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

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
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.

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

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.

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

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.

scholarly journals Incremental Healthcare Expenditures Associated with Thyroid Disorders among Individuals with Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Amit D. Raval ◽  
Usha Sambamoorthi
Keyword(s):  
Health Status ◽  
Medical Expenditure Panel Survey ◽  
Cross Sectional Study ◽  
Least Square ◽  
Medical Expenditure ◽  
Thyroid Disorders ◽  
Healthcare Expenditures ◽  
Cross Sectional ◽  
Outpatient Prescription ◽  
Lifestyle Risk Factors

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.

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

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.

scholarly journals Trends in healthcare expenditures and resource utilization among a nationally representative population with opioids in the United States: a serial cross-sectional study, 2008 to 2017

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mark Bounthavong ◽  
Kangho Suh ◽  
Meng Li ◽  
Patrick M. Spoutz ◽  
Britney Ann Stottlemyer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Propensity Score ◽  
Resource Utilization ◽  
Economic Burden ◽  
Healthcare Costs ◽  
Medical Expenditure ◽  
Healthcare Expenditures ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Nationally Representative

Abstract Background Previous reports on healthcare costs and expenditures associated with populations prescribed an opioid primarily focused on populations who chronically use opioids or have opioid use disorder. However, studies that characterize the healthcare and expenditures costs among the wider number of people prescribed opioids in a nationally representative population are unavailable. We sought to characterize the healthcare costs and expenditures associated with a population prescribed an opioid in the U.S. from 2008 to 2017. Methods A serial cross-sectional design was used to compare the economic burden of adult household respondents who were prescribed and not prescribed an opioid using pooled data from the Medical Expenditure Panel Survey (MEPS) between 2008 and 2017. Respondents with an opioid prescription were matched to respondents without an opioid prescription using propensity score match methods with survey weights. Two-part generalized linear models were used to estimate the survey-weighted annual healthcare expenditures and resource utilization adjusting for multiple covariates. Additionally, 10-year trend comparisons between the groups were performed. Costs were adjusted to 2019 US dollars. Results There was a weighted total of 31,696,671 respondents with an opioid and 31,536,639 respondents without an opioid after propensity score matching. The sample had a mean (SD) age of 50.63 years (18.03), 58.9% females, and 81.6% Whites. Total annual economic burden among RPOs was $524 billion. Annual total expenditures per respondent with and without an opioid were $16,542 and $7067, respectively (P < 0.001). Similarly, adjusted prescription, outpatient, emergency department, and inpatient expenditures were significantly higher for respondents with an opioid compared to respondents without an opioid. Average annual increases in expenditures were significantly greater among respondents with an opioid compared to respondents without an opioid for total (+$185; 95% CI: $37–$334) and prescription (+$78; 95% CI: $28–$128) expenditures. There were no differences in the average annual trends for outpatient, emergency department, and inpatient expenditures between respondents with and without an opioid. Conclusions Respondents with an opioid prescription had higher healthcare expenditures and resource utilization compared to respondents without an opioid prescription from 2008 to 2017. Specifically, significant annual increases were observed for total and prescription expenditures. Additionally, 10-year trends in total and prescription expenditures were higher among respondents with an opioid than respondents without an opioid.

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

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.

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

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.

DIABETES MANAGEMENT AT COMMUNE HEALTH CENTERS OF THUA THIEN HUE PROVINCE

2019 ◽  
pp. 106-108
Author(s):  
Duc Toan Vo ◽  
Nam Hung Nguyen ◽  
Ho Thi Quynh Anh Le ◽  
Minh Tam Nguyen
Keyword(s):  
Primary Care ◽  
Early Detection ◽  
Diabetes Management ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Key Words Diabetes ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Management Services

Diabetes and its consequences have become serious public health problems in many countries. Enhancing continuity of care and diabetes management at primary care plays a crucial, sustainable and cost-effective role in health care. Objectives: To describe the current situation of diabetes management at commune health centers (CHCs) in Thua Thien Hue province. Methods: A cross-sectional study was conducted in the total 152 CHCs in Thua Thien Hue province. Service availability and readiness assessment (SARA-WHO) instrument was used to assess diabetes management of CHCs. Results: Diabetes diagnosis and/or treatment were available at 40.8% of CHCs surveyed. There was a low percentage of CHCs fully equipped for screening and early detection of diabetes (18.4%). Most of CHCs delivered prevention services regarding risk factors of diabetes. All CHCs weren’t equipped with adequate medication for diabetes management prescribed by the Ministry of Health. Metformin (33.6%) and gliclazide (28.3%) were offered at the CHCs. Conclusion: Diabetes prevention and management services at grassroots level have not been fully and widely deployed throughout the province. It’s strongly recommended to enhance the availability and readiness of diabetes management services and to invest the essential supplies and medication for diabetes screening, early detection and treatment at primary care, particularly for CHCs in the rural and mountainous areas. Key words: Diabetes management, commune health center, primary care, SARA

scholarly journals Burden of Depression among Working-Age Adults with Rheumatoid Arthritis

Arthritis ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Arijita Deb ◽  
Nilanjana Dwibedi ◽  
Traci LeMasters ◽  
Jo Ann Hornsby ◽  
Wenhui Wei ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Working Age ◽  
Nationally Representative ◽  
Using Data

Objective. This study estimated the excess clinical, humanistic, and economic burden associated with depression among working-age adults with Rheumatoid Arthritis (RA). Methods. A retrospective cross-sectional study was conducted among working-age (18 to 64 years) RA patients with depression (N=647) and without depression (N=2,015) using data from the nationally representative Medical Expenditure Panel Survey for the years 2009, 2011, 2013, and 2015. Results. Overall, 25.8% had depression. In adjusted analyses, adults with RA and depression compared to those without depression were significantly more likely to have pain interference with normal work (severe pain: AOR = 2.22; 95% CI = 1.55, 3.18), functional limitations (AOR = 2.17; 95% CI = 1.61, 2.94), and lower mental health HRQoL scores. Adults with RA and depression had significantly higher annual healthcare expenditures ($14,752 versus 10,541, p<.001) and out-of-pocket spending burden. Adults with RA and depression were more likely to be unemployed and among employed adults, those with depression had a significantly higher number of missed work days annually and higher lost annual wages due to missed work days. Conclusions. This study highlights the importance of effectively managing depression in routine clinical practice of RA patients to reduce pain and functional limitations, improve quality of life, and lower direct and indirect healthcare costs.

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