Health Care Expenditures and Financial Burden: A Comparison of Adults in Same-Sex Couples and Different-Sex Couples

2021 ◽  
pp. 107755872110043
Author(s):  
Kyle A. Gavulic ◽  
Gilbert Gonzales
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Same Sex ◽  
Same Sex Couples ◽  
Bisexual And Transgender ◽  
Antiviral Medications ◽  
Lgbt Populations

We used data from the 2014-2017 Medical Expenditure Panel Survey to compare health care expenditures and financial burden between adults in same-sex couples ( n = 514) and adults in different-sex couples ( n = 41,043). Compared with men in different-sex couples ($3,994), men in same-sex couples ($6,896) were more likely to spend more on health care, especially on prescription medications ($2,745 vs. $1,050), which was primarily driven by antiviral medications ($1,061 vs. $35). Women in same-sex couples ($5,886) reported similar health care expenditures compared with women in different-sex couples ($5,619). However, women in same-sex couples were significantly more likely to experience financial burden compared with women in different-sex couples (25.7% vs. 11.3%). We speculate that the disparities reported here are due to a variety of issues, including elevated health needs requiring prescriptions for lesbian, gay, bisexual, and transgender (LGBT) men and lower incomes for LGBT women. More research is needed to understand health services utilization and expenditure patterns among LGBT populations.

Incremental health care services and expenditures associated with depression among individuals with cutaneous lupus erythematosus (CLE)

Lupus ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1107-1115 ◽  
Author(s):  
M E Ogunsanya ◽  
S O Nduaguba ◽  
C M Brown
Keyword(s):  
Health Care ◽  
Prescription Drugs ◽  
Lupus Erythematosus ◽  
Medical Expenditure Panel Survey ◽  
Cutaneous Lupus Erythematosus ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Medication Costs ◽  
Cutaneous Lupus

Objectives The objective of this paper is to describe the annual direct medical expenditures for cutaneous lupus erythematosus (CLE) patients, and to estimate the incremental health care expenditures and utilization associated with depression among adults with CLE, while controlling for covariates. Methods Using the 2014 Medical Expenditure Panel Survey (MEPS), we compared CLE patients with and without depression to determine differences in: (a) health care utilization—inpatient, outpatient, office-based and emergency room (ER) visits, and prescriptions filled; and (b) expenditures—total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demography-adjusted and comorbidity-adjusted multivariate models (age, gender, race/ethnicity, marital status, education, perception of health status, poverty category, smoking status, and Charlson Comorbidity Index). Results The total direct medical expenditure associated with CLE is estimated at approximately $29.7 billion in 2014 US dollars. After adjusting for covariates, adults with CLE and depression had more hospital discharges (utilization ratio (UR) = 1.13, 95% confidence interval (CI) (1.00–1.28)), ER visits (UR = 1.17, 95% CI (1.09–1.37)), and prescribed medicines (UR = 2.15, 95% CI (1.51–3.05)) than those without depression. Adults with CLE and depression had significantly higher average annual total expenditure that those without depression ($19,854 vs. $9735). Conclusions High health care expenditures are significant for patients with CLE, especially among those with depression. Prescription drugs, inpatient visits, and ER visits contributed most to the total expenditures in CLE patients with depression. Early diagnosis and treatment of depression in CLE patients may reduce total health care expenditures and utilization in this population.

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.

State-Level Health Care Expenditures Associated With Disability

2021 ◽  
pp. 003335492097980
Author(s):  
Olga A. Khavjou ◽  
Wayne L. Anderson ◽  
Amanda A. Honeycutt ◽  
Laurel G. Bates ◽  
NaTasha D. Hollis ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
District Of Columbia ◽  
People With Disabilities ◽  
State Level ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Behavioral Risk ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance

