Financial Burdens of Out-of-Pocket Spending Among Medicare Fee-for-Service Beneficiaries: Role of the "Big Four" Chronic Health Conditions
Financial Burdens of Out-of-Pocket Spending Among Medicare Fee-for-Service Beneficiaries: Role of the "Big Four" Chronic Health Conditions
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DOI：
10.1177/10775587211032837
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发表时间：
2021-08-27
影响因子：
2.5
通讯作者：
Liu, Haiyong
中科院分区：
文献类型：
--
作者：
Basu, Rashmita;Liu, Haiyong
虽然医疗保险是65岁或以上美国人医疗保险的普遍来源，但该计划需要在自付（OOP）支出方面分担大量费用。我们进行了一项回顾性研究，使用2016年至2018年医疗保险当前受益人调查的数据（n = 10431），这些数据与行政数据相关联，以估计与“四大”慢性病（心血管疾病、癌症、糖尿病和慢性肺病）相关的OOP支出。我们估计了一个广义的线性模型，调整了易感性，使能性和需求因素，以估计年度OOP支出。我们发现，与没有上述任何一种疾病的人相比，患有“四大”慢性病中的任何一种的受益人花费的OOP费用高出15% (p < 0.001)，并且将年收入的>= 20%用于OOP支出的可能性高出56%（调整后的优势比= 1.56;p < 0.001）。面向对象的支出在不同的疾病类型中似乎是异质的，并且随着时间的推移而变化。
While Medicare is the universal source of health care coverage for Americans aged 65 years or older, the program requires significant cost sharing in terms of out-of-pocket (OOP) spending. We conducted a retrospective study using data from 2016 to 2018 Medicare Current Beneficiary Surveys of elderly community-dwelling beneficiaries (n = 10,431) linked with administrative data to estimate OOP spending associated with the "big four" chronic diseases (cardiovascular disease, cancer, diabetes, and chronic lung disease). We estimated a generalized linear model adjusting for predisposing, enabling, and need factors to estimate annual OOP spending. We found that beneficiaries with any of the "big four" chronic conditions spent 15% (p < .001) higher OOP costs and were 56% more likely to spend >= 20% of annual income on OOP expenditure (adjusted odds ratio = 1.56; p < .001) compared with those without any of those conditions. OOP spending appears to be heterogeneous across disease types and changing by conditions over time.