scholarly journals Direct Medical Expenditures Associated with Eye Complications among Adults with Diabetes in the United States

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Abdulkarim M. Meraya ◽  
Monira Alwhaibi ◽  
Moteb A. Khobrani ◽  
Hafiz A. Makeen ◽  
Saad S. Alqahtani ◽  
...  
Keyword(s):  
Study Design ◽  
Prescription Drugs ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
The United States ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Physical And Mental Health ◽  
Poverty Level ◽  
Healthcare Expenditures

Objectives. National estimates of healthcare expenditures by types of services for adults with comorbid diabetes and eye complications (ECs) are scarce. Therefore, the first objective of this study is to estimate total healthcare expenditures and expenditures by types of services (inpatient, outpatient, prescription, and emergency) for adults with ECs. The second objective is to estimate the out-of-pocket spending burden among adults with ECs. Study Design. A cross-sectional study design using data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey was employed. The sample included adults aged 21 years or older with diabetes (n=8,420). Principal Findings. Of adults with diabetes, 18.9% had ECs. Adults ECs had significantly higher incremental total medical expenditures of $3,125. The highest incremental expenditures were associated with outpatient and prescription drugs. After controlling for sex, age, race, poverty level, insurance coverage, prescription coverage, perceived physical and mental health, the number of chronic physical and mental conditions, marital status, education, the region of residence, smoking status, exercise, and chronic kidney disease (CKD), there was no difference in the out-of-pocket spending burden between adults with and those without ECs. However, adults with comorbid diabetes and CKD were more likely to have the out-of-pocket spending burden than those without CKD. Conclusions. The study showed that ECs in individuals with diabetes are associated with high incremental direct medical and out-of-pocket expenditures. Therefore, it requires more health initiatives, interventions, strategies, and programs to address and minimize the risk involved in such affected individuals.

scholarly journals National Trends in Out-of-Pocket 1 Costs Among U.S. Adults With Diabetes Aged 18–64 Years: 2001–2017

2021 ◽  
Author(s):  
Yu Wang ◽  
Joohyun Park ◽  
Rui Li ◽  
Elizabeth Luman ◽  
Ping Zhang
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Drug Prescription ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Complication Rates ◽  
Poverty Level ◽  
Cost Rate ◽  
National Trends ◽  
The Impact

<b>Objective</b> <p>To assess national trends in out-of-pocket (OOP) costs among adults aged 18–64 years with diabetes in the United States. </p> <p><b>Research design and methods</b></p> <p>Using data from the 2001–2017 Medical Expenditure Panel Survey, we estimated total per person annual OOP costs (insurance premiums, prescription drug costs, inpatient and outpatient deductibles, and copays, and other payments not covered by insurance) and high OOP cost rate defined as the percentage of people with OOP spending more than 10% of their family’s pretax income. We examined trends overall, by subgroup (insurance type, income level, insulin use, size of patient’s employer, and whether the patient was enrolled in a high deductible health plan), and by type of service. Changes in trends were identified using joinpoint analysis; costs were adjusted to 2017 US dollars.</p> <p><b>Results</b></p> <p>From 2001 to 2017, OOP costs decreased 4.3%, from $4,328 to $4,139, and high OOP cost rate fell 32%, from 28% to 19% (<i>P</i> < 0.001). Changes in the high OOP cost rate varied by subgroup, declining among those with public or no insurance and those with an income <200% of the federal poverty level (<i>P</i> < 0.001), but remaining stable among those with private insurance and higher income. Drug prescription OOP costs decreased among all subgroups (<i>P</i> < 0.001). Decreases in total (-$58 vs -$37, <i>P</i> < 0.001) and prescription (-$79 vs -$68, <i>P</i> < 0.001) OOP costs were higher among insulin users than noninsulin users. </p> <p><b>Conclusions</b></p> OOP costs among US nonelderly adults with diabetes declined, especially among those least able to afford them. Future studies may explore factors contributing to the decline in OOP costs and the impact on the quality of diabetes care and complication rates.

scholarly journals National Trends in Out-of-Pocket 1 Costs Among U.S. Adults With Diabetes Aged 18–64 Years: 2001–2017

2021 ◽  
Author(s):  
Yu Wang ◽  
Joohyun Park ◽  
Rui Li ◽  
Elizabeth Luman ◽  
Ping Zhang
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Drug Prescription ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Complication Rates ◽  
Poverty Level ◽  
Cost Rate ◽  
National Trends ◽  
The Impact

