Influence of Rheumatoid Arthritis on Employment, Function, and Productivity in a Nationally Representative Sample in the United States

2010 ◽  
Vol 37 (3) ◽  
pp. 544-549 ◽  
Author(s):  
PATRICK W. SULLIVAN ◽  
VAHRAM GHUSHCHYAN ◽  
XING-YUE HUANG ◽  
DENISE R. GLOBE
Keyword(s):  
Rheumatoid Arthritis ◽  
Negative Binomial ◽  
Medical Expenditure Panel Survey ◽  
Smoking Status ◽  
International Classification Of Diseases ◽  
The United States ◽  
Medical Expenditure ◽  
Significant Difference ◽  
Inability To Work ◽  
Nationally Representative

Objective.The Medical Expenditure Panel Survey (MEPS) was used to estimate the national influence of rheumatoid arthritis (RA) on employment, limitations in work or housework, inability to work or do housework, missed work days, days spent sick in bed, and annual wages.Methods.MEPS is a nationally representative survey of the US population. Multiple logistic, negative binomial, and Heckman selection regression methods were used, controlling for age, sex, race, ethnicity, smoking status, income, education, and chronic comorbidity. RA was identified using International Classification of Diseases-9 code 714.Results.In unadjusted descriptive statistics, individuals with RA were older, had more chronic conditions, missed more work days, spent more days sick in bed, had lower employment rates, had higher rates of limitations and inability to work, and received disability benefits at higher rates. After adjustment, multiple regression analyses showed individuals with RA were 53% less likely to be employed [OR 0.47, 95% CI 0.34–0.65], 3.3 times more likely to have limitations in work or housework (95% CI 2.35–4.64), 2.3 times more likely to be unable to work or do housework (95% CI 1.55–3.53), and spent 3.6 times as many days sick in bed as those without RA (95% CI 2.32–5.53). RA was associated with an expected loss of $8957 in annual earnings (95% CI $1881–$15,937). There was no statistically significant difference in missed work days or the level of wages.Conclusion.In the most recent available national data for adults, RA was associated with reductions in employment, productivity, and function.

scholarly journals The Direct Healthcare Expenditures of Prostate Cancer by Disease Severity: Evidence from US National Survey Data

10.36469/9844 ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 83-96
Author(s):  
Peter J. Mallow ◽  
Jie Chen ◽  
John A. Rizzo ◽  
John R. Penrod ◽  
Geralyn C. Trudel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Severity ◽  
Healthcare Costs ◽  
Medical Expenditure Panel Survey ◽  
Metastatic Cancer ◽  
International Classification Of Diseases ◽  
The United States ◽  
Medical Expenditure ◽  
Healthcare Expenditures ◽  
Nationally Representative

Background: In the United States, approximately 2.8 million men have a history of prostate cancer (PC). Objective: This study quantified the effects of PC, overall and by disease severity on direct healthcare costs to insurers and patients. Methods: Using 1996–2010 data from the Medical Expenditure Panel Survey (MEPS), a large, nationally representative US database, multivariate analyses were used to assess the relationship between PC and direct annual healthcare costs to insurers and patients, at individual and US aggregate levels. Men aged 40 years and older with International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code 185 were identified. Disease severity was determined with clinical assistance and based, in part, on the data in MEPS. The cohorts were: localized cancer not treated with chemotherapy, localized cancer treated with chemotherapy, and metastatic cancer. Results: The MEPS database included 1297 patients with PC: 811 patients with localized PC not treated with chemotherapy, 426 patients with PC treated with chemotherapy, and 60 patients with metastatic PC. PC had a larger effect on incremental costs for metastatic patients, $20 357, vs $16 709 for localized PC with chemotherapy, and $5238 for localized PC with no chemotherapy. When aggregated to the US population, PC accounted for an incremental annual cost of $15 billion. The largest aggregate annual costs were incurred by patients with localized PC treated with chemotherapy ($8.6 billion), compared to those not treated with chemotherapy ($4.8 billion) and metastatic patients ($1.6 billion). Conclusions: The aggregate annual costs of PC are substantial for all groups examined and greatest for patients with localized cancer treated with chemotherapy. This reflects the relatively high prevalence and high per capita healthcare expenditures associated with this group. With a growing and aging population, the prevalence of PC is expected to rise, increasing the burden on public health.

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.

