Abstract 244: Sex-based Differences in Economic and Health-related Burden of Depression on Adults With Cardiovascular Disease

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Javier Valero-Elizondo ◽  
Joseph A Salami ◽  
Oluseye Ogunmoroti ◽  
Shozab Ali ◽  
Alejandro Arrieta ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Healthcare Costs ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditures ◽  
Medical Costs ◽  
Medical Expenditure ◽  
Study Population ◽  
Per Capita ◽  
Nationally Representative ◽  
Artery Disease

Background: Depression is commonly present in patients with cardiovascular disease (CVD). Among those with established CVD, depression is more common in women and associated with worse outcome. However, how depression affects overall health care expenditures, as well as whether depression among women has a greater impact on medical costs, has not been well studied, which is the aim of the present study. Methods: The 2012 Medical Expenditure Panel Survey was analyzed to explore this project. Variables of interest were defined as CVD (coronary artery disease, stroke, peripheral artery disease, dysrhythmias or heart failure) and depression diagnoses, ascertained by ICD-9-CM codes (410, 413, 433-437, 427-28, 440, 443, 447 and 296, 311, respectively). We restricted our study population to non-institutionalized adults ≥ 18 years of age. Two-part models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess the mean expenditure per capita for each sex/depression status. Results: 27,288 surveyed persons constituted our study population (mean age 67 ± 12.4, 46% female), translating to an approximate of 231 million people across the U.S. Overall, CVD was noted in 15.6 million, of which 18% were patients with depression (2.9 million). Of this nationally representative sample, those with CVD were 86% more likely to be diagnosed with depression (OR 1.86, 95% CI 1.51, 2.28, p<0.001) than Non-CVD. Additionally, among CVD individuals, females were 66% more likely be diagnosed with depression than males (OR 1.66, 95% CI 1.23, 2.23, p=0.001). CVD diagnosis was independently associated with higher healthcare costs among individuals with depression. Moreover, on adjusted analysis, females with depression were also associated with $4,380.14 higher medical costs than those without depression (Table 1). When comparing female vs. males with CVD and depression diagnoses, adjusted mean expenditure per capita was $14,162 (95% CI 10,211 - 18,112) and $11,325 (95% CI 7,769 - 14,881), respectively. Conclusion: CVD patients, especially women, were more likely to have depression, and had considerable higher medical expenditures. The results reinforce the paramount importance of assessing and managing depression among those with CVD to favorably impact healthcare costs.

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.

Abstract 25: Favorable Modifiable Cardiovascular Risk Profile is Associated with Lower Healthcare Costs: The 2012 Medical Expenditure Panel Survey

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Javier Valero-Elizondo ◽  
Joseph A Salami ◽  
Oluseye Ogunmoroti ◽  
Ehimen C Aneni ◽  
Rehan Malik ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Complex Design ◽  
Final Study ◽  
Strategic Goals ◽  
Nationally Representative ◽  
Artery Disease

Background: The AHA’s 2020 Strategic Goals emphasize the value of favorable modifiable risk factor (MRF) profile to reduce the burden of CVD morbidity and mortality. In this study we aimed to quantify the overall and incremental impact of MRF on health care expenditure in the U.S among those with and without CVD. Methods: The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS), a nationally representative adult sample (≥ 40 years). Direct costs were calculated for all-cause health care resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias or heart failure), ascertained by ICD-9-CM codes, and MRF (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity and/or obesity). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures, taking into consideration the survey’s complex design. Results: The final study sample consisted of 15,651 MEPS participants (57 ± 12 years, 52% female). Overall, 6,231 (39%) had 0-1, 7,429 (49%) had 2-3, and 1,991 (12%) had ≥ 4 MRF, translating to 55.5, 69.9 and 17.9 million adults ≥ 40 years in U.S, respectively. Generally, there was a direct decrease in health expenditures with favorable MRF across CVD status (Table). These differences persisted after taking into account demographics, insurance status and comorbid conditions. Among those without established CVD, the average medical expenditure was $4,013 (95% CI 5,117, 2,910) and $2,696 (95% CI 4,416, 977) lower for those with 0-1 & 2-3 MRF, as compared to those with ≥ 4 MRF. Conclusion: Favorable MRF profile is associated with significantly lower medical expenditure among individuals with and without established CVD. Our study provides robust estimates for potential healthcare savings with nationwide policies focusing on preventing and managing modifiable CV risk factors.

Abstract 13: Economic Impact of Moderate-vigorous Physical Activity Among Those with and without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Javier Valero-Elizondo ◽  
Joseph A Salami ◽  
Chukwuemeka U Osondu ◽  
Adnan Younus ◽  
Alejandro Arrieta ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Medical Expenditure Panel Survey ◽  
Vigorous Physical Activity ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Cvd Risk ◽  
Vigorous Exercise ◽  
Physically Active ◽  
Artery Disease

