scholarly journals Trends in Obesity and Medical Expenditure among Women with Diabetes, 2008-2016: Differences by Race/Ethnicity

2020 ◽  
Vol 30 (4) ◽  
pp. 621-628
Author(s):  
Joni S. Williams ◽  
Kaiwei Lu ◽  
Olaitan Akinboboye ◽  
Oluwatoyin Olukotun ◽  
Zhipeng Zhou ◽  
...  
Keyword(s):  
Medical Expenditure Panel Survey ◽  
Hispanic Women ◽  
Statistical Significance ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Income Insurance ◽  
Obesity Trends ◽  
Race Ethnicity ◽  
Nationally Representative

Objectives: Diabetes results in $327 billion in medical expenditures annually, while obesity, a risk factor for type 2 diabetes, leads to more than $147 billion in expendi­ture annually. The aims of this study were: 1) to evaluate racial/ethnic trends in obesity and medical expenditures; and 2) to assess incremental medical expenditures among a nationally representative sample of women with diabetes.Methods: Nine years of data (2008–2016) from the Medical Expenditure Panel Survey Full Year Consolidated File (unweighted = 11,755; weighted = 10,685,090) were used. The outcome variable was medical expenditure. The primary independent variable was race/ethnicity defined as non-Hispanic Black (NHB), Hispanic, or non-Hispanic White (NHW). Covariates included age, education, marital status, income, insurance, employment, region, comorbidity, and year. Cochran-Armitage tests determined statistical significance of trends in obesity and mean expenditure. Two-part modeling using Probit and gamma distribution was used to assess incremental medical expenditure. Data were clustered to 2008-2010, 2011-2013, 2014-2016.Results: Trends in medical expenditures dif­fered significantly between NHB and NHW women between 2008-2016 (P<.001). His­panic women paid $1,291 less compared with NHW women, after adjusting for rel­evant covariates. There were no significant differences in obesity trends from 2008- 2016 between NHB (P=.989) or Hispanic women with diabetes (P=.938) compared with NHW women with diabetes.Conclusions: These findings suggest the need to further understand the factors asso­ciated with differences in trends for medical expenditures between NHB and NHW women with diabetes and incremental med­ical expenditures in Hispanic women with diabetes compared with NHW women with diabetes.Ethn Dis. 2020;30(4);621-628; doi:10.18865/ed.30.4.621

Associations of multiple (≥5) chronic conditions among a nationally representative sample of older United States adults with self-reported pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
David R. Axon ◽  
Daniel Arku
Keyword(s):  
United States ◽  
Older Adults ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Multiple Chronic Conditions ◽  
Work Limitations ◽  
Nationally Representative

Abstract Objectives The association between an individuals’ demographic and health characteristics and the presence of multiple chronic conditions is not well known among older United States (US) adults. This study aimed to identify the prevalence and associations of having multiple chronic conditions among older US adults with self-reported pain. Methods This retrospective, cross-sectional study used data from the 2017 Medical Expenditure Panel Survey. Study subjects were aged ≥50 years and had self-reported pain in the past four weeks. The outcome variable was multiple (≥5) chronic conditions (vs. <5 chronic conditions). Hierarchical logistic regression models were used to identify significant associations between demographic and health characteristics and multiple chronic conditions with significance indicated at an a priori alpha level of 0.05. The complex survey design was accounted for when obtaining nationally-representative estimates. Results The weighted population was 57,074,842 US older adults with pain, of which, 66.1% had ≥5 chronic conditions. In fully-adjusted analyses, significant associations of ≥5 comorbid chronic conditions included: age 50–64 vs. ≥65 years (adjusted odds ratio [AOR]=0.478, 95% confidence interval [CI]=0.391, 0.584); male vs. female gender (AOR=1.271, 95% CI=1.063, 1.519); white vs. other race (AOR=1.220, 95% CI=1.016, 1.465); Hispanic vs. non-Hispanic ethnicity (AOR=0.614, 95% CI=0.475, 0.793); employed vs. unemployed (AOR=0.591, 95% CI=0.476, 0.733); functional limitations vs. no functional limitations (AOR=1.862, 95% CI=1.510, 2.298); work limitations vs. no work limitations (AOR=1.588, 95% CI=1.275, 1.976); little/moderate vs. quite a bit/extreme pain (AOR=0.732, 95% CI=0.599, 0.893); and excellent/very good (AOR=0.375, 95% CI=0.294, 0.480) or good (AOR=0.661, 95% CI=0.540, 0.810) vs. fair/poor physical health. Conclusions Approximately 38 million of the 57 million US older adults with pain in this study had ≥5 chronic conditions in 2017. Several characteristics were associated with multiple chronic conditions, which may be important for health care professionals to consider when working with patients to manage their pain. This study was approved by The University of Arizona Institutional Review Board (2006721124, June 12, 2020).

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 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.

scholarly journals National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults With Cancer: 2001 to 2008

2011 ◽  
Vol 29 (20) ◽  
pp. 2821-2826 ◽  
Author(s):  
Didem S.M. Bernard ◽  
Stacy L. Farr ◽  
Zhengyi Fang
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Chronically Ill ◽  
Medical Expenditure ◽  
Never Married ◽  
Patients With Cancer ◽  
Nationally Representative ◽  
Total Burden

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists.

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

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.

The Effect of SCHIP Expansions on Health Insurance Decisions by Employers

2005 ◽  
Vol 42 (3) ◽  
pp. 218-231 ◽  
Author(s):  
Thomas Buchmueller ◽  
Philip Cooper ◽  
Kosali Simon ◽  
Jessica Vistnes
Keyword(s):  
Health Insurance ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Cross Sectional ◽  
Insurance Program ◽  
Health Insurance Program ◽  
State Variation ◽  
Nationally Representative ◽  
Insurance Decisions

This study uses repeated cross-sectional data from the Medical Expenditure Panel Survey—Insurance Component (MEPS-IC), a large nationally representative survey of establishments, to investigate the effect of the State Children's Health Insurance Program (SCHIP) on health insurance decisions by employers. The data span the years 1997 to 2001, the period when states were implementing SCHIP. We exploit cross-state variation in the timing of SCHIP implementation and the extent to which the program increased eligibility for public insurance. We find evidence suggesting that employers whose workers were likely to have been affected by these expansions reacted by raising employee contributions for family coverage options, and that take-up of any coverage, generally, and family coverage, specifically, dropped in these establishments. We find no evidence that employers stopped offering single or family coverage outright.

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