<b>Objective</b> <p>To assess national trends in out-of-pocket (OOP) costs among adults aged 18–64 years with diabetes in the United States. </p> <p><b>Research design and methods</b></p> <p>Using data from the 2001–2017 Medical Expenditure Panel Survey, we estimated total per person annual OOP costs (insurance premiums, prescription drug costs, inpatient and outpatient deductibles, and copays, and other payments not covered by insurance) and high OOP cost rate defined as the percentage of people with OOP spending more than 10% of their family’s pretax income. We examined trends overall, by subgroup (insurance type, income level, insulin use, size of patient’s employer, and whether the patient was enrolled in a high deductible health plan), and by type of service. Changes in trends were identified using joinpoint analysis; costs were adjusted to 2017 US dollars.</p> <p><b>Results</b></p> <p>From 2001 to 2017, OOP costs decreased 4.3%, from $4,328 to $4,139, and high OOP cost rate fell 32%, from 28% to 19% (<i>P</i> < 0.001). Changes in the high OOP cost rate varied by subgroup, declining among those with public or no insurance and those with an income <200% of the federal poverty level (<i>P</i> < 0.001), but remaining stable among those with private insurance and higher income. Drug prescription OOP costs decreased among all subgroups (<i>P</i> < 0.001). Decreases in total (-$58 vs -$37, <i>P</i> < 0.001) and prescription (-$79 vs -$68, <i>P</i> < 0.001) OOP costs were higher among insulin users than noninsulin users. </p> <p><b>Conclusions</b></p> OOP costs among US nonelderly adults with diabetes declined, especially among those least able to afford them. Future studies may explore factors contributing to the decline in OOP costs and the impact on the quality of diabetes care and complication rates.

Influence of Rheumatoid Arthritis on Employment, Function, and Productivity in a Nationally Representative Sample in the United States

2010 ◽  
Vol 37 (3) ◽  
pp. 544-549 ◽  
Author(s):  
PATRICK W. SULLIVAN ◽  
VAHRAM GHUSHCHYAN ◽  
XING-YUE HUANG ◽  
DENISE R. GLOBE
Keyword(s):  
Rheumatoid Arthritis ◽  
Negative Binomial ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
International Classification Of Diseases ◽  
The United States ◽  
Medical Expenditure ◽  
Significant Difference ◽  
Inability To Work ◽  
Nationally Representative

Objective.The Medical Expenditure Panel Survey (MEPS) was used to estimate the national influence of rheumatoid arthritis (RA) on employment, limitations in work or housework, inability to work or do housework, missed work days, days spent sick in bed, and annual wages.Methods.MEPS is a nationally representative survey of the US population. Multiple logistic, negative binomial, and Heckman selection regression methods were used, controlling for age, sex, race, ethnicity, smoking status, income, education, and chronic comorbidity. RA was identified using International Classification of Diseases-9 code 714.Results.In unadjusted descriptive statistics, individuals with RA were older, had more chronic conditions, missed more work days, spent more days sick in bed, had lower employment rates, had higher rates of limitations and inability to work, and received disability benefits at higher rates. After adjustment, multiple regression analyses showed individuals with RA were 53% less likely to be employed [OR 0.47, 95% CI 0.34–0.65], 3.3 times more likely to have limitations in work or housework (95% CI 2.35–4.64), 2.3 times more likely to be unable to work or do housework (95% CI 1.55–3.53), and spent 3.6 times as many days sick in bed as those without RA (95% CI 2.32–5.53). RA was associated with an expected loss of $8957 in annual earnings (95% CI $1881–$15,937). There was no statistically significant difference in missed work days or the level of wages.Conclusion.In the most recent available national data for adults, RA was associated with reductions in employment, productivity, and function.