Association of Self-Reported Frequent Exercise Among a Nationally Representative Sample of Older People in the United States With Self-Reported Pain

2020 ◽  
pp. 1-8
Author(s):  
David R. Axon ◽  
Niloufar Emami
Keyword(s):  
Physical Health ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Poor Physical Health ◽  
Nationally Representative ◽  
Fair Poor

This retrospective, cross-sectional database study aimed to identify characteristics associated with self-reported frequent exercise (defined as moderate- to vigorous-intensity exercise for ≥30 min five times a week) in older U.S. (≥50 years) adults with pain in the past 4 weeks, using 2017 Medical Expenditure Panel Survey data and hierarchical logistic regression models. The variables significantly associated with frequent exercise included being male (adjusted odds ratio [AOR] = 1.507, 95% confidence interval [CI] [1.318, 1.724]); non-Hispanic (AOR = 1.282, 95% CI [1.021, 1.608]); employed (AOR = 1.274, 95% CI [1.040, 1.560]); having no chronic conditions versus ≥5 conditions (AOR = 1.576, 95% CI [1.094, 2.268]); having two chronic conditions versus ≥5 conditions (AOR = 1.547, 95% CI [1.226, 1.952]); having no limitation versus having a limitation (AOR = 1.209, 95% CI [1.015, 1.441]); having little/moderate versus quite/extreme pain (AOR = 1.358, 95% CI [1.137, 1.621]); having excellent/very good versus fair/poor physical health (AOR = 2.408, 95% CI [1.875, 3.093]); and having good versus fair/poor physical health (AOR = 1.337, 95% CI [1.087, 1.646]). These characteristics may be useful to create personalized pain management protocols that include exercise for older adults with pain.

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.

Impact of comorbid conditions on health care expenditure and work-related outcomes in patients with rheumatoid arthritis

2020 ◽  
pp. jrheum.200231
Author(s):  
Martin Vu ◽  
Natalie Carvalho ◽  
Philip M. Clarke ◽  
Rachelle Buchbinder ◽  
An Tran-Duy
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Health Care ◽  
Negative Binomial ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Comorbid Conditions ◽  
Work Related ◽  
The Impact

Objective To evaluate the impact of comorbid conditions on direct health care expenditure and work-related outcomes in patients with rheumatoid arthritis (RA). Methods This was a retrospective analysis of the Medical Expenditure Panel Survey from 2006 to 2015 in 4,967 adult RA patients in the USA. Generalised linear models were used for health care expenditure and income, logistic model for employment status, and zero-inflated negative binomial model for absenteeism. Thirteen comorbid conditions were included as potential predictors of direct cost and work-related outcomes. The models were adjusted for sociodemographic factors including sex, age, region, marital status, race/ethnicity, income, education and smoking status. Results RA patients with heart failure had the highest incremental annual health care expenditure (US$8,205; 95% CI, US$3,683-US$12,726) compared to those without the condition. Many comorbid conditions including hypertension, diabetes, depression, obstructive pulmonary disease, cancer, stroke and heart failure reduced the chance of RA patients aged between 18-64 years being employed. Absenteeism of employed RA patients was significantly affected by hypertension, depression, disorders of the eye and adnexa or stroke. On average, an RA patient with heart failure earned US$15,833 (95% CI, US$4,435- US$27,231) per year less than an RA patient without heart failure. Conclusion Comorbid conditions in RA patients were associated with higher annual health care expenditure, lower likelihood of employment, higher rates of absenteeism and lower income. Despite its low prevalence, heart failure was associated with the highest incremental health care expenditure and the lowest likelihood of being employed compared to other common comorbid conditions.

scholarly journals Burden of Depression among Working-Age Adults with Rheumatoid Arthritis

Arthritis ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Arijita Deb ◽  
Nilanjana Dwibedi ◽  
Traci LeMasters ◽  
Jo Ann Hornsby ◽  
Wenhui Wei ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Cross Sectional Study ◽  
Medical Expenditure ◽  
Cross Sectional ◽  
Working Age ◽  
Nationally Representative ◽  
Using Data

