Preventing Chronic Disease | Chronic Condition Combinations and Health Care Expenditures and Out-of-Pocket Spending Burden Among Adults, Medical Expenditure Panel Survey, 2009 and 2011 - CDC
Chronic Condition Combinations and Health Care Expenditures and Out-of-Pocket Spending Burden Among Adults, Medical Expenditure Panel Survey, 2009 and 2011
Abdulkarim M. Meraya, MS; Amit D. Raval, MPharm; Usha Sambamoorthi, PhD
Suggested citation for this article: Meraya AM, Raval AD, Sambamoorthi U. Chronic Condition Combinations and Health Care Expenditures and Out-of-Pocket Spending Burden Among Adults, Medical Expenditure Panel Survey, 2009 and 2011. Prev Chronic Dis 2015;12:140388. DOI: http://dx.doi.org/10.5888/pcd12.140388
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EDITORS Camille Martin, Editor, Preventing Chronic Disease. Disclosure: Camille Martin has disclosed no relevant financial relationships. CME AUTHOR Charles P. Vega, MD, Clinical Professor of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: McNeil Pharmaceuticals. AUTHORS AND CREDENTIALS Disclosures: Abdulkarim M. Meraya, MS has disclosed no relevant financial relationships. Amit D. Raval, MPharm, has disclosed the following relevant financial relationships: Received grants for clinical research from: Sanofi pharmaceuticals. Usha Sambamoorthi, PhD, has disclosed the following relevant financial relationships: Received grants for clinical research from: Sanofi pharmaceuticals. Affiliations: Abdulkarim M. Meraya, Amit D. Raval, Usha Sambamoorthi, West Virginia University, Morgantown, West Virginia. |
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Abstract
Introduction
Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions.
Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions.
Methods
We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden.
We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden.
Results
Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P< .001). In adjusted models, adults with all 4 conditions had higher expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04).
Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P< .001). In adjusted models, adults with all 4 conditions had higher expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04).
Conclusion
Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers.
Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers.
Acknowledgments
This project was supported by the National Institute of General Medical Sciences, no. U54GM104942. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Author Information
Corresponding Author: Abdulkarim M. Meraya, MS, Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, PO Box 9510, Morgantown, WV 26506. Telephone: 304-293-1442. Email: ammeraya@mix.wvu.edu.
Author Affiliations: Amit D. Raval, Usha Sambamoorthi, West Virginia University, Morgantown, West Virginia.
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