Health Care Expenditures of Living With a Disability: Total Expenditures, Out-of-Pocket Expenses, and Burden, 1996 to 2004
Health Care Expenditures of Living With a Disability: Total Expenditures, Out-of-Pocket Expenses, and Burden, 1996 to 2004
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DOI：
10.1016/j.apmr.2009.02.020
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发表时间：
2009-09-01
影响因子：
4.3
通讯作者：
Sambamoorthi, Usha
中科院分区：
文献类型：
--
作者：
Mitra, Sophie;Findley, Patricia A.;Sambamoorthi, Usha
目的：估计与残疾相关的卫生保健支出及其近期趋势。设计：调查数据的回顾性分析。设置：不适用。参与者：多年数据（1996-2004）的医疗支出调查（MEPS）的全国代表性样本的平民，非制度化的美国人口。干预措施：不适用。主要结果测量：卫生保健支出包括卫生保健总支出、自付总支出（OOP）和负担（OOP与家庭收入的比率）。所有的分析占复杂的调查设计的MEPS.Results：1996年至2004年，6%至9%的人在工作年龄组（21- 61岁）被确定为有残疾。与非残疾人相比，残疾人的卫生总支出、OOP支出和负担一直较高。2004年，残疾人的平均总支出估计为10 508美元，非残疾人为2 256美元。在多元回归框架中，1996年至2004年期间，残疾人的支出、OOP支出和负担一直较高。尽管支出、OOP支出和负担随着时间的推移而增加，但在控制了人口统计学、社会经济学和健康状况后，这3项医疗保健成本并未发现对残疾人有不成比例的变化。在1996年至2004年期间，残疾人的保健支出、OOP支出，与非残疾人相比，残疾人的生活负担更重，这可能对他们的健康和生活水平产生不利影响。
Objective: To estimate the health care expenditures associated with a disability and their recent trends.Design: Retrospective analysis of survey data.Setting: Not applicable.Participants: Data from multiple years (1996-2004) of the Medical Expenditure Panel Survey (MEPS) for a nationally representative sample of civilian, noninstitutionalized U.S. population.Interventions: Not applicable.Main Outcome Measures: Health care expenditures consisted of total health care expenditures, total out-of-pocket (OOP) spending, and burden (the ratio of OOP to family income). All the analyses accounted for the complex survey design of the MEPS.Results: Between 1996 and 2004, 6% to 9% of persons in the working-age group (21-61y) were identified as having a disability. Persons with disabilities consistently had higher total health expenditures, OOP spending, and burden compared with their counterparts without disabilities. In 2004, the average total expenditures were estimated at $10,508 for persons with disabilities and at $2256 for those without disabilities. In a multiple regression framework, persons with disabilities were consistently found to have higher expenditures, OOP spending, and burden between 1996 and 2004. Although expenditures, OOP spending, and burden increased over time, after controlling for demographic, socioeconomic, and health status, these 3 health care costs were not found to change disproportionately for persons with disability.Conclusions: During the 1996 to 2004 period, persons with disabilities were consistently found to have significantly higher health expenditures, OOP spending, and burden compared with their counterparts without disabilities, which may adversely affect their health and standard of living.