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.

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.

Abstract 127: Disparities in Total Health Care Expenditure, and Payment Type Related to Hypertension Between Non Hispanics and Hispanics in the USA: Results From the Medical Expenditure Panel Survey (2013 - 2014)

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Emir Veledar ◽  
Anshul Saxena ◽  
Emeka Osondu ◽  
Javier Valero Elizondo ◽  
Khurram Nasir
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Inpatient Cost ◽  
Medication Cost ◽  
Panel Survey ◽  
The Usa

Background: Each year in the USA, more than 75 million adults are diagnosed with hypertension (HTN), but less than 54% have this condition under control. Due to poor management, mortality due to HTN or related complications was 410,000 in 2014 and resulted in close to $50 billion spent. We sought to examine disparities in the proportion of events and related expenditure due to HTN between 54 million Hispanics, representing 17% in the USA population and non Hispanics. Methods and Population: We used data from the Medical Expenditure Panel Survey (MEPS), the most complete source of data on the cost and use of health care and health insurance coverage for 2013 and 2014. Cost was grouped as related to ambulatory, emergency room, inpatient, home visits and medications. By source, payments were grouped as paid by family, MEDICARE, MEDICAID, private insurance, VA, Tricare and other. Results: Overall, there were 61.2 and 61.9 million total events associated with HTN in 2013 and 2014 respectively; Hispanics accounted for 5.8 (9.5%) and 5.4 (8.7%) million events each year. On an average, HTN events involving Hispanics were costlier up to $90 - $300 more than non Hispanics ($1053 vs. $ 746 in 2013; and $890 vs. $804 in 2014). For Hispanics, payments were mainly covered by MEDICAID (42.1%) and MEDICARE (27.5%), compared to MEDICARE (39.3%) and private insurance (23.7%) for non-Hispanic population. Hispanics HTN expenditures were $6.1 billion (12.9%) in 2013 and 5.3 billion (10.3%) in 2014 and Hispanics had disproportionately fewer number of events than expected 17%, and the structure of their costs for those events was not different from non-Hispanics. In regression model, accounting for demographics and type of insurance, being Hispanic was a significant predictor of the total, ambulatory and inpatient cost, but not emergency room or medication cost. Conclusion and Discussion: Hispanics participate disproportionately less in HTN events and costs compared to their proportion in population, even when age, demographic and socioeconomic factors are accounted for. They also have on average higher and more complex events compared with non Hispanics. Almost 70% of HTN expenditure for Hispanics in 2013-2014 was covered by MEDICAID and MEDICARE indicating socioeconomic disparities.

Abstract 215: GenderDisparities in Health Care Expenditure Among Patients With MI and Depression: ResultsFrom the Medical Expenditure Panel Survey 2014

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Emir Veledar ◽  
Anshul Saxena ◽  
Victor Okunrintemi ◽  
Javier Valero-Elizondo
Keyword(s):  
Health Care ◽  
Medical Expenditure Panel Survey ◽  
Survey Methods ◽  
Private Insurance ◽  
Health Care Expenditure ◽  
Medical Expenditure ◽  
Panel Survey ◽  
Cost Of Health Care ◽  
National Estimates ◽  
Gender Based

Introduction: Previous studies have linked depression and cardiovascular diseases, however gender differences in cost of hospitalization and care associated with events related to depression and myocardial infarction (MI) is not studied in detail. We utilized data from 2014 Medical Expenditure Panel Survey (MEPS) to evaluate national estimates of such costs. Hypothesis: Proportion of depression and MI and corresponding healthcare expenditures are high in general population and differ between genders. Also, payments are appropriated differently between payers. Methods: Participants from 2014 MEPS with events attributed to MI and/ or depression were included in this study. Mean (95% CI) event related cost, and total cost of health care was calculated using survey methods. Expenditure and utilization cost was grouped as related to ambulatory, emergency room, inpatient, home visits and medications. By source, payments were grouped as paid by family, MEDICARE, MEDICAID, private insurance, VA, Tricare and other. Results: There were 23486 participants in the study, representing 242,628,543 individuals in the US who were 20 years or above. Total health expenditure in 2014 among these was $1.5 trillion (Males: $696,940,498,022; Females: $837,486,094,699) with $27,937,582,549 attributed to depression (Males: $10,991,761,342; Females: $16,945,821,207) and $51,142,260,003 to MI (Males: $40,676,887,518; Females: $10,465,372,485). There were around 6,174,408 (2.5%) and 27,269,837 (11.2%) events associated with MI and depression respectively. Approximately 901,762 individuals reported both events. Among males, MI was 4,189,696 (3.6%) and among females, 1,984,711 (1.6%). Depression was reported 8,755,276 (7.5%) among males and 18,514,560 (14.6%) among females. Among females who were depressed, 2.3% reported MI, and 1.4% among those who were not depressed. Among males who were depressed, 5.4% reported MI and 3.4% among those who were not depressed. Among depressed males, AMI hospitalization was 0.31% whereas among depressed females, AMI hospitalization was 0.24%. Conclusion: Among both depressed and non-depressed populations, males had significantly higher proportion of MI and hospitalizations related to AMI when compared to females. But, out of total MI costs for males, less than 1% cost was accrued by depressed; whereas, of total MI cost for females, 9.6% of cost was accrued by depressed females showing gender based disparities in healthcare cost and utilization. With Medicare paying between 78%-83% of all MI costs, treating depression can result in significant savings.

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.

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.

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