Financial Burdens of Out-of-Pocket Spending Among Medicare Fee-for-Service Beneficiaries: Role of the “Big Four” Chronic Health Conditions

2021 ◽  
pp. 107755872110328
Author(s):  
Rashmita Basu ◽  
Haiyong Liu
Keyword(s):  
Cost Sharing ◽  
Generalized Linear Model ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Fee For Service ◽  
Health Care Coverage ◽  
Using Data ◽  
Financial Burdens ◽  
Big Four

While Medicare is the universal source of health care coverage for Americans aged 65 years or older, the program requires significant cost sharing in terms of out-of-pocket (OOP) spending. We conducted a retrospective study using data from 2016 to 2018 Medicare Current Beneficiary Surveys of elderly community-dwelling beneficiaries ( n = 10,431) linked with administrative data to estimate OOP spending associated with the “big four” chronic diseases (cardiovascular disease, cancer, diabetes, and chronic lung disease). We estimated a generalized linear model adjusting for predisposing, enabling, and need factors to estimate annual OOP spending. We found that beneficiaries with any of the “big four” chronic conditions spent 15% ( p < .001) higher OOP costs and were 56% more likely to spend ≥20% of annual income on OOP expenditure (adjusted odds ratio = 1.56; p < .001) compared with those without any of those conditions. OOP spending appears to be heterogeneous across disease types and changing by conditions over time.

Quantifying the Cost of Disability Transitions in Medicare

2016 ◽  
Vol 29 (5) ◽  
pp. 788-804 ◽  
Author(s):  
Mingliang Dai ◽  
Pamela Roberto ◽  
Sarah Tom ◽  
Emma Gentry ◽  
Bruce Stuart
Keyword(s):  
Generalized Linear Model ◽  
Chronic Conditions ◽  
Daily Living ◽  
Community Dwelling ◽  
Medicare Part ◽  
Future Research ◽  
Fee For Service ◽  
Disability Progression ◽  
The Cost ◽  
The Impact

Objective: To investigate the impact of disability transitions on annual Medicare Part A and B cost. Method: We analyzed 6,385 community-dwelling beneficiaries who were continuously enrolled in fee-for-service Medicare Part A and B from 2008 to 2009. We estimated adjusted effects of disability transitions on Medicare cost using a generalized linear model. Results: Transitions to more severe disability states were associated with significantly higher average annual Medicare cost ranging from US$2,639 to US$5,405. Lower spending levels were observed for beneficiaries with improvements in functioning. Beneficiaries who transitioned from severe to moderate activities of daily living (ADLs) disability cost significantly less (−US$6,045) than those who remained severely disabled. Discussion: Interventions aimed at preventing disability progression and efforts to restore functional capacity are promising strategies for containing costs and generating savings for Medicare. Future research is needed to assess the longer term impact of disability in association with the progression of chronic conditions.

scholarly journals The role of improved social support for healthy eating in a lifestyle intervention: Texercise Select

2020 ◽  
Vol 24 (1) ◽  
pp. 146-156
Author(s):  
Aya Yoshikawa ◽  
Matthew Lee Smith ◽  
Shinduk Lee ◽  
Samuel D Towne ◽  
Marcia G Ory
Keyword(s):  
Social Support ◽  
Dietary Intake ◽  
Healthy Eating ◽  
Chronic Conditions ◽  
Structural Equation ◽  
Comparison Group ◽  
Intervention Group ◽  
Community Dwelling ◽  
Future Research

AbstractObjective:We examined the measurement and mediating role of social support in dietary intake among participants in Texercise Select, an intervention for improving lifestyle behaviours.Design:Quasi-experimental study. Participants reported their dietary intake, level of social support measured by the new Social Support for Healthy Eating scale, sociodemographics and disease profile. We conducted exploratory factor analysis for scale evaluation and structural equation modelling for mediation analysis to test if changes in dietary-specific social support mediate the relationship between the intervention and changes in dietary intake.Setting:Texas.Participants:Community-dwelling middle-aged and older adults completed a self-reported survey at baseline and 3-month follow-up (intervention group n 211, comparison group n 175).Results:The majority of the sample was aged ≥70 years (mean 74·30, sd 8·54), female (82·1 %) and had at least two chronic conditions (63·5 %). The acceptable levels of reliability and validity of the dietary-specific social support scale were confirmed. Compared with the comparison group, the intervention group reported improved intake of fruit/vegetables and water, and improved dietary-specific social support. Improved dietary-specific social support mediated the association between intervention and change in fruit/vegetable intake, controlling for sociodemographics, number of chronic conditions and geographic residence. About 12 % of intervention effect was mediated by social support.Conclusions:The current study confirms positive intervention effects on healthy eating, and highlights social support relating to dietary behaviours that may be helpful for healthy eating. Future research should investigate additional social support for developing healthy eating behavioural skills.

Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms

2020 ◽  
pp. 089826432095291
Author(s):  
Carlos A. Reyes-Ortiz ◽  
Mario U. Perez-Zepeda ◽  
José M. Ocampo-Chaparro ◽  
Adalberto Campo-Arias ◽  
Miguel G. Borda ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Odds Ratio ◽  
Well Being ◽  
Community Dwelling ◽  
Mediating Effect ◽  
Mediation Analyses ◽  
History Of ◽  
Using Data ◽  
Significant Mediator

Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older ( n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20–1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07–1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.

