Harman J, Kelleher KJ; Academy for Health Services Research and Health Policy. Meeting.
Abstr Acad Health Serv Res Health Policy Meet. 2002; 19: 17.
University of Pittsburgh School of Medicine, 3811 O'Hara Street, Suite 430, Pittsburgh, PA 15213; Tel: (412) 624-1872; Fax: (412) 624-2360; E-mail: harmanjs@msx.upmc.edu
RESEARCH OBJECTIVE: Because most health insurance plans have more limited benefits and greater cost sharing for mental health services, individuals with psychiatric conditions are likely to have higher out-of-pocket health care costs than other individuals. The objective of this research is to assess the out-of-pocket health care costs for individuals with and without psychiatric conditions to assess the relative economic burden of obtaining health care. STUDY DESIGN: Data from the 1997 Medical Expenditure Panel Survey were used to obtain nationally representative estimates of out-of-pocket costs for health care over the course of the year. Using sampling weights, national estimates of the mean out-of-pocket costs for individuals with and without psychiatric conditions are estimated. The impact of having a psychiatric condition on mean out-of-pocket costs is then assessed using a weighted two-part model that controls for factors such as age, race, income, education, type of insurance, functional limitations, and self-reported health status. Significant differences in out-of-pocket costs are then assessed by bootstrapping 95% confidence intervals. POPULATION STUDIED: A nationally representative sample of non-institutionalized individuals. PRINCIPAL FINDINGS: Individuals with self-reported psychiatric conditions had unadjusted mean out-of-pocket costs of $783, which was significantly higher than the mean out-of-pocket costs of $349 reported by individuals who did not have a psychiatric condition. The median out-of-pocket costs were $350 for individuals with psychiatric conditions and $85 for those without. Having a psychiatric condition was a significant predictor of out-of-pocket costs, even after adjusting for socioeconomic factors, health status, and functional limitations. The adjusted mean out-of-pocket costs for individuals with psychiatric conditions was $724, while the adjusted mean out-of-pocket costs for those without a psychiatric condition was $360, a difference of $364. The 95% CI of this difference in cost is $290 to $430. The adjusted mean out-of-pocket costs were $213 more for children with psychiatric disorder than children without a psychiatric disorder, $333 more for non-elderly adults with psychiatric disorders, and $694 more for elderly persons with psychiatric disorders compared to those without. The adjusted mean out-of-pocket costs were $383, $239, and $524 more for individuals with psychiatric conditions than for those without any psychiatric conditions for individuals with private insurance, with public insurance, and with no health insurance, respectively. CONCLUSIONS: Individuals with psychiatric conditions have out-of-pocket health care costs that are more than double the costs faced by individuals without psychiatric conditions. An especially large difference in out-of-pocket costs between elderly persons with and without psychiatric disorders was observed, with elderly persons with psychiatric conditions having the largest out-of-pocket cost burden of any age group. Because most health insurance plans, including Medicare, have more limited mental health benefits, individuals with psychiatric conditions are likely to have high out-of-pocket expenditures and are more likely to face financial restraints to receiving care than other individuals. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Equitable benefits in mental health care coverage are needed to reduce the excess out-of-pocket cost burden faced by individuals with psychiatric conditions. PRIMARY FUNDING SOURCE: National Institute of Mental Health
Publication Types:
Keywords:
- Adult
- Aged
- Child
- Cost Sharing
- Health Care Costs
- Health Expenditures
- Health Services Needs and Demand
- Health Status
- Humans
- Income
- Insurance Benefits
- Insurance, Health
- Medicare
- Mental Disorders
- Mental Health Services
- Socioeconomic Factors
- economics
- hsrmtgs
Other ID:
UI: 102273701
From Meeting Abstracts