Estimating model-based nonnegative population marginal means in application to medical expenditures covered by different health care policies – A study on Medical Expenditure Panel Survey

2020 ◽  
pp. 096228022095424
Author(s):  
Mingmei Tian ◽  
Jihnhee Yu
Keyword(s):  
Public Health ◽  
Medical Expenditure Panel Survey ◽  
Model Fitting ◽  
Additive Model ◽  
Real Data ◽  
Population Characteristics ◽  
Medical Expenditure ◽  
Public Health Issue ◽  
Panel Survey ◽  
Marginal Means

The medical care expenditure is historically an important public health issue, which greatly impacts the government’s health policies as well as patients’ financial and medical decisions. In population health research, we commonly discretize a numeric attribute to a few ordinal groups to examine population characteristics. Oftentimes, the population marginal mean estimation by the ANOVA approach is inflexible since it uses pre-defined grouping of the covariate. In this paper, we propose a method to estimate the population marginal mean using the B-spline-based regression in a manner of a generalized additive model as an alternative for the ANOVA. Since the medical expenditure is always nonnegative, a Bayesian approach is also implemented for the nonnegative constraint on the marginal mean estimates. The proposed method is flexible to estimate marginal means for user-specified grouping after model fitting in a post-hoc manner, a clear advantage over the ANOVA approach. We show that this method is inferentially superior to the ANOVA through theoretical investigations and an extensive Monte Carlo study. The real data analysis using Medical Expenditure Panel Survey data assisted by some visualization tools demonstrates an applicability of the proposed approach and leads us some interesting observations that may be relevant to public health discussions.

Characteristics of Mail-Order Pharmacy Users: Results From the Medical Expenditures Panel Survey

2018 ◽  
Vol 33 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Junyi Ma ◽  
Li Wang
Keyword(s):  
Family Income ◽  
Medical Expenditure Panel Survey ◽  
Population Characteristics ◽  
Medical Expenditure ◽  
Lower Percentage ◽  
Outcome Variable ◽  
Mail Order ◽  
Panel Survey ◽  
Sampling Weights ◽  
Mail Order Pharmacy

Background: There is a paucity of research on the population characteristics of mail-order pharmacy users. Objective: This study utilized a nationally representative sample to examine the characteristics of mail-order pharmacy users. Methods: This study used data from the 2012 Medical Expenditure Panel Survey (MEPS). The outcome variable was defined as whether the participant had used a mail-order pharmacy during the study year. Logistic regression was conducted to determine the factors which influence mail-order pharmacy use. All analyses incorporated MEPS sampling weights to adjust for the complex survey design. Results: Among the 14,106 adults included, approximately 18% of them had used a mail-order pharmacy at least once to fill their prescription in 2012. Compared to community pharmacy users, mail-order pharmacy users were more likely to be white, older, married, have a higher family income, a higher educational level, have health insurance, and have a prescription with at least a 30-day supply. There is no difference in gender or urban/rural disparity. In addition, mail-order pharmacy users had a lower percentage of out-of-pocket costs. Conclusion: Mail-order pharmacy use was significantly associated with certain patient characteristics. Policymakers should consider these characteristics when promoting mail-order pharmacy use.

Abstract 25: Patient-reported Outcomes, Resource Utilization, and Healthcare Expenditures Across the 3 Major Atherosclerotic Diseases: The Medical Expenditure Panel Survey (meps)

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Martin Tibuakuu ◽  
Victor Okunrintemi ◽  
Andi Shahu ◽  
Ratchford V Ratchford ◽  
Nazir Savji ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Reported Outcomes ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Health Campaigns ◽  
Healthcare Expenditures ◽  
Patient Reported ◽  
Artery Disease ◽  
Public Health Campaigns

Background: Public health campaigns aimed at reducing the morbidity, mortality and economic burden of atherosclerotic cardiovascular disease (ASCVD) have mainly targeted coronary artery disease (CAD). Stroke and peripheral artery disease (PAD) are associated with substantial medical and financial burden for patients and the US healthcare system. Objective: We sought to compare the associations of patient-reported outcomes, resource utilization, and healthcare expenditures across the 3 major ASCVD types (CAD, stroke, or PAD). Methods: We used data from the Medical Expenditure Panel Survey (MEPS) conducted between 2006-2015 and included adults aged ≥18 yrs. MEPS is a nationally representative US sample and provides information on patient-reported outcomes (PROs), medical conditions, healthcare utilization and expenditures. The ASCVD types were ascertained by ICD-9 codes and/or self-reported data. Participants with more than 1 ASCVD type were not included. The associations of PROs and health utilization were quantified and contrasted across the 3 ASCVD types using multivariable adjusted regression models. A 2-part econometric model was used to assess healthcare expenditures. Results: The study sample included 14,262 MEPS participants with 1 type of ASCVD, translating into 15.9 million US adults. The mean age (SD) was 65 (±14) yrs; 48% were women, 59.6% had the diagnosis of CAD only, 37.5% stroke only, and 2.9% PAD only. Participants with stroke were more likely to report poor patient-provider communication [OR 1.37 (95% CI 1.18-1.59)], poor healthcare satisfaction, and more ED visits, and were less likely to be on a statin and aspirin, compared to CAD ( Table ). Participants with PAD also had higher odds of not being on aspirin [3.10 (2.31-4.16)] and statin [2.01 (1.37-2.95)], compared to CAD. PAD was associated with the highest annual total and out-of-pocket expenditures among the 3 ASCVDs. Conclusion: Both stroke and PAD were associated with low uptake of guideline-directed preventive therapies, compared to CAD, with PAD having the highest healthcare expenditures among the 3 ASCVD types. Our results highlight a missed opportunity for secondary ASCVD prevention among patients with PAD and stroke, and the need for public health campaigns to direct equal attention to all 3 major ASCVDs.

scholarly journals Modeling the Conditional Dependence between Discrete and Continuous Random Variables with Applications in Insurance

Mathematics ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 45
Author(s):  
Emilio Gómez-Déniz ◽  
Enrique Calderín-Ojeda
Keyword(s):  
Structural Model ◽  
Medical Expenditure Panel Survey ◽  
Health Care Use ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Conditional Distributions ◽  
Conditional Dependence ◽  
Outpatient Visits ◽  
Conditional Expectations ◽  
The U.S

We jointly model amount of expenditure for outpatient visits and number of outpatient visits by considering both dependence and simultaneity by proposing a bivariate structural model that describes both variables, specified in terms of their conditional distributions. For that reason, we assume that the conditional expectation of expenditure for outpatient visits with respect to the number of outpatient visits and also, the number of outpatient visits expectation with respect to the expenditure for outpatient visits is related by taking a linear relationship for these conditional expectations. Furthermore, one of the conditional distributions obtained in our study is used to derive Bayesian premiums which take into account both the number of claims and the size of the correspondent claims. Our proposal is illustrated with a numerical example based on data of health care use taken from Medical Expenditure Panel Survey (MEPS), conducted by the U.S. Agency of Health Research and Quality.

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.

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