TY - JOUR
T1 - Alzheimer Disease and Related Disorders and Out-of-Pocket Health Care Spending and Burden among Elderly Medicare Beneficiaries
AU - Dwibedi, Nilanjana
AU - Findley, Patricia A.
AU - Wiener, Constance R.
AU - Shen, Chan
AU - Sambamoorthi, Usha
N1 - Funding Information:
Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institute of Health under award number U546M104942, WVCTSI (R.C.W. and U.S.).
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Objective: To estimate the excess burden of out-of-pocket health care spending associated with Alzheimer disease and related disorders (ADRD) among older individuals (age 65 y and older). Methods: We adopted a retrospective, cross-sectional study design with data from 2012 Medicare Current Beneficiary Survey. The study sample comprised of elderly community-dwelling individuals who had positive total health care expenditures, and enrolled in Medicare throughout the calendar year (462 with ADRD, and 7160 without ADRD). We estimated the per-capita total annual out-of-pocket spending on health care and out-of-pocket spending by service type: Inpatient, outpatient, home health, prescription drugs, and other services. We measured out-of-pocket spending burden by calculating the percentage of income spent on health care and defined high out-of-pocket spending burden as having this percentage above 10%. Multivariable analyses included ordinary least squares regressions and logistic regressions and these analyses adjusted for predisposing, enabling, need, personal health care practices and external environment characteristics. Results: The average annual per-capita out-of-pocket health care spending was greater among individuals with ADRD compared with those without ADRD ($3285 vs. $1895); home health and prescription drugs accounted for 52% of total out-of-pocket spending among individuals with ADRD and 34% among individuals without ADRD. Elderly individuals with ADRD were more likely to have high out-of-pocket spending burden (adjusted odds ratio, 1.49; 95% confidence interval, 1.13-1.97) compared with those without ADRD. Conclusion: ADRD is associated with excess out-of-pocket health care spending, primarily driven by prescription drugs and home health care use.
AB - Objective: To estimate the excess burden of out-of-pocket health care spending associated with Alzheimer disease and related disorders (ADRD) among older individuals (age 65 y and older). Methods: We adopted a retrospective, cross-sectional study design with data from 2012 Medicare Current Beneficiary Survey. The study sample comprised of elderly community-dwelling individuals who had positive total health care expenditures, and enrolled in Medicare throughout the calendar year (462 with ADRD, and 7160 without ADRD). We estimated the per-capita total annual out-of-pocket spending on health care and out-of-pocket spending by service type: Inpatient, outpatient, home health, prescription drugs, and other services. We measured out-of-pocket spending burden by calculating the percentage of income spent on health care and defined high out-of-pocket spending burden as having this percentage above 10%. Multivariable analyses included ordinary least squares regressions and logistic regressions and these analyses adjusted for predisposing, enabling, need, personal health care practices and external environment characteristics. Results: The average annual per-capita out-of-pocket health care spending was greater among individuals with ADRD compared with those without ADRD ($3285 vs. $1895); home health and prescription drugs accounted for 52% of total out-of-pocket spending among individuals with ADRD and 34% among individuals without ADRD. Elderly individuals with ADRD were more likely to have high out-of-pocket spending burden (adjusted odds ratio, 1.49; 95% confidence interval, 1.13-1.97) compared with those without ADRD. Conclusion: ADRD is associated with excess out-of-pocket health care spending, primarily driven by prescription drugs and home health care use.
KW - Alzheimer disease and related disorders
KW - Out-of-pocket health care spending
KW - elderly Medicare beneficiaries
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U2 - 10.1097/MLR.0000000000000869
DO - 10.1097/MLR.0000000000000869
M3 - Article
C2 - 29309391
AN - SCOPUS:85044505735
SN - 0025-7079
VL - 56
SP - 240
EP - 246
JO - Medical care
JF - Medical care
IS - 3
ER -