scholarly journals Out-of-Pocket Spending for Ambulatory Physical Therapy Services From 2008 to 2012: National Panel Survey

2015 ◽  
Vol 95 (12) ◽  
pp. 1680-1691 ◽  
Author(s):  
Julia Chevan ◽  
Daniel L. Riddle ◽  
Shelby D. Reed
Keyword(s):  
Physical Therapy ◽  
Urban Areas ◽  
Medical Expenditure Panel Survey ◽  
Public Funding ◽  
Data File ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Factors Associated ◽  
Episode Of Care ◽  
Episodes Of Care

Background Out-of-pocket (OOP) expenditures are incurred as insurers and employers shift some of the burden of health care costs onto consumers. As cost-sharing increases, OOP expenditures could be a barrier to physical therapy care. Objective The purposes of this study were: (1) to identify factors associated with any OOP physical therapy spending and (2) to identify factors associated with higher spending among individuals incurring OOP costs. Design The study was a retrospective analysis using the 4 most recently available panels of data from the Medical Expenditure Panel Survey (MEPS) encompassing 2008–2012. Methods A data file containing episodes of physical therapy care for 2,189 people was created. Logistic regression was used to identify factors related to having an OOP expenditure. A multivariable generalized linear model was used to identify factors related to mean OOP expenditures. Results On average, an episode of care encompassed 9.9 visits, with mean total expenditures of $1,708 (median: $792). Fifty-four percent of episodes of care had an OOP expenditure. For individuals with OOP expenditures, the mean OOP expenditure for an episode of care was $351 (median: $144). Being female or non-Hispanic and having a higher income were associated with higher odds of incurring an OOP expenditure, whereas being in worse general health, >65 years of age, or nonwhite and having public funding were associated with lower odds of incurring an OOP expenditure. Amounts of OOP spending were higher in urban areas and in all census geographic regions relative to the Northeast region. Limitations Estimates are based on household-reported survey data, limited to ambulatory care, and do not include institutionalized individuals. Conclusions At 54%, the proportion of individuals with OOP expenditures for physical therapy is lower than for general medical care. Several predictors were found of having OOP expenditures and of the magnitude of those expenditures.

scholarly journals Impact of Out-of-Pocket Expenditure on Physical Therapy Utilization for Nonspecific Low Back Pain: Secondary Analysis of the Medical Expenditure Panel Survey Data

2016 ◽  
Vol 96 (2) ◽  
pp. 212-221 ◽  
Author(s):  
Janet Dolot ◽  
Deborah Viola ◽  
Qiuhu Shi ◽  
Matthew Hyland
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Survey Data ◽  
Medical Expenditure Panel Survey ◽  
Secondary Analysis ◽  
Medical Expenditure ◽  
Low Back ◽  
Panel Survey ◽  
Episode Of Care

Background Physical therapy decreases low back pain, improves function, and may lead to decreased use of medical services. However, factors predicting physical therapy utilization for patients with low back pain are not well understood. Objectives The purpose of this study was to identify the impact of out-of-pocket expenditure on physical therapy utilization for US adults with nonspecific low back pain. Design This study was a secondary analysis of retrospective Medical Expenditure Panel Survey data. Methods The participants were US adults with nonspecific low back pain. The outcome variable was the number of visits per episode of care. The research variable was out-of-pocket expenditure. Covariate variables were Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) component scores. Descriptive statistics and multiple linear regression analyses were performed. Results Three hundred fourteen adults met the inclusion criteria and submitted SF-12 scores, representing nearly 4 million adults. Out-of-pocket expenditure, physical component score, and the age-insurance category “18–64 years with public coverage only for all of the year or uninsured all of the year” negatively predicted visits per episode of care in the final regression model. Limitations Limitations of the study included use of a nonexperimental design, lack of information about symptom severity and content of physical therapy, and SF-12 scores were not taken coincidental with the episode of care. Conclusions Out-of-pocket expenditure negatively predicts physical therapy utilization. More research is needed to identify all factors influencing physical therapy utilization so that effective health policies may be developed.

scholarly journals Modeling the Conditional Dependence between Discrete and Continuous Random Variables with Applications in Insurance

Mathematics ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 45
Author(s):  
Emilio Gómez-Déniz ◽  
Enrique Calderín-Ojeda
Keyword(s):  
Structural Model ◽  
Medical Expenditure Panel Survey ◽  
Health Care Use ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Conditional Distributions ◽  
Conditional Dependence ◽  
Outpatient Visits ◽  
Conditional Expectations ◽  
The U.S

We jointly model amount of expenditure for outpatient visits and number of outpatient visits by considering both dependence and simultaneity by proposing a bivariate structural model that describes both variables, specified in terms of their conditional distributions. For that reason, we assume that the conditional expectation of expenditure for outpatient visits with respect to the number of outpatient visits and also, the number of outpatient visits expectation with respect to the expenditure for outpatient visits is related by taking a linear relationship for these conditional expectations. Furthermore, one of the conditional distributions obtained in our study is used to derive Bayesian premiums which take into account both the number of claims and the size of the correspondent claims. Our proposal is illustrated with a numerical example based on data of health care use taken from Medical Expenditure Panel Survey (MEPS), conducted by the U.S. Agency of Health Research and Quality.

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