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Volume 90, Issue 9, Pages 1532-1540 (September 2009)


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Health Care Expenditures of Living With a Disability: Total Expenditures, Out-of-Pocket Expenses, and Burden, 1996 to 2004

Sophie Mitra, PhDaCorresponding Author Informationemail address, Patricia A. Findley, DrPH, MSWb, Usha Sambamoorthi, PhDcd

Abstract 

Mitra S, Findley PA, Sambamoorthi U. Health care expenditures of living with a disability: total expenditures, out-of-pocket expenses, and burden, 1996 to 2004.

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.

a Department of Economics, Fordham University, New York, NY

b School of Social Work, Rutgers University, New Brunswick, NJ

c Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA

d Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA

Corresponding Author InformationCorrespondence to Sophie Mitra, PhD, Dept of Economics, Fordham University, 441 E Fordham Rd, Bronx, NY 10458-9993

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author or on any organization with which the author is associated.

 Reprints are not available from the author.

PII: S0003-9993(09)00318-9

doi:10.1016/j.apmr.2009.02.020


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