scholarly journals Dynamic Inefficiencies in an Employment-Based Health Insurance System: Theory and Evidence

2011 ◽  
Vol 101 (7) ◽  
pp. 3047-3077 ◽  
Author(s):  
Hanming Fang ◽  
Alessandro Gavazza
Keyword(s):  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Comparative Statics ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Labor Turnover ◽  
Institutional Settings ◽  
The Us ◽  
General Human Capital ◽  
Retirement Study

We investigate the effects of the institutional settings of the US health care system on individuals' life-cycle medical expenditures. Health is a form of general human capital; labor turnover and labor-market frictions prevent an employer-employee pair from capturing the entire surplus from investment in an employee's health. Thus, the pair underinvests in health during working years, thereby increasing medical expenditures during retirement. We provide empirical evidence consistent with the comparative statics predictions of our model using the Medical Expenditure Panel Survey (MEPS) and the Health and Retirement Study (HRS). Our estimates suggest significant inefficiencies in health investment in the United States. (JEL D14, D91, G22, I11, J32)

scholarly journals Weight Mobility and Obesity in a Representative Sample of the US Adult Population

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Deanna J. M. Isaman ◽  
Amy E. Rothberg
Keyword(s):  
Representative Sample ◽  
Medical Expenditure Panel Survey ◽  
Adult Population ◽  
The United States ◽  
Incidence Rates ◽  
Medical Expenditure ◽  
The Us ◽  
Prevalence Of Obesity ◽  
One Year ◽  
Overweight Or Obesity

Background. Despite the attention given to the prevalence of obesity, surprisingly little is known about the incidence or reduction of obesity. We report the 1-year incidence and remission of obesity in a representative sample of the US population. Methods. Individuals from the Medical Expenditure Panel Survey (MEPS) panel 17 were classified into standard obesity categories at enrollment and one year later. Incidence rates were calculated by age. Results. Although the overall prevalence of obesity remained nearly constant, remission rates from obesity (stratified by age) ranged from 11 to 27% while incidence rates ranged from 6 to 16%. For almost all age levels, the proportion of individuals leaving an obese or overweight state was greater than or equal to the proportion who progressed to a more severe level of overweight or obesity. Overall, 36% of adults lost at least 2.5 kg/m2 in the one-year period; only 8% gained 2.5 kg/m2 or more. Individuals less than 25 years of age had higher rates of leaving overweight (23% versus <16%) and obesity (27% versus 24%) classifications than people of other ages. Conclusions. Prevalence rates of obesity are well documented in the United States, but incidence is understudied. Public health efforts that target young people with overweight or obesity may yield the greatest benefit.

The Economic Toll of Intimate Partner Violence Against Women in the United States

2004 ◽  
Vol 19 (3) ◽  
pp. 259-272 ◽  
Author(s):  
Wendy Max ◽  
Dorothy P. Rice ◽  
Eric Finkelstein ◽  
Robert A. Bardwell ◽  
Steven Leadbetter
Keyword(s):  
Intimate Partner Violence ◽  
Violence Against Women ◽  
Partner Violence ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Intimate Partner ◽  
Medical Expenditure ◽  
Physical Assault ◽  
The Us ◽  
Partner Violence Against Women

This study provides estimates of the economic cost of intimate partner violence perpetrated against women in the US, including expenditures for medical care and mental health services, and lost productivity from injury and premature death. The analysis uses national survey data, including the National Violence Against Women Survey and the Medical Expenditure Panel Survey, to estimate costs for 1995. Intimate partner violence against women cost $5.8 billion dollars (95% confidence interval: $3.9 to $7.7 billion) in 1995, including $320 million ($136 to $503 million) for rapes, $4.2 billion ($2.4 to $6.1 billion) for physical assault, $342 million ($235 to $449 million) for stalking, and $893 million ($840 to $946 million) for murders. Updated to 2003 dollars, costs would total over $8.3 billion. Intimate partner violence is costly in the US. The potential savings from efforts to reduce this violence are substantial. More comprehensive data are needed to refine cost estimates and monitor costs over time.

scholarly journals Direct Medical Expenditures Associated with Eye Complications among Adults with Diabetes in the United States

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Abdulkarim M. Meraya ◽  
Monira Alwhaibi ◽  
Moteb A. Khobrani ◽  
Hafiz A. Makeen ◽  
Saad S. Alqahtani ◽  
...  
Keyword(s):  
Study Design ◽  
Prescription Drugs ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
The United States ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Physical And Mental Health ◽  
Poverty Level ◽  
Healthcare Expenditures

Objectives. National estimates of healthcare expenditures by types of services for adults with comorbid diabetes and eye complications (ECs) are scarce. Therefore, the first objective of this study is to estimate total healthcare expenditures and expenditures by types of services (inpatient, outpatient, prescription, and emergency) for adults with ECs. The second objective is to estimate the out-of-pocket spending burden among adults with ECs. Study Design. A cross-sectional study design using data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey was employed. The sample included adults aged 21 years or older with diabetes (n=8,420). Principal Findings. Of adults with diabetes, 18.9% had ECs. Adults ECs had significantly higher incremental total medical expenditures of $3,125. The highest incremental expenditures were associated with outpatient and prescription drugs. After controlling for sex, age, race, poverty level, insurance coverage, prescription coverage, perceived physical and mental health, the number of chronic physical and mental conditions, marital status, education, the region of residence, smoking status, exercise, and chronic kidney disease (CKD), there was no difference in the out-of-pocket spending burden between adults with and those without ECs. However, adults with comorbid diabetes and CKD were more likely to have the out-of-pocket spending burden than those without CKD. Conclusions. The study showed that ECs in individuals with diabetes are associated with high incremental direct medical and out-of-pocket expenditures. Therefore, it requires more health initiatives, interventions, strategies, and programs to address and minimize the risk involved in such affected individuals.

