scholarly journals High Out-of-pocket Health Care Cost Burden Among Medicare Beneficiaries With Diabetes, 1999–2017

2021 ◽  
Author(s):  
Joohyun Park ◽  
Ping Zhang ◽  
Yu Wang ◽  
Xilin Zhou ◽  
Kevin A. Look ◽  
...  
Keyword(s):  
Health Care Cost ◽  
Medicare Beneficiaries ◽  
Joinpoint Regression ◽  
Medicare Current Beneficiary Survey ◽  
The Past ◽  
Race Ethnicity ◽  
Using Data ◽  
Design And Methods ◽  
Increasing Trends ◽  
Income Quartile

<b>Objective</b> <p>We examined the magnitude of and trends in the burden of out-of-pocket (OOP) costs among Medicare beneficiaries ages 65 years or older with diabetes overall, and by income level, by race/ethnicity, and compared to beneficiaries without diabetes. </p> <p><b>Research Design and Methods </b></p> <p>Using data from the 1999−2017 Medicare Current Beneficiary Survey, we estimated average annual per capita OOP costs and percentage of beneficiaries experiencing high OOP burden, defined as OOP costs >10% or >20% of household income. We used joinpoint regression to examine the trends and generalized linear model and logistic regression for comparisons between beneficiaries with and without diabetes. Cost and income estimates were adjusted to 2017 USD.</p> <p><b>Results </b></p> <p>Total OOP costs were $3,609 to $5,283, with significant increases until 2005 followed by a leveling off. The prevalence of high OOP burden was 57% to 72% at the 10% income threshold and 29% to 41% at the 20% threshold, with significant increasing trends until 2003 followed by decreases. Total OOP costs were the highest in the ≥75% income quartile, whereas prevalence of high OOP burden was highest in the <25% and 25−50% income quartiles. Non-Hispanic whites had the highest OOP costs and prevalence of high OOP burden. Beneficiaries with diabetes had significantly higher OOP costs ($498, <i>P</i> <0.01) and were more likely to have high OOP burden than those without diabetes (odds ratios 1.32 and 1.25 at >10% and >20% thresholds, respectively, <i>P </i><0.01). </p> <p><b>Conclusions</b></p> Over the past 2 decades, Medicare beneficiaries ages 65 years or older with diabetes have faced substantial OOP burden, with large income-related disparities.

scholarly journals High Out-of-pocket Health Care Cost Burden Among Medicare Beneficiaries With Diabetes, 1999–2017

2021 ◽  
Author(s):  
Joohyun Park ◽  
Ping Zhang ◽  
Yu Wang ◽  
Xilin Zhou ◽  
Kevin A. Look ◽  
...  
Keyword(s):  
Health Care Cost ◽  
Medicare Beneficiaries ◽  
Joinpoint Regression ◽  
Medicare Current Beneficiary Survey ◽  
The Past ◽  
Race Ethnicity ◽  
Using Data ◽  
Design And Methods ◽  
Increasing Trends ◽  
Income Quartile

<b>Objective</b> <p>We examined the magnitude of and trends in the burden of out-of-pocket (OOP) costs among Medicare beneficiaries ages 65 years or older with diabetes overall, and by income level, by race/ethnicity, and compared to beneficiaries without diabetes. </p> <p><b>Research Design and Methods </b></p> <p>Using data from the 1999−2017 Medicare Current Beneficiary Survey, we estimated average annual per capita OOP costs and percentage of beneficiaries experiencing high OOP burden, defined as OOP costs >10% or >20% of household income. We used joinpoint regression to examine the trends and generalized linear model and logistic regression for comparisons between beneficiaries with and without diabetes. Cost and income estimates were adjusted to 2017 USD.</p> <p><b>Results </b></p> <p>Total OOP costs were $3,609 to $5,283, with significant increases until 2005 followed by a leveling off. The prevalence of high OOP burden was 57% to 72% at the 10% income threshold and 29% to 41% at the 20% threshold, with significant increasing trends until 2003 followed by decreases. Total OOP costs were the highest in the ≥75% income quartile, whereas prevalence of high OOP burden was highest in the <25% and 25−50% income quartiles. Non-Hispanic whites had the highest OOP costs and prevalence of high OOP burden. Beneficiaries with diabetes had significantly higher OOP costs ($498, <i>P</i> <0.01) and were more likely to have high OOP burden than those without diabetes (odds ratios 1.32 and 1.25 at >10% and >20% thresholds, respectively, <i>P </i><0.01). </p> <p><b>Conclusions</b></p> Over the past 2 decades, Medicare beneficiaries ages 65 years or older with diabetes have faced substantial OOP burden, with large income-related disparities.

