio-metabolic conditions owing to the similar challenges faced in management of depression in individuals with these conditions. We used a retrospective cross-sectional design and data from multiple years of the Medical Expenditure Panel Survey, a nationally representative household-survey on healthcare utilization and expenditures. Study sample consisted of adults aged 21 or older with self-reported depression and cancer (n=528) or self-reported depression and diabetes, heart disease or hypertension (n=1643). Depression treatment comprised of any use of antidepres- sants and/or any use of mental health counseling services. Treatment rates for depression were 78.0% and 81.7% among individuals with cancer and cardio-metabolic conditions respectively. After controlling for socio-demographic, access-to-care, number of physician-visits, health-status, and lifestyle risk-factors related variables; individuals with cancer were less likely to report any treatment for depression (Adjusted Odds Ratio=0.67; 95% Confidence Interval=0.49, 0.92) compared to individuals with cardio-metabolic conditions (P≤0.01). Our findings highlight the possibility that competing demands may crowd out treatment for depression and that cancer diagnosis may be a barrier to depression treatment.

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Prediction of medical expenditures of diagnosed diabetics and the assessment of its related factors using a random forest model, MEPS 2000–2015

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzz135 ◽

2020 ◽

Vol 32 (2) ◽

pp. 99-112

Author(s):

Jing Wang ◽

Leiyu Shi

Keyword(s):

Random Forest ◽

Medical Expenditure Panel Survey ◽

Age Groups ◽

Correlation Coefficients ◽

Absolute Error ◽

Cross Sectional Study ◽

Medical Expenditures ◽

Medical Expenditure ◽

Related Factors ◽

Cross Sectional

Abstract Objective To predict the medical expenditures of individual diabetics and assess the related factors of it. Design and setting Cross-sectional study. Setting and participants Data were collected from the US household component of the medical expenditure panel survey, 2000–2015. Main outcome measure Random forest (RF) model was performed with the programs of randomForest in R software. Spearman correlation coefficients (rs), mean absolute error (MAE) and mean-related error (MRE) was computed to assess the prediction of all the models. Results Total medical expenditure was increased from $105 Billion in 2000 to $318 Billion in 2015. rs, MAE and MRE between the predicted and actual values of medical expenditures in RF model were 0.644, $0.363 and 0.043%. Top one factor in prediction was being treated by the insulin, followed by type of insurance, employment status, age and economical level. The latter four variables had no impact in predicting of medical expenditure by being treated by the insulin. Further, after the sub-analysis of gender and age-groups, the evaluating indicators of prediction were almost identical to each other. Top five variables of total medical expenditure among male were same as those among all the diabetics. Expenses for doctor visits, hospital stay and drugs were also predicted with RF model well. Treatment with insulin was the top one factor of total medical expenditure among female, 18-, 25- and 65-age-groups. Additionally, it indicated that RF model was little superior to traditional regression model. Conclusions RF model could be used in prediction of medical expenditure of diabetics and assessment of its related factors well.

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Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk

Pain Research and Treatment ◽

10.1155/2016/8538101 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 2

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.

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Association of Self-Reported Functional Limitations among a National Community-Based Sample of Older United States Adults with Pain: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm10091836 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1836

Author(s):

David R. Axon ◽

Darlena Le

Keyword(s):

United States ◽

Medical Expenditure Panel Survey ◽

Functional Limitations ◽

Functional Limitation ◽

Cross Sectional Study ◽

Medical Expenditure ◽

Outcome Variable ◽

Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models

The characteristics of self-reported functional limitations among older United States (US) adults with pain are currently unknown. This cross-sectional study aimed to determine the characteristics associated with functional limitations among non-institutionalized older (≥50 years) US adults with pain using 2017 Medical Expenditure Panel Survey (MEPS) data. Eligible subjects were alive for the calendar year, aged ≥50 years, and experienced pain within the past four weeks. Hierarchical logistic regression models were utilized to determine significant characteristics associated with functional limitations (outcome variable; yes, no). Functional limitations included difficulty with bending, stooping, climbing stairs, grasping objects, lifting, reaching overhead, standing for long periods of time, or walking. Extrapolation of national data values was possible by adjusting for the complex MEPS design. We found approximately 22 million of the 57 million older US adults (≥50 years) who reported pain had a functional limitation in 2017. Characteristics associated with functional limitations included: gender, race, ethnicity, employment status, marital status, pain intensity, physical health, number of chronic conditions, and frequent exercise status. Knowledge of characteristics associated with functional limitations may provide an opportunity to identify and resolve gaps in patient care among this population.

