Heart Disease, Trauma and Diabetes Incur Highest Cost Per Person Medical Expenses

MedicalResearch.com Interview with:

Anita Soni, PhD, MBA Survey Analyst/Statistician Agency for Healthcare Research and Quality

Dr. Anita Soni

Anita Soni, PhD, MBA
Survey Analyst/Statistician
Agency for Healthcare Research and Quality

MedicalResearch.com: What is the background for this study?

Response: This statistical brief uses the data from the Medical Expenditure Panel Survey (MEPS), which collects a broad range of data related to the health care of the U.S. civilian noninstitutionalized population including health insurance coverage, the number and types of health care events and the sources of payment and payment amounts for those events. The survey also gathers information on which medical conditions are associated with the reported health care events. Condition-specific health care expenditure information derived from MEPS data is useful for policy makers in determining where to focus health policies to improve the quality and efficiency of the health care system from the perspective of disease treatment and management.

This Statistical Brief presents data regarding medical expenditures for nine conditions for which an estimated 10 percent or more of the U.S. civilian noninstitutionalized population (individuals age 18 and older) received health care in 2013.

MedicalResearch.com: What are the main findings?

• Among the nine conditions reported as a reason for receiving treatment for ten percent or more of the total U.S. adult population in 2013, the five most prevalently treated conditions were hypertension, hyperlipidemia, mental disorders, osteoarthritis and other non-traumatic joint disorders, and COPD/asthma.
• The highest average expenses per person were for the treatment of heart conditions, trauma-related disorders, and diabetes mellitus, while hyperlipidemia and hypertension had the lowest.
• Medicare and private insurance together paid more than half the expenditures for all of the top treated conditions.
• Trauma-related disorders had the highest percentage of expenditures associated with emergency room visits and lowest percentage associated with prescription medicines.
• Heart conditions had the highest percentage of expenditures associated with inpatient stays, as well as the highest percentage of Medicare payments and the lowest percentage of out-of-pocket payments.

MedicalResearch.com: What should readers take away from your report?

Response: More than 10 percent of US civilian non institutionalized population (individuals age 18 and older) reported these 9 chronic conditions These conditions include hypertension, hyperlipidemia, mental disorders, osteoarthritis, COPD/asthma, trauma-related disorders, GI problems, diabetes, and heart conditions, which together account for approximately half of condition-related health care expenses for adults.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We should look at these expenditures by other factors such as age and/or race.

MedicalResearch.com: Is there anything else you would like to add?

Response: More than half of the expenditures for each condition examined were paid by private insurance or Medicare. Private insurance payments ranged from 23.5 percent for hypertension to 44.6 percent for GI disorders. Medicare payments associated with eight of the nine conditions ranged from 27.0 percent (mental disorders) to 37.8 percent (hypertension). Heart conditions had the highest proportion of expenses covered by Medicare (46.7 percent), as well as the lowest percentage of out-of-pocket payments (5.4 percent). The three conditions with the highest out-of-pocket percentages were mental disorders (15.9 percent), hypertension (15.5 percent), and hyperlipidemia (14.6 percent).
The MEPS Household Component collects data on the civilian noninstitutionalized population in the U.S. through in-person interviews with one respondent in each household who is knowledgeable about each household member’s health conditions, insurance coverage, health care use and expenditures, and other characteristics.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Soni, A. and Mitchell E. Expenditures for Commonly Treated Conditions among Adults Age 18 and Older in the U.S. Civilian Noninstitutionalized Population, 2013. Statistical Brief #487. May 2016. Agency for Healthcare Research and Quality, Rockville, MD. 

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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