scholarly journals Functional Hearing Loss and Social Engagement Among Medicare Beneficiaries

2019 ◽  
Vol 76 (1) ◽  
pp. 195-200 ◽  
Author(s):  
Aishwarya Shukla ◽  
Thomas K M Cudjoe ◽  
Frank R Lin ◽  
Nicholas S Reed
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Social Engagement ◽  
Social Activity ◽  
Medicare Beneficiaries ◽  
Cross Sectional ◽  
The Past ◽  
Hearing Ability ◽  
Nationally Representative ◽  
Using Data

Abstract Objectives Hearing loss is common in older adults and limits communication. We investigated the independent association between functional hearing loss and social engagement in a nationally representative sample of older adults. Methods Using data from the 2015 Medicare Current Beneficiaries Survey, we modeled the cross-sectional association between self-reported hearing ability and limitation in social activity over the past month using multivariable logistic regression. Results The majority of the study population was female (54.8%) and non-Hispanic white (74.3%). Participants (40.4%) reported “a little trouble” hearing and 7.4% reported “a lot of trouble” hearing. Those who reported any trouble hearing had higher odds of limited social engagement in the past month. After adjustment for demographic, clinical, and functional covariates, those who reported “a lot of trouble” hearing had 37% higher odds of limited social activity in the past month compared to those with normal hearing. Discussion These results suggest that hearing loss may be an important risk factor for limited social engagement and downstream negative health consequences, independent of other disability and health conditions.

scholarly journals Emergency department increased use of observation care for elderly medicare patients

2018 ◽  
Vol 7 (3) ◽  
pp. 9 ◽  
Author(s):  
Gelareh Z. Gabayan ◽  
Li-Jung Liang ◽  
Brian Doyle ◽  
David Yu-Chuang Huang ◽  
Catherine A. Sarkisian
Keyword(s):  
Emergency Department ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Inpatient Service ◽  
Medicare Beneficiaries ◽  
The Past ◽  
Medicare Patients ◽  
Nationally Representative ◽  
Using Data ◽  
The Relationship

Background: Over the past decade, a growing number of older Medicare beneficiaries visit the emergency department (ED) and have been placed in observation care. We investigated and compared the prevalence and factors associated with patients age ≥ 65 years with Medicare insurance who are placed in the hospital, observation care, or discharged following an ED visit.Methods: We conducted a retrospective cohort study using data from a nationally representative 5% sample of Medicare patients age ≥ 65 years during the year 2013. We performed multiple generalized estimating equation (GEE) logistic regression analyses to assess the relationship between placement in a hospital vs. discharge, observation care vs. discharge, and observation care vs. admission.Results: Of 537,455 Medicare beneficiaries age ≥ 65 years who visited an ED in 2013, 48.0% (N = 258,083) were discharged, 10.5% (N = 56,184) placed in observation care, and 41.5% (N = 223,188) were admitted to the inpatient service following the ED visit. The top 2 diagnoses associated with placement in the hospital vs. discharge were ischemic heart disease and renal disease. Patients with symptomatic diagnoses such as chest pain and dizziness were more likely to be placed in observation care following an ED visit as compared to admission to the hospital.Conclusions: Compared to prior studies, we found a greater number of older Medicare ED patients placed in observation care and a lower number admitted to the hospital. Most common diagnoses of placement in observation care were symptom-based as compared to being admitted to the hospital which were disease-based.