INOVASI PEMBELAJARAN AKIDAH AKHLAK MENGGUNAKAN METODE ROLE PLAY DALAM MENINGKATKAN PRESTASI BELAJAR SISWA

2018 ◽  
Vol 2 (1) ◽  
pp. 52-63
Author(s):  
Ansori Ansori
Keyword(s):  
Data Reduction ◽  
Role Play ◽  
Learning Goals ◽  
New Paradigm ◽  
Learning Materials ◽  
Analysis Technique ◽  
Flexible Schedule ◽  
Using Data ◽  
Real Action

The use of various methods will greatly help students in achieving learning goals. As role play method is one way mastery of learning materials through the development of imagination and appreciation of students on learning materials. Data collection techniques in this study are observation, interviews, and documentation. To analyze the data in this research using data analysis technique of Miles and Huberman model that is data reduction (Data Reduction), data presentation (Data Display) and conclusion (Conclution Drawing / verification) The findings in this research is innovation of role play method can change paradigm to the new paradigm so that the role of the teacher is more as a facilitator, counselor, consultant, and comrade study Flexible schedule, open as needed Learning directed by students themselves Problem-based, project, real world, real action, and reflection Design and investigation. Computers as tools, and dynamic media presentations.

The role of corporate investment in social responsible practices in the promotion of employees’ organizational citizenship behaviour

2014 ◽  
Author(s):  
Ana Patrícia Duarte ◽  
José Gonçalves das Neves
Keyword(s):  
Job Satisfaction ◽  
Organizational Citizenship ◽  
Economic Uncertainty ◽  
Socially Responsible ◽  
Organizational Survival ◽  
Current Scenario ◽  
Reducing Costs ◽  
Using Data ◽  
Airline Company

In the current scenario of economic uncertainty, where many organizations struggle harder for reducing costs while improving their competitiveness, employees’ organizational citizenship behaviours might have an enhanced importance for organizational survival and success. A model proposing that corporate engagement in internal socially responsible practices enhances employees’ job satisfaction and consequently increases employees’ extra-role behaviours was tested. Using data obtained from a sample of employees from an airline company (n=133), the model was examined and supported. We have therefore concluded that organizations may foster employees’ extra-role behaviours by investing in corporate socially responsible practices that signal corporate concern with employees and promote job satisfaction.

Peranan Ketua Pengurus dan Manajer Dalam Penyusunan dan Penerapan Laporan Keuangan Berbasis SAK ETAP Pada Koperasi di Kota Palembang

2019 ◽  
Vol 14 (2) ◽  
pp. 119
Author(s):  
Riza Syahputera ◽  
Martha Rianty
Keyword(s):  
Data Analysis ◽  
Sampling Technique ◽  
Financial Statements ◽  
Significant Positive Effect ◽  
Analysis Technique ◽  
Regression Test ◽  
Using Data ◽  
The City ◽  
Positive Effect

AbstractThis study aims to determine the effect of the role of the Chairperson and Cooperative Manager in the preparation and application of Financial Statements based on SAK ETAP in cooperatives in the city of Palembang. This research is a quantitative study using data obtained from questionnaires and measured using a Likert scale. The sampling technique used is purposive sampling. The sample used in this study was the Chairperson of the cooperative and the manager of the cooperative in the city of Palembang. The cooperatives studied were 203 cooperatives. The data analysis technique used is multiple linear regression test. The results showed that the role of cooperative leaders and managers had a significant positive effect on the preparation and application of SAK ETAP-based financial statements.Keywords : chairman, manager, SAK ETAP, cooperative

Influence of Confucian culture on entrepreneurial decision making using data from China's floating population

2020 ◽  
Vol 48 (7) ◽  
pp. 1-12
Author(s):  
Ran Xiong ◽  
Ping Wei
Keyword(s):  
Decision Making ◽  
Floating Population ◽  
Positive Role ◽  
Confucian Culture ◽  
Chinese Nation ◽  
Using Data ◽  
Entrepreneurial Decision ◽  
And Behavior ◽  
The Relationship

Confucian culture has had a deep-rooted influence on Chinese thinking and behavior for more than 2,000 years. With a manually created Confucian culture database and the 2017 China floating population survey, we used empirical analysis to test the relationship between Confucian culture and individual entrepreneurial choice using data obtained from China's floating population. After using the presence and number of Confucian schools and temples, and of chaste women as instrumental variables to counteract problems of endogeneity, we found that Confucian culture had a significant role in promoting individuals' entrepreneurial decision making among China's floating population. The results showed that, compared with those from areas of China not strongly influenced by Confucian culture, individuals from areas that are strongly influenced by Confucian culture were more likely to choose entrepreneurship as their occupation choice. Our findings reveal cultural factors that affect individual entrepreneurial behavior, and also illustrate the positive role of Confucianism as a representative of the typical cultures of the Chinese nation in the 21st century.

CEO and CFO Equity Incentives and the Pricing of Audit Services

2013 ◽  
Vol 33 (2) ◽  
pp. 1-25 ◽  
Author(s):  
B. Anthony Billings ◽  
Xinghua Gao ◽  
Yonghong Jia
Keyword(s):  
Positive Association ◽  
Audit Fees ◽  
Internal Controls ◽  
Audit Risk ◽  
Pricing Decisions ◽  
Equity Incentives ◽  
Accounting Scandals ◽  
Using Data ◽  
Distinctive Role

SUMMARY: The alleged perverse role of managerial incentives in accounting scandals, and the distinctive role of auditors in identifying and intervening in attempted earnings manipulation, highlight the importance of explicitly considering executive incentive plans by auditors in the auditing process. By empirically testing auditors' responses to CEO/CFO equity incentives in planning and pricing decisions using data from 2002 through 2009, we document compelling evidence that CFO equity incentives are positively associated with audit fees and CEO equity incentives are not statistically related to audit fees, suggesting that auditors perceive heightened audit risk associated with CFO equity incentives. Our further analyses reveal that the positive association between CFO equity incentives and audit fees is more pronounced in firms with weak internal controls, indicating heightened risk associated with CFO equity incentives in this setting perceived by auditors. JEL Classifications: G30, G34, M42, M52.

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