The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

Baird, Katherine

doi:10.1177/2050312115623792

Cited by 21 publications

(20 citation statements)

References 39 publications

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“…Each family member has the same family‐level outcomes. We follow the literature and aggregate family‐level outcomes over the matched observations. We compare family medical out‐of‐pocket expenditures across imputation methods within the intervention group between 2013 and 2014: using the old imputation methods estimated medical expenditures averaged $4307 in 2013 and using the new imputation methods estimated medical expenditures averaged $4547 in 2014.…”

Section: Resultsmentioning

confidence: 99%

“…We follow the literature and conduct person‐level analyses, which facilitates studying subgroups defined by characteristics that may vary within families. We stratify the sample based on age (nonelderly and elderly), insurance status, and whether the state expanded Medicaid.…”

Section: Data Variables and Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The capacity to monitor changes in affordability is important for assessing the health care system, studying the impact of policy changes on medical financial burdens, and studying the impact of medical financial burdens on patients . The CPS is an important source of information on medical financial burdens . The CPS first asked about aggregate out‐of‐pocket medical spending in the 2010 survey, but the specific questions changed in the 2011 and 2014 surveys, and imputation procedures for missing information improved in the 2014 survey, and income questions changed in the 2015 survey .…”

Section: Introductionmentioning

confidence: 99%

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Effects of improvements in the CPS on the estimated prevalence of medical financial burdens

Hill

Solomon

Maclean

2019

Health Services Research

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Objective To measure the effects of questionnaire and imputation improvements in the Current Population Survey (CPS) on the estimated prevalence of high medical financial burden, that is, families spending more than 10 percent of income on medical care. Data Source Matched longitudinal sample of CPS data for 2013 and 2014 calendar years. Study Design The CPS used a split‐sample design to field traditional and redesigned questions about 2013 income, and old and new out‐of‐pocket premium imputation procedures, respectively. For both samples, CPS data for 2014 were from the redesigned income questions and the new imputation procedures. We quantify the effects of the combined survey improvements using differences‐in‐differences methods. Principal Findings The improvements were not associated with changes in the estimate of burden in the full sample. Estimated prevalence increased by 2.6 percentage points among nonelderly adults with private insurance, decreased by 6.6 percentage points among nonelderly adults with public coverage, and decreased by 5.8 percentage points among elderly adults with Medicare and no private coverage. Conclusions Improvements in the CPS changed the estimated prevalence of high medical financial burden among key subgroups. Researchers should use caution when tracking burden across the time‐period in which these improvements were implemented.

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Section: Resultsmentioning

confidence: 99%

Section: Data Variables and Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of improvements in the CPS on the estimated prevalence of medical financial burdens

Hill

Solomon

Maclean

2019

Health Services Research

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“…A diverse geographic distribution of participants presents another difficulty in accurately measuring cost of treatments that could be nominated in different currencies, with different pricing policies, etc., as noted by Baird (2016). In general, self-reported health outcomes are subjective and directly contingent on social experience, and Molina (2016) raises some measurement problems related to "reporting heterogeneity."…”

Section: Limitationsmentioning

confidence: 99%

Patient-reported outcomes: A 5-year long study reveals previously unreported therapeutic, demographic, socio-economic, and other correlations in vitiligo

Valle

Коробко

Sigova

et al. 2018

Dermatologic Therapy

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Vitiligo is a non‐lethal, non‐communicable, immune‐mediated, and generally progressive skin disease, with poorly understood etiopathogenesis and weak evidence base. The aim of the study is to contribute to the scant research on the patient‐reported outcomes in vitiligo, and to examine the presence of associations between various inputs for possible use in clinical practice. The study was designed as a web‐based questionnaire with 40 inputs across seven dimensions. The questions include demographics, skin type, eye and natural hair color, age of respondent and age of onset, possible triggers, disease extent, localization, progression and activity, the efficacy of most common treatment modalities, medication side‐effects, heredity and diseases among parents, and out‐of‐pocket expenses for treatments to date. The analysis presented with this work contributes to the discussion about the relation between therapies, socio‐economic factors, and treatment outcomes in vitiligo. All physicians should adequately manage patient expectations in terms of overall treatment duration and expected out‐of‐pocket expenses, and actively evaluate patients at shorter intervals. A more aggressive therapeutic approach using telehealth devices should be considered to supplement therapy, monitor treatment progress, and protocol compliance.

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A Worldwide Price Comparison of Glaucoma Medications, Laser Trabeculoplasty, and Trabeculectomy Surgery

Zhao

Rahmathullah²,

Almobarak

et al. 2018

JAMA Ophthalmol

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IMPORTANCE Medical and surgical interventions for glaucoma are effective only if they are affordable to patients. Little is known about how affordable glaucoma interventions are in developing and developed countries.OBJECTIVE To compare the prices of topical glaucoma medications, laser trabeculoplasty, and trabeculectomy relative with median annual household income (MA-HHI) for countries worldwide.DESIGN, SETTING AND PARTICIPANTS Cross-sectional observational study. For each country, we obtained prices for glaucoma medications, laser trabeculoplasty, and trabeculectomy using government pricing data, drug databases, physician fee schedules, academic publications, and communications with local ophthalmologists. Prices were adjusted for purchasing power parity and inflation to 2016 US dollars, and annual therapy prices were examined relative to the MA-HHI. Interventions costing less than 2.5% of the MA-HHI were considered affordable. MAIN OUTCOMES AND MEASURESDaily cost for topical glaucoma medications, cost of annual therapy with glaucoma medications, laser trabeculoplasty, and trabeculectomy relative to MA-HHI in each country.RESULTS Data were obtained from 38 countries, including 17 developed countries and 21 developing countries, as classified by the World Economic Outlook. We observed considerable variability in intervention prices compared with MA-HHI across the countries and across interventions, ranging from 0.1% to 5% of MA-HHI for timolol, 0.1% to 27% for latanoprost, 0.2% to 17% for laser trabeculoplasty, and 0.3% to 42% for trabeculectomy. Timolol was the most affordable medication in all countries studied and was 2.5% or more of MA-HHI in only 2 countries (5%). The annual cost of latanoprost was 2.5% or more of MA-HHI in 15 countries (41%) (15 developing countries [75%] and no developed countries). The cost of laser trabeculoplasty was 2.5% or more of the MA-HHI in 15 countries (44%) (11 developing countries [65%] and 4 developed countries [24%]). The cost of trabeculectomy was 2.5% or more of the MA-HHI in 28 countries (78%) (18 developing countries [95%] and 10 developed countries [59%]). In 18 countries (53%), laser trabeculoplasty cost less than a 3-year latanoprost supply.CONCLUSIONS AND RELEVANCE For many patients worldwide, the costs of medical, laser, and incisional surgical interventions were 2.5% or more of the MA-HHI. Successfully reducing global blindness from glaucoma requires addressing multiple contributing factors, including making glaucoma interventions more affordable.

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The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

Cited by 21 publications

References 39 publications

Effects of improvements in the CPS on the estimated prevalence of medical financial burdens

Effects of improvements in the CPS on the estimated prevalence of medical financial burdens

Patient-reported outcomes: A 5-year long study reveals previously unreported therapeutic, demographic, socio-economic, and other correlations in vitiligo

A Worldwide Price Comparison of Glaucoma Medications, Laser Trabeculoplasty, and Trabeculectomy Surgery

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