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Health Care Expenditures and Length of Disability Across Medical Conditions.

ABSTRACT: OBJECTIVE:To describe the relationship between the length of short-term disability (STD) and health care spending. METHODS:Medical claims for insured US employees on STD were evaluated to describe the distribution of disability durations and health expenditures across major diagnostic categories and common medical conditions. Correlations between health expenditures and disability durations were examined. RESULTS:The most expensive 10% of cases accounted for more than half of total health spending. The longest 10% of cases accounted for more than one-third of total disability time. Only one-third of the most expensive cases were also among the longest in duration. Disability durations were moderately correlated with medical spending and this relationship was modified by comorbid conditions and age. CONCLUSION:Psychosocial barriers, in addition to biomedical factors, should be considered to achieve optimal functional outcomes and well-being of patients.

SUBMITTER: Zaidel CS

PROVIDER: S-EPMC6075891 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Health Care Expenditures and Length of Disability Across Medical Conditions.

Zaidel Catherine S CS Ethiraj Rajesh K RK Berenji Manijeh M Gaspar Fraser W FW

Journal of occupational and environmental medicine 20180701 7

<h4>Objective</h4>To describe the relationship between the length of short-term disability (STD) and health care spending.<h4>Methods</h4>Medical claims for insured US employees on STD were evaluated to describe the distribution of disability durations and health expenditures across major diagnostic categories and common medical conditions. Correlations between health expenditures and disability durations were examined.<h4>Results</h4>The most expensive 10% of cases accounted for more than half ...[more]

PMID: 29465513

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Project description:ObjectiveTo disentangle the relationships among food insecurity, health care utilization, and health care expenditures.Data sources/study settingWe use national data on 13 465 adults (age ≥ 18) from the 2016 Medical Expenditure Panel Survey (MEPS), the first year of the food insecurity measures.Study designWe employ two-stage empirical models (probit for any health care use/expenditure, ordinary least squares, and generalized linear models for amount of utilization/expenditure), controlling for demographics, health insurance, poverty status, chronic conditions, and other predictors.Principal findingsOur results show that the likelihood of any health care expenditure (total, inpatient, emergency department, outpatient, and pharmaceutical) is higher for marginal, low, and very low food secure individuals. Relative to food secure households, very low food secure households are 5.1 percentage points (P < .001) more likely to have any health care expenditure, and have total health care expenditures that are 24.8 percent higher (P = .011). However, once we include chronic conditions in the models (ie, high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma), these underlying health conditions mitigate the differences in expenditures by food insecurity status (only the likelihood of any having any health care expenditure for very low food secure households remains statistically significant).ConclusionsPolicy makers and government agencies are focused on addressing deficiencies in social determinants of health and the resulting impacts on health status and health care utilization. Our results indicate that chronic conditions are strongly associated with food insecurity and higher health care spending. Efforts to alleviate food insecurity should consider the dual burden of chronic conditions. Finally, future research can address specific mechanisms underlying the relationships between food security, health, and health care.

Project description:BackgroundCancer survivors with a disability are among the most vulnerable in health status and financial hardship, but no prior research has systematically examined how disability modifies health-care use and costs. This study examined the association between functional disability among cancer survivors and their health-care utilization and medical costs.MethodsWe generated nationally representative estimates using the 2015-2019 Medical Expenditure Panel Survey. Outcomes included use of 6 service types (inpatient, outpatient, office-based physician, office-based nonphysician, emergency department, and prescription) and medical costs of aggregate services and by each of 6 service types. The primary independent variable was a categorical variable for the total number of functional disabilities. We employed multivariable generalized linear models and 2-part models, adjusting for sociodemographics and health conditions and accounting for survey design.ResultsAmong cancer survivors (n = 9359; weighted n = 21 046 285), 38.8% reported at least 1 disability. Compared with individuals without a disability, cancer survivors with 4 or more disabilities experienced longer hospital stays (adjusted average marginal effect = 1.14 days, 95% confidence interval [CI] = 0.55 to 1.73), more visits to an office-based physician (average marginal effect = 1.43 visits, 95% CI = 0.51 to 2.35), and a greater number of prescriptions (average marginal effect = 12.1 prescriptions, 95% CI = 9.27 to 15.0). Their total (average marginal effect = $9537, 95% CI = $5713 to $13 361) and out-of-pocket (average marginal effect = $639, 95% CI = $79 to $1199) medical costs for aggregate services were statistically significantly higher. By type, disability in independent living was most strongly associated with greater costs for aggregate services.ConclusionsCancer survivors with a disability experienced greater health-care use and higher costs. Cancer survivorship planning for health care and financial stability should consider the patients' disability profile.

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Health Care Expenditures and Length of Disability Across Medical Conditions.

Publications

Health Care Expenditures and Length of Disability Across Medical Conditions.

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