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Predictors of Mental Health Status among Older United States Adults with Pain

Behavioral Sciences ◽

10.3390/bs11020023 ◽

2021 ◽

Vol 11 (2) ◽

pp. 23

Author(s):

David R. Axon ◽

Jonathan Chien

Keyword(s):

Mental Health ◽

United States ◽

Health Status ◽

Medical Expenditure Panel Survey ◽

Poor Mental Health ◽

Mental Health Status ◽

Medical Expenditure ◽

Cross Sectional ◽

Logistic Regression Models ◽

Good Mental Health

Poor mental health is common among older adults with pain, resulting in high economic burden and impaired quality of life. This retrospective, cross-sectional database study aimed to identify characteristics associated with good mental health status among United States (US) adults aged ≥50 years with self-reported pain in the last four weeks using a weighted sample of 2017 Medical Expenditure Panel Survey data. Hierarchical multivariable logistic regression models were used to identify statistically significant predictors of good (versus poor) perceived mental health status. From a weighted population of 57,074,842 individuals, 85.5% (95% confidence interval (CI) = 84.4%, 86.7%) had good perceived mental health. Good mental health was associated most strongly with physical health status (adjusted odds ratio (AOR) = 9.216, 95% CI = 7.044, 12.058). Employed individuals were 1.7 times more likely to report good mental health versus unemployed (AOR = 1.715, 95% CI = 1.199, 2.452). Individuals who had completed less than high school education (AOR = 0.750, 95% CI = 0.569, 0.987) or who reported having a limitation (AOR = 0.513, 95% CI = 0.384, 0.684) were less likely to report good mental health. These key characteristics can be utilized to predict mental health status, which may be investigated to better manage concurrent pain and poor mental health.

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Health Status and Predictors of Hypertension, Blood Pressure, and Pulse Rate of Jamaicans During the Covid-19 Pandemic

10.47363/jmhc/2021(3)140 ◽

2019 ◽

pp. 1-12

Author(s):

Paul Andrew Bourne ◽

◽

Vincent M.S. Peterkin ◽

Keyword(s):

Public Health ◽

Blood Pressure ◽

Health Status ◽

Research Design ◽

Pulse Rate ◽

Cross Sectional Study ◽

Least Square ◽

Unhealthy Lifestyle ◽

Cross Sectional Survey ◽

Cross Sectional

The objectives of the current research are to examine Jamaicans’ health status, pulse rate, body mass index (BMI), hypertension, and factors influencing 1) hypertension, 2) blood pressure, and 3) pulse rate, during COVID-19. A cross-sectional survey using associational research design by way of convenience sampling was used to conduct this research. This study examined correlation of age, gender, BMI, hypertension, and blood pressure among Jamaicans age ranging from 15 to 85 and above. Cross–sectional study and associational research design were used to collect data for the period of June to August 2020. The study demonstrated that hypertension is significantly predicted by gender, age, and pulse rate one─Omnibus tests of model (χ2(4) =138.947, P < 0.0001, -2Ll=2098.67) and Wald statistic being 90.161, P < 0.0001, and the variance in model 10.8% (Nagelkerke R2). Furthermore, ordinary least square (OLS) regression can be used to model pulse rate (bpm) for Jamaicans (F [4, 1676] =17.236, P < 0.0001), with the model explaining 4.0% of the variance in pulse rate of Jamaicans. Gender, BMI and Hypertensive emerged as the factors that determine the pulse rate of Jamaicans. Diastolic & systolic blood pressure were determined by age, weight, and pulse rate, with age being the most significant predictor. The risk of hypertension was higher among population groups who were overweight and obese. Gender was found to correlate with blood pressure and hypertension; female participants were more likely to be hypertensive than the male participants. BMI measurement should be recommended as a simple and effective predictor of hypertension in public health strategies. There is empirical evidence that can be used to establish that Jamaicans health status has worsen since March 10, 2020, and that Covid-19 has brought with it unhealthy lifestyle practices, which are pending public health challenges come 2021 and beyond.

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