Abstract 254: Persistent SES Disparities in Cardiovascular Risk Factors and Health in the United States: MEPS 2002-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Javier Valero-Elizondo ◽  
Erica S Spatz ◽  
Joseph A Salami ◽  
Chukwuemeka U Osondu ◽  
Nihar R Desai ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Pooled Analysis ◽  
High Income ◽  
Self Report ◽  
Medical Expenditure ◽  
Poverty Level ◽  
Logistic Regression Models

Background: Given the health and cost burden of cardiovascular (CV) disease, we aimed to describe the trends in CV risk factors (CRF) in the US over the last twelve years, and quantify the disparities in healthcare by socioeconomic status (SES). Methods: The 2002-2013 Medical Expenditure Panel Survey (MEPS), a nationally representative sample was the basis for our study. CRFs (hypertension, diabetes mellitus, hypercholesterolemia, smoking, lack of physical activity and obesity) were identified by ICD9CM codes and/or self-report. Individuals were stratified by income level (per the federal poverty level), and proportions and logistic regression models were used to study trends and relationships for each CRF in two-year intervals. All analyses took into consideration the survey’s complex design. Inclusion criteria: age ≥ 18, BMI ≥ 18.5 and a positive sampling weight. Results: The study sample consisted of 250,371 MEPS participants (46 ± 14 years of age, 49% male), translating into 1.3 billion US adults. During the study period, the proportion of individuals with obesity increased overall, though moreso among people of low SES (Table). Trends in diabetes prevalence increased (from 9.6% to 12.8% in “Poor/Near Poor” and 5.6% to 8.3% in “High Income”, both p trend < 0.001) and hypertension (from 28.5% to 36.3% in “Poor/Near Poor” and 24.2% to 33.4% in “High Income”, both p trend < 0.001), though the greatest relative change was observed among the Middle/High Income SES group. Prevalence of inadequate physical activity increased in all SES categories, with the “Poor/Near Poor” group having the most drastic change (32.4% vs. 55.4%, p trend < 0.001), and a relative percent change of 71.1% increase in this category. Smoking declined across time in all SES categories, and hypercholesterolemia showed no significant changes. In pooled analysis, the odds of having a “Poor CRF Profile” (≥ 4 CRFs) for “Poor/Near Poor” SES were 36% higher when compared to “High Income” SES (OR 1.36, 95% CI [1.30, 1.44]) (Table). Conclusion: Disparities in the prevalence of CRFs have increased over the past 12 years, and have worsened for some conditions, including obesity, diabetes, hypertension and physical inactivity. There is a need for healthcare initiatives and policies to target the groups most in need.

scholarly journals National medical expenditures by smoking status in American adults: an application of Manning’s two-stage model to nationally representative data

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026592
Author(s):  
David I Swedler ◽  
Ted R Miller ◽  
Bina Ali ◽  
Geetha Waeher ◽  
Steven L Bernstein
Keyword(s):  
Medical History ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
Demographic Data ◽  
Adult Life ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Former Smokers ◽  
Never Smokers ◽  
The Impact

ObjectivesTo assess the medical expenditures of American adults by their smoking status—Current, Former or Never smokers. We update these expenditures through 2015 controlling for personal characteristics and medical history and assess the impact of years-since-quitting and decade of life.Setting and participantsWeighted sample of American adults, 2011–2015. The linked National Health Interview Survey (NHIS) and Medical Expenditure Panel Survey (MEPS) are annual weighted representations of approximately 250 million adults. Sampling of NHIS is multistage with data collected throughout the year.Primary outcome measuresUsing data from NHIS and MEPS, we collected demographic data, self-reported medical history and current smoking status. Smoking status was designated as Never, Current and Former, along with years-since-quitting. Total medical expenditures were collected from MEPS for 2011–2015. We used Manning’s two-part model to estimate average expenditures per individual and marginal costs for individuals at all levels of smoking status.ResultsAmerican adults averaged US$4830 in average medical expenditures. Never smokers (US$4360, 95% CI 4154.3 to 4566.3), had lower expenditures than Current (US$5244, 95% CI 4707.9 to 5580.3) and Former (US$5590, 95% CI 5267.4 to 5913.5) smokers. CI for Current and Former smokers overlapped. Results were similarly significant when controlling for disease history. Years-since-quitting did not affect expenditures. In each decade of adult life, Former smokers had the highest annual medical expenditures, followed by Current and then Never smokers.ConclusionsWe updated annual medical expenditures during the Affordable Care Act era by smoking status using the current best practice model. While we identify Former smokers as having higher medical expenditures than Current smokers, we do not examine how care-seeking behaviour varies between levels of each risk factor.

