Objective: To compare annual mean number of encounters and annual mean expenditures incurred by persons meeting a case definition for "disability" based on "activity limitation," versus their non-disabled counterparts.
Methods: Review of the Household and Medical Provider Components of the 1996 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of utilization, expenditures, and insurance coverage conducted by the U.S. Agency for Healthcare Research and Quality. This investigator defined "disability" as a composite of "activity limitations" depicted by 15 MEPS variables, and "expenditures" as the sum of direct payments for care, including payments out-of-pocket and by insurers of all types.
Results: MEPS yielded a weighted estimate of 40.7 million Americans meeting the case definition, representing 15.1 percent of the civilian noninstitutionalized population. Persons with disabilities exhibited nearly three-fold greater mean number of office-based provider visits compared with their non-disabled counterparts (10.4 vs. 3.6 visits), more than fifty-fold greater mean number of inpatient hospital admissions (.33 vs. .006 admissions), and nearly four-fold greater mean number of prescriptions and refills (22.1 vs. 5.5 prescriptions). Persons with disabilities exhibited nearly five-fold greater annual mean total health care expenditures than persons without disabilities ($6,372.01 vs. $1,315.32), more than seven-fold greater inpatient facility expenditures ($2,610.77 vs. $365.55), and more than four-fold greater prescription expenditures ($773.00 vs. $174.16). Differences between group means achieved statistical significance at the p < .01 level in all comparisons.
Conclusion: Estimating the costs associated with the higher degree of utilization intensity among persons with activity limitations is essential for informing disability and health policy decisions.
Learning Objectives: At the conclusion of the session, participants will be able to quantify the degree of differences in health care utilization exhibited by persons with and without disabilities; identify expenditure categories accounting for the largest proportions of overall health care expenditures among persons with disabilities; and express familiarity with a new federal survey that provides population-based expenditure data on community-dwelling Americans with activity limitations, as a complement to expenditure data pertaining only to diagnoses
Keywords: Disability Policy, Healthcare Costs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: U.S. Agency for Healthcare Research and Quality;
U.S. Centers for Disease Control and Prevention;
both agencies are in the U.S. Department of Health and Human Services
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.