Objective Given the growth in national disability-associated health care expenditures (DAHE) and the changes in health insurance–specific DAHE distribution, updated estimates of state-level DAHE are needed. The objective of this study was to update state-level estimates of DAHE. Methods We combined data from the 2013-2015 Medical Expenditure Panel Survey, 2013-2015 Behavioral Risk Factor Surveillance System, and 2014 National Health Expenditure Accounts to calculate state-level DAHE for US adults in total, per adult, and per (adult) person with disability (PWD). We adjusted expenditures to 2017 prices and assessed changes in DAHE from 2003 to 2015. Results In 2015, DAHE were $868 billion nationally (range, $1.4 billion in Wyoming to $102.8 billion in California) accounting for 36% of total health care expenditures (range, 29%-41%). From 2003 to 2015, total DAHE increased by 65% (range, 35%-125%). In 2015, DAHE per PWD were highest in the District of Columbia ($27 839) and lowest in Alabama ($12 603). From 2003 to 2015, per-PWD DAHE increased by 13% (range, −20% to 61%) and per-capita DAHE increased by 28% (range, 7%-84%). In 2015, Medicare DAHE per PWD ranged from $10 067 in Alaska to $18 768 in New Jersey. Medicaid DAHE per PWD ranged from $9825 in Nevada to $43 365 in the District of Columbia. Nonpublic–health insurer per-PWD DAHE ranged from $7641 in Arkansas to $18 796 in Alaska. Conclusion DAHE are substantial and vary by state. The public sector largely supports the health care costs of people with disabilities. State policy makers and other stakeholders can use these results to inform the development of public health programs that support and provide ongoing health care to people with disabilities.

scholarly journals Income-Based Disparities in Financial Burdens of Medical Spending Under the Affordable Care Act in Families With Individuals Having Chronic Conditions

2019 ◽  
Vol 56 ◽  
pp. 004695801987181
Author(s):  
Wendy Yi Xu ◽  
Sheldon M. Retchin ◽  
Eric E. Seiber ◽  
Yiting Li
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Poverty Level ◽  
Medical Spending ◽  
Financial Burdens ◽  
Behavioral Conditions

This study examined income-based disparities in financial burdens from out-of-pocket (OOP) medical spending among individuals with multiple chronic physical and behavioral conditions, before and after the Affordable Care Act’s (ACA) implementation in 2014. Using the 2012-2015 Medical Expenditure Panel Survey data, we studied changes in financial burdens experienced by nonelderly U.S. populations. Financial burdens were measured by (1) high financial burden, defined as total OOP medical spending exceeding 10% of annual household income; (2) health care cost-sharing ratio, defined as self-paid payments as a percent of total health care payments, excluding individual contributions to premiums; and (3) the total OOP costs spent on health care utilization. The findings indicated reductions in the proportion of those who experienced a high financial burden, as well as reductions in the OOP costs for some individuals. However, individuals with incomes below 138% federal poverty level (FPL) and those with incomes between 251% and 400% FPL who had multiple physical and/or behavioral chronic conditions experienced large increases in high financial burden after the ACA, relative to those with incomes greater than 400% FPL. While the ACA was associated with relieved medical financial burdens for some individuals, the worsening high financial burden for moderate-income individuals with chronic physical and behavioral conditions is a concern. Policymakers should revisit the cost subsidies for these individuals, with a particular focus on those with chronic conditions.

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 Estimated Health Care Utilization and Expenditures in Individuals With Heart Failure From the Medical Expenditure Panel Survey

2021 ◽  
Author(s):  
Sharon Klein ◽  
Shangqing Jiang ◽  
Jacob R. Morey ◽  
Akila Pai ◽  
Donna M. Mancini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Utilization ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditures ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Hospital Inpatient ◽  
Panel Survey ◽  
Medical Provider

Background: Heart failure (HF) constitutes a growing burden for public health and the US health care system. While the prevalence of HF is increasing, differences in health care utilization and expenditures within various sociodemographic groups remain poorly defined. Methods: We used the Medical Expenditure Panel Survey to assess annual health care utilization and expenditures from 2012 to 2017. Health care utilization was based on the annual frequency of various health care encounters. Annual total and out-of-pocket expenditures were evaluated for hospital inpatient stays, emergency room visits, outpatient visits, office-based medical provider visits, prescribed medicines, dental visits, home health aid visits, and other medical expenses. We performed univariable and multivariable regression analysis based on patient characteristics including sociodemographic and comorbidity variables. Results: Our results showed that total health care expenditures among patients with HF were $21 177 (95% CI, $18 819–$24 736) per year as compared with $5652 (95% CI, $5469–$5837) in those without HF ( P <0.001). Total expenditures within the population with HF were primarily being driven by expenditures associated with inpatient hospitalizations. Increasing number of comorbid conditions was associated with significant increases in total health care expenditures. Older age, female sex, earlier study years, number of comorbidities, higher level of education, and increasing family income brackets independently raised out-of-pocket expenditures. Conclusions: Our findings of increased health care utilization and expenditures based on sex, age, increasing number of comorbidities, wealthier income status, and increased education attainment level may be used for efforts aimed at better distributing health care resources to improve health outcomes in HF.

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