Background: Physical activity (PA) is an established factor for favorable cardiovascular disease (CVD) outcomes and quality of life. However, to date little is available on PA’s independent impact on healthcare cost. In this study, we aimed to estimate this effect on medical expenditure from a nationally representative cohort with and without CVD. Methods: The 2012 Medical Expenditure Panel Survey data was analyzed. Our study population was limited to non-institutionalized adults ≥ 40 years of age. Variables of interest were CVD (coronary artery disease, stroke, heart failure, dysrhythmias or peripheral artery disease), modifiable risk factors (MRF; hypertension, diabetes mellitus, hypercholesterolemia, smoking, and/or obesity), and PA (dichotomous variable: defined as moderate-vigorous exercise of ≥ 30 minutes, 5 times/week). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures per capita, taking into consideration the survey’s complex design. Results: Our final study sample consisted of 15,651 surveyed individuals (mean age: 58.5 ± 12 years, 46% male). Overall, 46% engaged in at least moderate exercise, translating to 21 million physically active adults in the U.S. Of those with CVD, 34% reported PA, vs. 47% without CVD. In those without CVD, a higher prevalence of PA was noted with lower MRF burden (≥ 3: 35%, 2: 44%, 0-1: 53%). Generally, participants reporting moderate-vigorous PA incurred significantly lower healthcare costs, seen both in those with and without CVD. Among those without CVD, those engaged in moderate-vigorous PA with 0-1 & ≥ 3 MRF had $1,038 & $1,785 less healthcare expenditure, respectively, than their less physically active counterparts. Conclusion: In addition to tremendously improving CVD risk, moderate-vigorous PA is also associated with significantly less healthcare spending. Our findings further reinforce the importance of physical activity in health promotion and CVD prevention.

Differences in Health Care Expenditures Among Non-Latino Whites and Asian Subgroups Vary Along the Distribution of the Expenditures

2019 ◽  
pp. 107755871987421 ◽  
Author(s):  
Sungchul Park ◽  
Jie Chen ◽  
Dylan H. Roby ◽  
Alexander N. Ortega
Keyword(s):  
Health Care ◽  
Limited English Proficiency ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
High Expenditure ◽  
Low Levels ◽  
Nationally Representative ◽  
The Difference ◽  
White Adults

Using a nationally representative sample from the 2013 to 2016 Medical Expenditure Panel Survey, we examined differences among non-Latino Whites and Asian subgroups (Asian Indians, Chinese, Filipinos, and other Asians) across distributions of total health care expenditures and out-of-pocket (OOP) expenditures. For total health care expenditures, differences between Asian and White adults persisted throughout the distribution, but the magnitude of the difference was larger at no or low levels of expenditures than at high expenditure levels. A similar pattern was observed in OOP expenditures, but the magnitude of the difference was substantially larger at low levels of expenditures. The extent of the difference varied by Asian subgroup, but this trend persisted across all the subgroups. Similar trends were observed by nativity and limited English proficiency. Our findings suggest that differences in health care expenditures between Whites and Asians are more pronounced at low expenditure levels.

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 DEPRESSION AND MEDICAL COST OF CARDIOVASCULAR DISEASES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S497-S497
Author(s):  
Guijing Wang ◽  
Chanhyun Park ◽  
Heesoo Joo ◽  
Nikki Hawkins ◽  
Jing Fang
Keyword(s):  
Medical Cost ◽  
Medical Expenditure Panel Survey ◽  
Medical Costs ◽  
Medical Expenditure ◽  
Economic Modelling ◽  
International Classification Of Disease ◽  
Prevalence Of Depression ◽  
Modelling Techniques ◽  
Nationally Representative

Abstract Prevalence of cardiovascular disease (CVD), the leading cause of death worldwide, increases with age. Depression is a prevalent comorbidity with CVD. This study investigates the medical costs of CVD associated with depression using a nationally representative data, 2015 Medical Expenditure Panel Survey. Patients aged ≥18 were identified by using the International Classification of Disease, 9th Revision codes of 390-459 for CVD and 296 or 311 for depression (N=23,755). Medical costs were actual payments received by providers and classified by service types and payment sources. We estimated the medical costs for each service type and payment source using economic modelling techniques controlling for various potential confounders. Overall prevalence of depression was 11.4%; 17.0% in persons with CVD and 8.7% in persons without CVD (p&lt;0.001). Medical cost with depression was estimated at $6900 (p&lt;0.001) for persons with CVD and $2211 (p&lt;0.001) for those without. Costs on depression-related prescription medicines accounted for the largest portion of medical costs among persons with CVD ($3095, p&lt;0.001). For persons with depression but without CVD, costs on outpatient visits accounted for the largest proportion ($1179, p&lt;0.001). Medicare payments accounted for the largest portion of the depression-associated costs at $3338 (p=0.014) for persons with CVD. Compared with persons without CVD, those with CVD demonstrated doubled rates of depression. Depression-associated medical costs among individuals with CVD were tripled what they were for persons without CVD. Increased costs associated with depression were mainly for prescribed medicines and were financed by Medicare programs for persons with CVD.

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.

scholarly journals National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults With Cancer: 2001 to 2008

2011 ◽  
Vol 29 (20) ◽  
pp. 2821-2826 ◽  
Author(s):  
Didem S.M. Bernard ◽  
Stacy L. Farr ◽  
Zhengyi Fang
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Chronically Ill ◽  
Medical Expenditure ◽  
Never Married ◽  
Patients With Cancer ◽  
Nationally Representative ◽  
Total Burden

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists.

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

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