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Financial Burdens for Health Care

Financial Burdens for Health Care Jessica Banthin, Ph.D. Didem Bernard, Ph.D. September 9, 2008 Research Questions How have rising health care costs affected family budgets? How does risk of high out of pocket health care burdens vary by: insurance status Income categories age and gender

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Financial Burdens for Health Care

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  1. Financial Burdens for Health Care Jessica Banthin, Ph.D. Didem Bernard, Ph.D. September 9, 2008

  2. Research Questions • How have rising health care costs affected family budgets? • How does risk of high out of pocket health care burdens vary by: • insurance status • Income categories • age and gender • presence of chronic conditions

  3. Data:Medical Expenditure Panel Survey • The MEPS is annual survey sponsored by Agency for Healthcare Research & Quality • Nationally representative household survey consisting of 15,000 households and 39,000 individuals • Includes data on insurance coverage, health care utilization and expenditures, health status, medical conditions, & more • Most accurate source of nationally representative micro level data on out of pocket spending for medical care • Released on public use files, tables, statistical briefs: www.meps.ahrq.gov

  4. Methods: Constructing Measure of High Burden • Numerator: We calculated total out of pocket spending across all individuals in the family • Denominator: We calculated total family income and adjusted for taxes • We identify individuals living in families that spend more than 10% of family income on out of pocket expenses – “high burden” • Results are presented in terms of percent of individuals living in families with high financial burdens

  5. Methodological Considerations • Burden ratio (% of family income) is a composite or summary measure compressing many variables into one ratio • Provides big picture – no causal interpretation • Combines OOP premiums plus OOP payments on services • Defines burdens at family level because family members share resources • Use 10 percent of adjusted family income as reasonable threshold, other thresholds can be used

  6. Financial Burdens by Chronic Disease 2003 Likelihood of facing high financial burden: • All persons, 19.2% • Diabetes, 39.1% • Stroke, 56.0% • Heart disease, 32.7% • Hypertension, 30.9% • Arthritis, 30.7% • Mental disorder, 29.2%

  7. Conclusion • Tracking trends in high financial burdens provides policymakers with overview of issue • Identifies subgroups with elevated risk for high burdens • Helps inform debate on affordability issue • Also provides benchmark against which to measure proposed changes in policy

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