scholarly journals The Effects of State Medicaid Expansions for Working-Age Adults on Senior Medicare Beneficiaries

2017 ◽  
Vol 9 (3) ◽  
pp. 408-438 ◽  
Author(s):  
Melissa McInerney ◽  
Jennifer M. Mellor ◽  
Lindsay M. Sabik
Keyword(s):  
Healthcare Spending ◽  
Spillover Effects ◽  
Medicare Beneficiaries ◽  
Medicare Current Beneficiary Survey ◽  
Adverse Health Effects ◽  
Dual Eligibles ◽  
Working Age ◽  
Using Data ◽  
Medicaid Expansions ◽  
Medicare Spending

Do Medicaid expansions to working-age adults affect healthcare spending and utilization among older Medicare beneficiaries? Although economic theory provides conflicting predictions about the presence and direction of such spillover effects, it does identify circumstances when spillovers can reduce Medicare spending. Using data on Medicaid expansions during the 2000s and microdata from the Medicare Current Beneficiary Survey, we find that a 1 percentage point rise in the share of working-age adults eligible for Medicaid has modest effects on the average Medicare beneficiary's spending, but reduces average spending by $477 among dual eligibles. Importantly, we find no evidence of adverse health effects. (JEL G22, H75, I12, I13, I18, I38, J14)

Evoking Issues of Race and Ethnicity in Research on Physiology and Interpersonal Communication

2020 ◽  
pp. 260-287
Author(s):  
Shardé M. Davis
Keyword(s):  
Interpersonal Communication ◽  
Race And Ethnicity ◽  
Communication Research ◽  
Interpersonal Interactions ◽  
The Past ◽  
Race Ethnicity ◽  
Diverse Groups ◽  
Future Work ◽  
Area Of Study

Investigating the role of physiology in communication research is a burgeoning area of study that has gained considerable attention by relational scholars in the past decade. Unfortunately, very few published studies on this topic have evoked important questions about the role of race and ethnicity. Exploring issues of ethnicity and race provides a more holistic and inclusive view of interpersonal communication across diverse groups and communities. This chapter addresses the gap in literature by considering the ways in which race and ethnicity matter in work on physiology and interpersonal interactions. More specifically, this chapter will first discuss the conceptual underpinnings of race, ethnicity, and other relevant concepts and then review extant research within and beyond the field of communication on race, ethnicity, interpersonal interactions, and physiology. These discussions set the foundation for this chapter to propose new lines of research that pointedly connect these four concepts and advance key principles that scholars should consider in future work.

Increase associated risk of gynaecological cancer due to long-term exposure to high concentration of atmospheric SO2 industrial pollutant

2021 ◽  
pp. 1420326X2110036
Author(s):  
Qian Xu ◽  
Chan Lu ◽  
Rachael Gakii Murithi ◽  
Lanqin Cao
Keyword(s):  
Time Windows ◽  
Air Pollutant ◽  
Gynaecological Cancer ◽  
High Concentration ◽  
The Past ◽  
Short And Long Term ◽  
Using Data ◽  
Air Quality Monitoring Stations ◽  
Control Study

A cohort case–control study was conducted in XiangYa Hospital, Changsha, China, which involved 305 patients and 399 healthy women, from June 2010 to December 2018, to evaluate the association between Chinese women’s short- and long-term exposure to industrial air pollutant, SO2 and gynaecological cancer (GC). We obtained personal and family information from the XiangYa Hospital electronic computer medical records. Using data obtained from the air quality monitoring stations in Changsha, we estimated each woman’s exposure to the industrial air pollutant, sulphur dioxide (SO2), for different time windows, including the past 1, 5, 10 and 15 years before diagnosis of the disease. A multiple logistic regression model was used to assess the association between GC and SO2 exposure. GC was significantly associated with long-term SO2 exposure, with adjusted odds ratio (95% confidence interval) = 1.56 (1.10–2.21) and 1.81 (1.07–3.06) for a per interquartile range increase in the past 10 and 15 years, respectively. Sensitivity analysis showed that different groups reacted in different ways to long-term SO2 exposure. We concluded that long-term exposure to high concentration of industrial pollutant, SO2 is associated with the development of GC. This finding has implications for the prevention and reduction of GC.

