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 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.

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.

scholarly journals Does Industrial Air Pollution Increase Health Care Expenditure? Evidence From China

2021 ◽  
Vol 9 ◽  
Author(s):  
Jin-Sheng Shen ◽  
Qun Wang ◽  
Han-Pu Shen
Keyword(s):  
Health Care ◽  
Air Pollution ◽  
Health Care Expenditure ◽  
Random Effect ◽  
Random Effect Model ◽  
Medical Expenditure ◽  
Added Value ◽  
Western China ◽  
Effect Model ◽  
The Impact

This paper discusses the impact of air pollution on medical expenditure in eastern, central, and western China by applying the fixed-effect model, random-effect model, and panel threshold regression model. According to theoretical and empirical analyses, there are different relationships between the two indexes in different regions of China. For eastern and central regions, it is obvious that the more serious the air pollution is, the more medical expenses there are. However, there is a non-linear single threshold effect between air pollution and health care expenditure in the western region. When air pollution is lower than this value, there is a negative correlation between them. Conversely, the health care expenditure increases with the aggravation of air pollution, but the added value is not enough to make up for the health problems caused by air pollution. The empirical results are basically consistent with the theoretical analysis, which can provide enlightenment for the government to consider the role of air pollution in medical expenditure. Policymakers should arrange the medical budget reasonably, according to its situation, to make up for the loss caused by air pollution.

The Impacts of the COVID-19 Pandemic on the Medical Expenditure Panel Survey

2021 ◽  
Vol 111 (12) ◽  
pp. 2157-2166
Author(s):  
Samuel H. Zuvekas ◽  
David Kashihara
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Insurance Coverage ◽  
Response Rates ◽  
Medical Expenditure ◽  
Care Utilization ◽  
Panel Survey ◽  
Quality Of Data ◽  
Statistical Precision ◽  
The Impact

The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). The MEPS is widely used to study how policy changes and major shocks, such as the COVID-19 pandemic, affect insurance coverage, access, and preventive and other health care utilization and how these relate to population health. We describe how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules. The impact of the pandemic on response rates varied considerably across the MEPS. Investigations to date show little effect on the quality of data collected. However, lower response rates may reduce the statistical precision of some estimates. We also describe several enhancements made to the MEPS that will allow researchers to better understand the impact of the pandemic on US residents, employers, and the US health care system. (Am J Public Health. 2021;111(12):2157–2166. https://doi.org/10.2105/AJPH.2021.306534 )

Abstract 25: Favorable Modifiable Cardiovascular Risk Profile is Associated with Lower Healthcare Costs: The 2012 Medical Expenditure Panel Survey

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Javier Valero-Elizondo ◽  
Joseph A Salami ◽  
Oluseye Ogunmoroti ◽  
Ehimen C Aneni ◽  
Rehan Malik ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Complex Design ◽  
Final Study ◽  
Strategic Goals ◽  
Nationally Representative ◽  
Artery Disease

Background: The AHA’s 2020 Strategic Goals emphasize the value of favorable modifiable risk factor (MRF) profile to reduce the burden of CVD morbidity and mortality. In this study we aimed to quantify the overall and incremental impact of MRF on health care expenditure in the U.S among those with and without CVD. Methods: The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS), a nationally representative adult sample (≥ 40 years). Direct costs were calculated for all-cause health care resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias or heart failure), ascertained by ICD-9-CM codes, and MRF (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity and/or obesity). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures, taking into consideration the survey’s complex design. Results: The final study sample consisted of 15,651 MEPS participants (57 ± 12 years, 52% female). Overall, 6,231 (39%) had 0-1, 7,429 (49%) had 2-3, and 1,991 (12%) had ≥ 4 MRF, translating to 55.5, 69.9 and 17.9 million adults ≥ 40 years in U.S, respectively. Generally, there was a direct decrease in health expenditures with favorable MRF across CVD status (Table). These differences persisted after taking into account demographics, insurance status and comorbid conditions. Among those without established CVD, the average medical expenditure was $4,013 (95% CI 5,117, 2,910) and $2,696 (95% CI 4,416, 977) lower for those with 0-1 & 2-3 MRF, as compared to those with ≥ 4 MRF. Conclusion: Favorable MRF profile is associated with significantly lower medical expenditure among individuals with and without established CVD. Our study provides robust estimates for potential healthcare savings with nationwide policies focusing on preventing and managing modifiable CV risk factors.

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