Association of Multimorbidity on Healthcare Expenditures Among Older United States Adults With Pain

2021 ◽  
pp. 089826432110118
Author(s):  
Srujitha Marupuru ◽  
David R Axon
Keyword(s):  
United States ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
Financial Burden ◽  
Home Healthcare ◽  
Medical Expenditure ◽  
Linear Regression Models ◽  
Healthcare Expenditures ◽  
Cross Sectional ◽  
Medication Costs

Objectives: This cross-sectional study compared the healthcare expenditures associated with multimorbidity (having ≥2 chronic conditions) versus no multimorbidity among older United States (US) adults (aged ≥ 50 years) with self-reported pain in the past 4 weeks. Methods: This research used data from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression models evaluated group differences in various annual healthcare expenditures. Results: Descriptive statistics indicated multimorbidity was associated with all personal characteristics ( p < 0.05) except gender and smoking status ( p > 0.05). Multimorbidity had 75.8% greater annual total health expenditures ( p = 0.0083), 40.6% greater office-based expenditures ( p = 0.0224), 100.6% greater prescription medication costs, ( p = 0.0268), yet 47.3% lower inpatient expenditures ( p = 0.0158), and 56.6% lower home healthcare expenditures ( p < 0.0001) than no multimorbidity. Discussion: This study found greater healthcare expenditures among older US adults with pain and multimorbidity, which captures the financial burden of comorbidity in this population.

scholarly journals Health Costs of Older Opioid Users with Pain and Comorbid Hypercholesterolemia or Hypertension in the United States

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 41
Author(s):  
David R. Axon ◽  
Srujitha Marupuru ◽  
Shannon Vaffis
Keyword(s):  
United States ◽  
Healthcare Expenditure ◽  
Medical Expenditure Panel Survey ◽  
Prescription Medication ◽  
The United States ◽  
Medical Expenditure ◽  
Future Research ◽  
Linear Regression Models ◽  
Healthcare Expenditures ◽  
Opioid Users

This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey data to quantify and assess differences in healthcare expenditures between opioid users and non-users among a non-institutionalized sample of older (≥50 years) United States adults with pain in the past four weeks and a diagnosis of comorbid hypercholesterolemia (pain–hypercholesterolemia group) or hypertension (pain–hypertension group). Hierarchical multivariable linear regression models were constructed by using logarithmically transformed positive cost data and adjusting for relevant factors to assess cost differences between groups. Percent difference between opioid users and non-users was calculated by using semi-logarithmic equations. Healthcare costs included inpatient, outpatient, office-based, emergency room, prescription medication, other, and total costs. In adjusted analyses, compared to non-users, opioid users in the pain–hypercholesterolemia and pain–hypertension groups respectively had 66% and 60% greater inpatient expenditure, 46% and 55% greater outpatient expenditure, 67% and 72% greater office-based expenditure, 50% and 60% greater prescription medication expenditure, 24% and 22% greater other healthcare expenditure, and 85% and 93% greater total healthcare expenditure. In conclusion, adjusted total healthcare expenditures were 85–93% greater among opioid users versus non-users in older United States adults with pain and comorbid hypercholesterolemia or hypertension. Future research is needed to identify opioid use predictors among these populations and reduce expenditures.

scholarly journals The Direct Healthcare Expenditures of Prostate Cancer by Disease Severity: Evidence from US National Survey Data

10.36469/9844 ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 83-96
Author(s):  
Peter J. Mallow ◽  
Jie Chen ◽  
John A. Rizzo ◽  
John R. Penrod ◽  
Geralyn C. Trudel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Severity ◽  
Healthcare Costs ◽  
Medical Expenditure Panel Survey ◽  
Metastatic Cancer ◽  
International Classification Of Diseases ◽  
The United States ◽  
Medical Expenditure ◽  
Healthcare Expenditures ◽  
Nationally Representative

Background: In the United States, approximately 2.8 million men have a history of prostate cancer (PC). Objective: This study quantified the effects of PC, overall and by disease severity on direct healthcare costs to insurers and patients. Methods: Using 1996–2010 data from the Medical Expenditure Panel Survey (MEPS), a large, nationally representative US database, multivariate analyses were used to assess the relationship between PC and direct annual healthcare costs to insurers and patients, at individual and US aggregate levels. Men aged 40 years and older with International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code 185 were identified. Disease severity was determined with clinical assistance and based, in part, on the data in MEPS. The cohorts were: localized cancer not treated with chemotherapy, localized cancer treated with chemotherapy, and metastatic cancer. Results: The MEPS database included 1297 patients with PC: 811 patients with localized PC not treated with chemotherapy, 426 patients with PC treated with chemotherapy, and 60 patients with metastatic PC. PC had a larger effect on incremental costs for metastatic patients, $20 357, vs $16 709 for localized PC with chemotherapy, and $5238 for localized PC with no chemotherapy. When aggregated to the US population, PC accounted for an incremental annual cost of $15 billion. The largest aggregate annual costs were incurred by patients with localized PC treated with chemotherapy ($8.6 billion), compared to those not treated with chemotherapy ($4.8 billion) and metastatic patients ($1.6 billion). Conclusions: The aggregate annual costs of PC are substantial for all groups examined and greatest for patients with localized cancer treated with chemotherapy. This reflects the relatively high prevalence and high per capita healthcare expenditures associated with this group. With a growing and aging population, the prevalence of PC is expected to rise, increasing the burden on public health.

