scholarly journals Two-Year Stability and Change in Access to and Reasons for Lacking a Usual Source of Care Among Working-Age US Adults

2017 ◽  
Vol 132 (6) ◽  
pp. 660-668 ◽  
Author(s):  
Michelle L. Stransky
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Usual Source Of Care ◽  
Short Term ◽  
Public Health Policies ◽  
Usual Source ◽  
Working Age ◽  
Source Of Care ◽  
Nationally Representative ◽  
Policies And Programs

Objective: The objective of this study was to investigate usual source of care (USC) over time. Methods: A nationally representative sample of working-age adults in the Medical Expenditure Panel Survey (Panels 16 [2011-2012] and 17 [2012-2013]) was divided into 3 groups based on USC questions asked during 2 waves: (1) those having a USC during both waves (always USC), (2) those not having a USC during either wave (never USC), and (3) those who gained or lost a USC between the 2 waves (changed USC). The study examined the sociodemographic and health characteristics associated with these groups and the main reasons for not having a USC among those who never had a USC and those who changed their USC. Results: Of the 10 792 adults in the analysis, a longitudinally weighted 18.8% reported that their USC changed during the period. Among adults in the changed USC group, those with private (odds ratio [OR] = 2.0, P = .001) or public (OR = 2.2, P = .001) health insurance and 1 (OR = 1.7, P = .04) or ≥2 (OR = 3.1, P = .02) chronic health conditions were more likely to transition to having a USC from not having a USC, compared with those who had no insurance and no chronic conditions. Compared with those in the changed USC group, those in the never USC group were more likely to report preferring not to have a USC (57.9% vs 80.1%, P < .001). Conclusions: Insurance and public health policies and programs are needed to reduce short-term changes in USC and increase the number of adults with ongoing, consistent USC.

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.

scholarly journals The Impact of Insurance and a Usual Source of Care on Emergency Department Use in the United States

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Winston Liaw ◽  
Stephen Petterson ◽  
David L. Rabin ◽  
Andrew Bazemore
Keyword(s):  
Emergency Department ◽  
Low Income ◽  
The United States ◽  
Medical Expenditure ◽  
Usual Source Of Care ◽  
Cross Sectional ◽  
Usual Source ◽  
Insurance Type ◽  
Source Of Care ◽  
The Impact

Background. Finding a usual source of care (USC) is difficult for certain populations. This analysis determines how insurance type and having a USC affect the settings in which patients seek care. Methods. In this cross-sectional study of the 2000–2011 Medical Expenditure Panel Surveys, we assessed the percentage of low-income persons with half or more of their ambulatory visits to the emergency department (ED). Respondents were stratified based on insurance type and presence of a USC. Results. In 2011, among Medicaid enrollees without USCs, 21.6% had half or more of their ambulatory visits to EDs compared to 8.1% for those with USCs. Among the uninsured without USCs, 24.1% went to an ED for half or more of their ambulatory visits compared to 8.8% for those with USCs in 2011. Among the privately insured without USCs, 7.8% went to an ED for half or more of their ambulatory visits compared to 5.0% for those with USCs in 2011. These differences remained in multivariate analyses. Conclusions. Those who lack USCs, particularly the uninsured and Medicaid enrollees, are more likely to rely on EDs.

scholarly journals Hearing Loss and Healthcare Access among Adults

2021 ◽  
Vol 42 (01) ◽  
pp. 047-058
Author(s):  
Elham Mahmoudi ◽  
Philip Zazove ◽  
Terrence Pleasant ◽  
Lisa Meeks ◽  
Michael M. McKee
Keyword(s):  
Hearing Loss ◽  
Prescription Drugs ◽  
Medical Expenditure Panel Survey ◽  
Healthcare Access ◽  
Medical Expenditure ◽  
Public Health Policies ◽  
Medical Needs ◽  
Nationally Representative ◽  
Access To Medical Care ◽  
Unmet Medical Needs

AbstractHearing loss (HL) is common among individuals aged 50 and older and is associated with increased healthcare costs. Whether HL is associated with less access to healthcare is unclear. In this study, we examined the association between HL and access to medical care and prescription drugs among individuals 50+ with and without HL. We used nationally representative 2013–2014 Medical Expenditure Panel Survey data, consisting of 1,977 adults with HL and 17,399 without. We applied an inverse propensity score weighting and regression modeling to adjust for any potential differences in health and socioeconomic conditions between the two groups. Adults with HL were more likely to be white, less educated, poorer, and with public insurance (p < 0.001). They were also likely to have hypertension, heart disease, stroke, emphysema, high cholesterol, diabetes, joint pain, and arthritis (p < 0.001). The odds of reporting unmet medical needs (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.29–2.66), delay in getting medical needs met (OR = 1.37; 95% CI = 1.00–1.87), and having unfilled prescriptions (OR = 1.81; 95% CI = 1.27–2.59) were higher among individuals with HL compared with their counterparts without HL. Individuals with HL have less access to care and prescription drugs. To ensure equitability in access, public health policies should address specific needs of people with HL.

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