Sexual harassment and psychological complaints: student- and class-level associations

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Brolin Låftman ◽  
Y Bjereld ◽  
B Modin ◽  
P Löfstedt
Keyword(s):  
School Climate ◽  
Sexual Harassment ◽  
Linear Regression Analysis ◽  
Well Being ◽  
Negative Effects ◽  
School Class ◽  
School Aged Children ◽  
The Past ◽  
Class Level ◽  
Using Data

Abstract Background Students who are subjected to sexual harassment at school report lower psychological well-being than those who are not exposed. Yet, it is possible that the occurrence of sexual harassment in the school class is stressful also for those who are not directly targeted, with potential negative effects on well-being for all students. The aim was to examine whether sexual harassment at the student- and at the class-level was associated with students' psychological complaints. Methods Data from the Swedish Health Behaviour in School-aged Children (HBSC) of 2017/18 was used, with information from students aged 11, 13 and 15 years (n = 3,720 distributed across 209 classes). Psychological complaints were constructed as a summative index of four items capturing how often the student had felt low, felt irritable or bad tempered, felt nervous, or had difficulties to fall asleep, during the past six months (Cronbach's alpha=0.78). Sexual harassment at the student-level was measured by one item concerning bullying at school: “Other students have exposed me to sexual jokes”. Students who reported that this had happened at least “2 or 3 times a month” were classified as exposed to sexual harassment at school. Sexual harassment at the class-level was defined as the school class proportion of students exposed to sexual harassment, reported in per cent. Two-level linear regression analysis was applied. Results Students who had been exposed to sexual harassment had higher levels of psychological complaints (b = 2.74, p &lt; 0.001). The proportion of students in the school class who had been exposed to sexual harassment was also associated with higher levels of psychological complaints, even when adjusting for sexual harassment at the student-level, gender and grade (b = 0.03, p = 0.015). Conclusions Sexual harassment is harmful for those who are exposed, but may also affect other students negatively. Thus, a school climate free from sexual harassment will profit all students. Key messages Using data collected among students aged 11, 13 and 15 years, this study showed that sexual harassment at the student- and class-level was associated with higher levels of psychological complaints. Sexual harassment is harmful for those who are exposed, but may also affect other students negatively. Thus, a school climate free from sexual harassment will profit all students.

scholarly journals Satisfaction With Health Care by Dual Sensory Impairment Status

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 798-798
Author(s):  
Lama Assi ◽  
Ahmed Shakarchi ◽  
Bonnielin Swenor ◽  
Nicholas Reed
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Health Determinants ◽  
Sensory Impairment ◽  
Medicare Beneficiaries ◽  
The Past ◽  
Patient Provider Communication ◽  
Care Satisfaction ◽  
Dual Sensory Impairment

Abstract Sensory impairment is a barrier to patient-provider communication and access to care, which may impact satisfaction with care. Satisfaction with the quality of care received in the past year was assessed in the 2017 Medicare Current Beneficiary Survey (weighted sample=53,905,182 Medicare beneficiaries). Self-reported sensory impairment was categorized as no sensory impairment, hearing impairment (HI)-only, vision impairment (VI)-only, and dual sensory impairment (DSI) – concurrent HI and VI. In a model adjusted for sociodemographic characteristics and health determinants, having DSI was associated with higher odds of dissatisfaction with the quality of care received (Odds Ratio [OR]=1.53, 95%Confidence Interval [CI]=1.14-2.06) relative to no sensory impairment; however, having HI-only or VI-only were not (OR=1.33, 95%CI=1.94-1.89, and OR=1.32, 95%CI=0.95-1.93, respectively). These findings have implications for healthcare providers as Medicare shifts to value-based reimbursement. Moreover, previous work that singularly focused on HI or VI alone may have failed to recognize the compounded effect of DSI.

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