scholarly journals Perceived Value of Health Insurance and Enrollment Decision among Low-Income Population

2018 ◽  
Vol 9 (2) ◽  
pp. 7 ◽  
Author(s):  
Jayoung Han
Keyword(s):  
Health Insurance ◽  
Prescription Drugs ◽  
Low Income ◽  
Medical Expenditure Panel Survey ◽  
Perceived Value ◽  
Medical Expenditure ◽  
Original Research ◽  
Poverty Level ◽  
Cross Sectional ◽  
Value Of Health

The individual mandate is one of the key features of the Affordable Care Act (ACA) and has contributed to a substantial decrease in the overall uninsured rate. We examined the relationship between the individual’s insurance status and his/her attitude towards risk and uncertainty among the nonelderly adults, without employer-sponsored insurance (ESI) sources and who are most likely to benefit from the ACA. A descriptive, cross-sectional study was conducted using the 2014 full-year consolidated data file from the Household Component of the Medical Expenditure Panel Survey-Household Component (MEPS-HC). This study included 4,848 individuals, aged 18–64 years, with incomes between 138–400 % of the Federal Poverty Level (FPL), and without access to public coverage or ESI. We examined the factors associated with the likelihood of being uninsured using a logit model. We found that the proportion of the uninsured among the low-income nonelderly adults without ESI (31.1%) was much higher than the one among the nonelderly adults (14.3%). The uninsured adults were likely to have lower demand for insurance and perceived value of insurance and were less likely to visit a doctor or to fill prescription drugs. More rigorous outreach efforts focusing on increasing perceived value of health insurance could contribute to an increased insurance coverage among low-income populations.   Type: Original Research

scholarly journals Obesity-Related Healthcare Expenditures in the US 2002–2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1702-1702
Author(s):  
Hong Xue ◽  
Shuo-yu Lin ◽  
Xiaolu Cheng
Keyword(s):  
Prescription Drugs ◽  
Healthcare Expenditure ◽  
Medical Expenditure Panel Survey ◽  
Temporal Trends ◽  
Medical Expenditure ◽  
Office Visits ◽  
Healthcare Expenditures ◽  
The Us ◽  
Obese Population ◽  
Per Capita

Abstract Objectives This study examined the temporal trends of obesity-related healthcare expenditures in the US between 2002 and 2016, and assessed the disparities across age, gender, race/ethnicity groups. Methods Nationally representative data from the Medical Expenditure Panel Survey (MEPS) between 2002 and 2016 were used. About 290,000 adults were included in the analyses. A two-part regression model was used to estimate the expenditures attributable to obesity. Results Between 2002–2016, obesity-related per capita healthcare expenditures increased from $4431 to $5638 in overweight and from $4898 to $5900 in obese populations (inflation-adjusted to 2016 USD). Our estimates suggested that obesity-related annual per capita healthcare across the lifespan (from 19 to 85 years old) for obese women could increase from $3356 to $13,630, significantly higher than their male counterparts (from $2473 to $10,813, P = 0.001). From age 19 to 85, obesity-related healthcare expenditure could increase from $3188 to $13,178 in non-Hispanic whites, greater than Hispanic (from $2210 to $9769, P &lt; 0.001), and black ($2583 to $11,126, P = 0.02). Office visits and prescription drugs contributed most to the growth of obesity-related healthcare costs between 2002 and 2016 in the obese population, accounting for 24% and 29% of total healthcare expenditure respectively in 2016 as compared to 22% and 25% in 2002. Conclusions Obesity-related healthcare expenditure has been increasing in the US between 2002 and 2016 with evident disparities across gender and racial/ethnic subpopulations. Physician office visits and prescription drugs are the key contributing factors to the increase in the obese population. Funding Sources N/A.

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