Objective. This study estimated the excess clinical, humanistic, and economic burden associated with depression among working-age adults with Rheumatoid Arthritis (RA). Methods. A retrospective cross-sectional study was conducted among working-age (18 to 64 years) RA patients with depression (N=647) and without depression (N=2,015) using data from the nationally representative Medical Expenditure Panel Survey for the years 2009, 2011, 2013, and 2015. Results. Overall, 25.8% had depression. In adjusted analyses, adults with RA and depression compared to those without depression were significantly more likely to have pain interference with normal work (severe pain: AOR = 2.22; 95% CI = 1.55, 3.18), functional limitations (AOR = 2.17; 95% CI = 1.61, 2.94), and lower mental health HRQoL scores. Adults with RA and depression had significantly higher annual healthcare expenditures ($14,752 versus 10,541, p<.001) and out-of-pocket spending burden. Adults with RA and depression were more likely to be unemployed and among employed adults, those with depression had a significantly higher number of missed work days annually and higher lost annual wages due to missed work days. Conclusions. This study highlights the importance of effectively managing depression in routine clinical practice of RA patients to reduce pain and functional limitations, improve quality of life, and lower direct and indirect healthcare costs.

scholarly journals Trends in Mail-Order Prescription Use among U.S. Adults from 1996 to 2018: A Nationally Representative Repeated Cross-Sectional Study

2020 ◽  
Author(s):  
Duy Do ◽  
Pascal Geldsetzer
Keyword(s):  
Medical Expenditure Panel Survey ◽  
The United States ◽  
Medical Expenditure ◽  
Annual Number ◽  
Considerable Proportion ◽  
Mail Order ◽  
Cross Sectional ◽  
Population Groups ◽  
Nationally Representative ◽  
The U.S

Background. Mail-order prescriptions are popular in the U.S., but the recent mail delays due to operational changes at the United States Postal Services (USPS) may postpone the delivery of vital medications. Despite growing recognition of the health and economic effects of a postal crisis on mail-order pharmacy consumers, little is known about the extent of mail-order prescription use, and most importantly, the population groups and types of medications that will likely be most affected by these postal delays. Methods. The prevalence of mail-order prescription use was assessed using a nationally representative repeated cross-sectional survey (the Medical Expenditure Panel Survey) carried out among adults aged 18 and older in each year from 1996 to 2018. We stratified use of mail-order prescription by socio-demographic and health characteristics. Additionally, we calculated which prescription medications were most prevalent among all mailed medications, and for which medications users were most likely to opt for mail-order prescription. Findings. 500,217 adults participated in the survey. Between 1996 and 2018, the prevalence of using at least one mail-order prescription in a year among U.S. adults was 9.8% (95% CI, 9.5%-10.0%). Each user purchased a mean of 19.4 (95% CI, 19.0-19.8) mail-order prescriptions annually. The prevalence of use increased from 6.9% (95% CI, 6.4%-7.5%) in 1996 to 10.3% (95% CI, 9.7%-10.9%) in 2018, and the mean annual number of mail-order prescriptions per user increased from 10.7 (95% CI, 9.8-11.7) to 20.5 (95% CI, 19.3-21.7) over the same period. Use of mail-order prescription in 2018 was common among adults aged 65 and older (23.9% [95% CI, 22.3%-25.4%]), non-Hispanic whites (13.6% [95% CI, 12.8%-14.5%]), married adults (12.7% [95% CI, 11.8%-13.6%]), college graduates (12.2% [95% CI, 11.3%-13.1%]), high-income adults (12.6%, [95% CI, 11.6%-13.6%]), disabled adults (19.3% [95% CI, 17.9%-20.7%]), adults with poor health status (15.6% [95% CI, 11.6%-19.6%]), adults with three or more chronic conditions (24.2% [95% CI, 22.2%-26.2%]), Medicare beneficiaries (22.8% [95% CI, 21.4%-24.3%]), and military-insured adults (13.9% [95% CI, 10.8%-17.1%]). Mail-order prescriptions were commonly filled for analgesics, levothyroxine, cardiovascular agents, antibiotics, and diabetes medications. Interpretation. The use of mail-order prescription, including for critical medications such as insulin, is increasingly common among U.S. adults and displays substantial variation between population groups. A national slowdown of mail delivery could have important health consequences for a considerable proportion of the U.S. population, particularly during the current Coronavirus disease 2019 epidemic.

scholarly journals Direct medical expenditure associated with rheumatoid arthritis in a nationally representative sample from the medical expenditure panel survey

2012 ◽  
Vol 64 (11) ◽  
pp. 1649-1656 ◽  
Author(s):  
Aniket A. Kawatkar ◽  
Steven J. Jacobsen ◽  
Gerald D. Levy ◽  
Swati S. Medhekar ◽  
Kumarapuram V. Venkatasubramaniam ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Representative Sample ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Nationally Representative

