Insurer and out‐of‐pocket costs of osteoarthritis in the US: Evidence from national survey data

H Kotlarz, CL Gunnarsson, H Fang… - Arthritis & Rheumatism …, 2009 - Wiley Online Library
H Kotlarz, CL Gunnarsson, H Fang, JA Rizzo
Arthritis & Rheumatism: Official Journal of the American College …, 2009Wiley Online Library
Objective Osteoarthritis (OA) is a major debilitating disease affecting∼ 27 million persons in
the US. Yet, the financial costs to patients and insurers remain poorly understood. The
purpose of this study was to quantify by multivariate analyses the relationships between OA
and annual health care expenditures borne by patients and insurers. Methods Data from the
Medical Expenditure Panel Survey (MEPS) for the years 1996–2005 were used. MEPS is a
large, nationally representative US database that includes information on health care …
Objective Osteoarthritis (OA) is a major debilitating disease affecting∼ 27 million persons in the US. Yet, the financial costs to patients and insurers remain poorly understood. The purpose of this study was to quantify by multivariate analyses the relationships between OA and annual health care expenditures borne by patients and insurers. Methods Data from the Medical Expenditure Panel Survey (MEPS) for the years 1996–2005 were used. MEPS is a large, nationally representative US database that includes information on health care expenditures, medical conditions, health insurance status, and sociodemographic characteristics. Individual and nationally aggregated cost estimates are provided. Results OA was found to contribute substantially to health care expenditures. Among women, OA increased out‐of‐pocket (OOP) expenditures by 1,379perannum(2007dollars)andinsurerexpendituresby 4,833. Among men, OA increased OOP expenditures by 694perannumandinsurerexpendituresby 4,036. Given the high prevalence of OA, the aggregate effects on health care expenditures were very large. OA raised aggregate annual medical care expenditures by 185.5billion.Ofthatamount,insurerexpenditureswere 149.4 billion and OOP expenditures were 36.1billion.BecauseofthegreaterprevalenceofOAinwomenandtheirmoreintensiveuseofhealthcare,totalexpendituresforthisgroupaccountedfor 118 billion, or almost two‐thirds of the total increase in health care expenditures resulting from OA. Conclusion The health care cost burden associated with OA is quite large for all groups examined and is disproportionately higher for women. Although insurers bear the brunt of treatment costs for OA, the OOP costs are also substantial.
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