Out-of-Pocket Expenditures for Adults with Multiple Chronic Conditions

MedicalResearch.com Interview with:
Anita Soni, PhD, MBA
Survey Analyst/Statistician Agency for Healthcare Research and Quality
Rockville, MD

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

Response: This statistical brief uses the data from the Medical Expenditure Panel Survey (MEPS), which is a nationally representative survey of the U.S. civilian noninstitutionalized population that collects data on the demographic characteristics, health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance coverage, income, and employment of Americans.

This brief focuses on adults 18 and older who received some medical care in 2014. Persons who have multiple chronic conditions—those who were treated for two or more conditions considered to be chronic during 2014 — are compared to those who, while they had medical care, reported use associated with only one or no chronic conditions. 

MedicalResearch.com: What are the main findings?

  • Among those using medical care, mean per person out-of-pocket expenditures for the U.S. civilian noninstitutionalized adult population who had multiple chronic conditions were more than double those of adults who had no or one chronic condition.
  • White, non-Hispanic adults with multiple chronic conditions had the highest per person out-of-pocket expenditures in comparison to black non-Hispanic, Hispanic, Asian non-Hispanic and other non-Hispanic adults with two or more chronic conditions.
  • High income adults with multiple chronic conditions had higher out of-pocket expenditures than those who had lower family income.
  • Among non-elderly adults who received medical care in 2014, those with multiple chronic conditions who were uninsured had higher mean out-of-pocket expenditures per person than those who had only public insurance.

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

Response: As the United States population continues to age, the prevalence of chronic conditions will continue to rise. Chronic conditions are those which are persistent and have long lasting effects that impact one’s ability to function well beyond an acute phase. While having one chronic condition increases the chances of an individual having higher medical expenses, having more than one may have a multiplicative effect on functioning and the need for health care. Persons with multiple chronic conditions may require, in addition to care for each specific condition, coordination of care to cover all of their health care needs. This increased use of medical care may contribute to persons with multiple chronic conditions having higher out-of-pocket medical expenses. This potentially high level of out-of pocket health care spending may impose an economic burden on some individuals and families.

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

Response: Multiple chronic conditions are associated with higher total and out-of-pocket medical spending. Continuing to track the factors associated with that higher spending can supply consumers, providers, and policymakers with valuable data aimed at informing efforts to improve healthcare access, use, and costs.

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

Response: There were also differences in out-of-pocket spending by race/ethnicity. Among adults who had expenses for medical care associated with multiple chronic conditions in 2014, the highest mean per-person out-of-pocket expenditures were for white, non-Hispanic adults ($1,463). This was more than double the amount reported for Hispanic adults ($710) and almost double that reported for black, non-Hispanic adults ($781). Moreover, across all race/ethnicity categories mean per person out-of-pocket expenditures were substantially higher for those with multiple chronic conditions compared with those who had one or no chronic conditions (white, non-Hispanic–$1,463 versus $707; black non-Hispanic–$781 versus $337; Hispanic–$710 versus $398; Asian non-Hispanic–$913 versus $407; and Other non-Hispanic–$1,148 versus $400, respectively).

The MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the U.S. civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.

For more information about MEPS visit the MEPS Web site at http://www.meps.ahrq.gov/.

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


Soni, A. Out-of-Pocket Expenditures for Adults with Multiple Chronic Conditions, U.S. Civilian Noninstitutionalized Population, 2014. Statistical Brief #498. February 2017. Agency for Healthcare Research and Quality, Rockville, MD.http://www.meps.ahrq.gov/mepsweb/data_files/publications/st498/stat498.shtml

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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