Psychosocial outcomes in active treatment through survivorship.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 241-241
Author(s):  
Sarah C. Reed ◽  
Janice Bell ◽  
Robin L. Whitney ◽  
Andra Davis ◽  
Rebecca Salisbury Lash ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Survivors ◽  
Active Treatment ◽  
Medical Expenditure Panel Survey ◽  
Psychosocial Outcomes ◽  
The United States ◽  
Post Treatment ◽  
Medical Expenditure ◽  
Targeted Interventions ◽  
Significant Difference

241 Background: An estimated 13.7 million cancer survivors live in the United States, a population projected to reach 18 million in 2022. Late- and long-term psychological and emotional effects of cancer can be severe and unfortunately, often go unrecognized and untreated. Few population based data exist that capture psychosocial outcomes across the cancer continuum, from active treatment through survivorship. Methods: We analyzed the Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (n=1,592) to examine psychosocial outcomes among active treatment and survivorship patients across the post-treatment trajectory. Survey-weighted regression models were used to determine the risk of depression (PHQ-2), psychological distress (K-6) and cancer-specific worry related to recurrence. The primary independent variable was post-treatment survivorship status, categorized in years (1-2; 3-4; 5-9; 10-20; >21years) compared to active treatment as the reference group. All models were adjusted for plausible confounding variables (age, sex, race/ethnicity, marital status, employment, income, education, health insurance and health status). Estimates are generalizable to US non-institutionalized populations. Results: No significant difference in the risk of depression (PHQ-2) or psychological distress (K-6) was evident between those in active treatment and cancer survivors at any time post-treatment and those in active treatment. In contrast, cancer-specific worry was significantly higher among those respondents in active treatment (OR 4.3; 95% CI: 2.8, 6.6) compared to those post-treatment. Within the post-treatment survivorship categories, cancer-specific worry generally declined with time post-treatment; however these associations were only significant among those whose treatment was more than 20 years ago (OR= 0.12; 95% CI: 0.04, 0.36) relative to those in active treatment. Conclusions: Psychosocial concerns are pervasive among cancer survivors and are similar to concerns among individuals undergoing active treatment. These findings highlight unmet psychosocial needs among cancer survivors and demonstrate the importance of targeted interventions across the survivorship continuum.

Emergency department use and expenditures among cancer survivors in the United States, 2008-2011.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 3-3
Author(s):  
Rebecca Salisbury Lash ◽  
Janice Bell ◽  
Robin L. Whitney ◽  
Sarah Reed ◽  
Andra Davis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cancer Survivors ◽  
Chronic Conditions ◽  
Negative Binomial ◽  
Medical Expenditure Panel Survey ◽  
Reference Group ◽  
The United States ◽  
Medical Expenditure ◽  
Future Research ◽  
Ed Visits

3 Background: The number of cancer survivors in the US surpassed 13 million in 2012. In response to rising costs or care and greater demand for services, recent national reports and policies promote cancer care coordination to reduce costly and potentially avoidable services such as Emergency Department (ED) visits. Such efforts must be informed by reliable estimates and improved understanding of ED use and costs among oncology patients. This study quantifies the extent to which cancer survivors use the ED compared to individuals with other chronic conditions and estimates related annual expenses. Methods: Data from the 2008-2011 Medical Expenditure Panel Survey (MEPS) and survey-weighted regression models were used to determine the odds of any ED use (logistic), counts of ED visits (negative binomial) and mean annual medical expenditures attributed to ED use (generalized linear models) in three groups of respondents: cancer survivors, those with chronic conditions other than cancer, and those with neither (reference group). All models were adjusted for important confounding variables (age, sex, race/ethnicity, education, health insurance and health status). Estimates are generalizable to US non-institutionalized populations. Results: Among individuals with cancer, other chronic conditions, and neither condition, 17%, 15% and 9% visited the ED, respectively. Mean annual expenditures attributed to ED use among those with visits were $1471 (95% CI: $1262-$1678), $1517 (95% CI:$1395-$1640) and $1106 (95% CI: $984-$1228). Cancer survivors and individuals with other chronic conditions consistently had significantly higher ED use and costs than did the reference group. The likelihood of having any ED visit was similar between cancer survivors and those with other conditions, however cancer survivors incurred more visits (IRR: 1.17; 95% CI: 1.01, 1.36). Conclusions: ED use and expenditures are substantial among cancer survivors and equal or exceed the same outcomes in individuals with other chronic conditions. Future research is recommended to explore specific areas of unmet health need that may be driving increased frequency of ED visits in the growing population of cancer survivors.

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