scholarly journals Medical Expenditure Measures in the Health and Retirement Study

2011 ◽  
Vol 14 (3) ◽  
Author(s):  
Dana P Goldman ◽  
Julie Zissimopoulos ◽  
Yang Lu
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Health And Retirement Study ◽  
Panel Survey ◽  
Medicare Current Beneficiary Survey ◽  
Retirement Decisions ◽  
Financial Preparation ◽  
Retirement Study

This paper reviews out-of-pocket (OOP) medical expenditure measures collected in the Health and Retirement Study (HRS). Medical expenditures are an important cost of poor health. Medical expenditure measures are important for understanding retirement decisions, financial preparation for retirement, and predicting the consequences of health care reform, particularly Medicare reform. Despite the comprehensiveness of the HRS, there are always limitations to what can be learned from population interviews. To assess the quality of current HRS measures of OOP spending, we compare various measures of OOP spending across survey waves to the Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey (MCBS), two surveys that expend considerable resources on measuring both OOP spending and total medical expenditures. Such comparisons make it possible to identify potential bias in the HRS data and to improve HRS measures of OOP. We find that the HRS produces good quality and useful data on OOP spending.

scholarly journals Examining the Pharmacist Labor Supply in the United States: Increasing Medication Use, Aging Society, and Evolution of Pharmacy Practice

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 137 ◽  
Author(s):  
Jonathan H. Watanabe
Keyword(s):  
Older Adults ◽  
Medical Expenditure Panel Survey ◽  
Clinical Care ◽  
Labor Demand ◽  
Pharmacy Practice ◽  
The United States ◽  
Medical Expenditure ◽  
Demographic Shift ◽  
Case Scenario ◽  
The Us

The increasing number of pharmacists in the US has generated concern regarding potential oversupply. A 2018 analysis from the National Center for Health Workforce Analysis (NCHWA) in the US projected a best case scenario of an oversupply of more than 18,000 pharmacists in the year 2030. In this commentary, the limitations of this general health labor force analysis by the NCHWA are described. The goal of this work was to provide a more nuanced examination of the pharmacist labor demand in the US. Data from the US Bureau of Labor Statistics (BLS) and the US Medical Expenditure Panel Survey (MEPS) were utilized to examine, annually over a ten year period ending in 2017, the number of pharmacists, the ratio of pharmacists to persons living in the US, the ratio of pharmacists to older adults living in the US, and the ratio of medications to pharmacists. The number of pharmacists grew from 266,410 in 2008 to 309,330 in 2017. As anticipated, despite a growing US population, the ratio of people living in the US per pharmacist dropped unabated from 1141 to 1053 from 2008 to 2017, respectively. However, the reverse trend was observed for the ratio of persons 65 years or older per pharmacist. This ratio increased from 146.1 older adults to each pharmacist in 2008 to 164.3 in 2017. The accelerating demographic shift to an older population is also reversing an overall trend in the number of medications to pharmacist that will continue for the foreseeable future. While the ratio of medications to pharmacist dropped overall from 2008 to 2016, it has begun to rise again from 2016 to 2017. Beyond the increasing number of medications attributable to a rapidly aging population, there is a growing demand for clinical care from pharmacists due to the maturing environment of complex, costly medications for chronic disease treatment. As the portion of total health expenditure is increasingly devoted to medications and the US health delivery system continues its movement to community-based care, the demand for pharmacist care will require a larger number of pharmacists trained for advanced-practice care.

scholarly journals Trends in Medical Care Expenditures of US Adults with Arthritis and Other Rheumatic Conditions 1997 to 2005

2009 ◽  
Vol 36 (11) ◽  
pp. 2531-2538 ◽  
Author(s):  
MIRIAM G. CISTERNAS ◽  
LOUISE B. MURPHY ◽  
EDWARD H. YELIN ◽  
AIMEE J. FOREMAN ◽  
DAVID J. PASTA ◽  
...  
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Population Increase ◽  
Comorbid Condition ◽  
The Us ◽  
Rheumatic Conditions ◽  
Nationally Representative ◽  
Relative Decline ◽  
Comorbidity Status

Objective.To examine trends in annual medical expenditures from 1997 to 2005 among adults with arthritis and other rheumatic conditions (denoted Arthritis group).Methods.We analyzed annual medical expenditures (2005 US dollars) among adults with Arthritis using the Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the US civilian, noninstitutionalized population. Expenditures were stratified by Arthritis and comorbidity status.Results.The Arthritis population increased by 22% (36.8 to 44.9 million) during this period, attributable entirely to the subpopulation with at least one comorbid condition (31.8 to 40.3 million). The overall, inflation-adjusted annual mean medical expenditures for adults with Arthritis increased from $6,848 in 1997 to $7,854 in 2005. In 1997, inpatient care was the most expensive component of overall expenditures (mean $2,702), but beginning in 2001, mean inpatient and ambulatory expenditures were almost identical. Mean prescription expenditures increased nearly every year, almost doubling from $970 in 1997 to $1,811 in 2005. Aggregate total expenditures for the Arthritis population increased markedly during this period, from $252.0 to $353.0 billion (+40%). Most of this increase was attributable to the population increase in the Arthritis and comorbid condition subgroup.Conclusion.Mean annual ambulatory and prescription expenditures for adults with Arthritis increased far above the rate of medical inflation, offsetting a relative decline in inpatient expenditures. Increases in overall mean and aggregate total expenditures are attributable to the increasing number of adults with Arthritis and at least one comorbid chronic condition. Projected increases in this population suggest that these expenditures will continue to rise.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

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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