Health Care Costs

Research Findings

Research Activities, April 2009:
Older patients stop using inhalers and end up in the hospital when insurers enact deductibles and copayments
Negative effects are seen when patients reach drug benefit thresholds in Medicare Part D
Seniors use fewer generic drugs as a result of Medicare Part D
Newest diabetes medications are more costly and widely prescribed than older diabetes drugs
Higher education and income levels are associated with increased willingness to pay for a psoriasis cure
Lower socioeconomic status results in poor physical and mental health outcomes for patients with lupus
A new tool helps companies estimate costs and possible savings for diabetes care

Research Activities, March 2009:
Educating patients before hospital discharge reduces readmissions, emergency department visits, and saves money
Blacks report greater difficulty in affording prescription medications than whites
Hospitals spend less for patients in Medicare Advantage than for patients in fee-for-service Medicare
Five therapeutic categories of prescribed drugs dominate spending on prescription medicines
Spending on outpatient prescription pain medicines has tripled in 10 years

Research Activities, February 2009:
Adolescent females who are overweight have higher health expenditures than adolescent males who are overweight
Hospice costs vary across patients and within a hospice stay
The volume and charges for vertebroplasty performed in Medicare patients doubled from 2001 to 2005, but rates varied considerably by State
Subsidies and education about the value of health insurance may help encourage the uninsured to enroll in health plans
Hospitals' cost for the top six cardiovascular treatments is nearing $60 billion
Hospitals spend less for patients in Medicare Advantage than for patients in fee-for-service Medicare

Research Activities, January 2009:
Doctor's use of e-prescribing systems linked to formulary data can boost drug cost savings
Cost-effectiveness of pertussis vaccine in adults confirmed in U.S. and German studies
X-ray of patients undergoing emergency surgery is cost-effective in preventing retained surgical sponges
Daily hemodialysis is cost-effective for intensive care patients with acute kidney injury

Research Activities, December 2008:
AHRQ sponsors first theme issue of Health Services Research with focus on improving efficiency and value in health care
Combination antihypertensive drugs raise out-of-pocket costs for patients

Research Activities, November 2008:
Hospital stay duration and cost for the elderly with non-dementia psychiatric illnesses varies by care settings
Changes in cost to patients reduce new use of antidepressants among the elderly, but have less impact on continued use
Study of the benefit of prophylactic antibiotics prior to major surgery raises questions about pay for performance
Patients' hospital bills jumped $70 billion in just one year

Research Activities, October 2008:
Patients receiving free pharmaceutical samples have higher out-of-pocket prescription costs
U.S. government spending on health care for seniors was five times that spent for children in 2002
Most rural hospitals need financial assistance in adopting health information systems
Patient perceptions of office visit copayments alter care-seeking behaviors
The gap between charges and payments for emergency department pediatric visits widened between 1996 and 2003
One-third of health center CEOs view health disparities collaboratives as negatively affecting centers' finances
Quality improvement endeavors often fail to cover their costs
Health insurance premiums have more than doubled since 1996

Research Activities, September 2008:
Surgical errors cost nearly $1.5 billion annually
Intimate partner violence affects the abused women as well as the care use and costs of their children
Women who receive food stamps are more likely to be overweight and obese and to spend more on health care
The Balanced Budget Act of 1997 reduced the number of home health aides

Research Activities, August 2008:
New Spanish-language consumer guide compares oral diabetes medications
Women who were abused as children use more health care services than those who weren't abused
Hospice care saves money for Medicare and Medicaid patients in nursing homes
Studies elaborate on the potential use of health information technology to improve care delivery
Direct-to-consumer advertising of antidepressants aims to increase pool of users
Studies examine effectiveness and cost-effectiveness of depression quality improvement programs in primary care
An antimicrobial stewardship program improves appropriate antimicrobial use among hospitalized children
University's open season shows embrace of preferred provider organizations but no backlash against HMOs
Treatment costs nearly double for hay fever and other allergies
Spending on cholesterol-reducing statins more than doubles in just five years

Research Activities, July 2008:
Counting surgical sponges and instruments can prevent some being left in the patient, but better methods are needed
Strep throat in children carries significant societal costs
Children often lose Medicaid coverage when their parents do, even though they are still eligible
As parents gain a job with private health insurance coverage, their children may lose public coverage
The financial burden of health care felt by low-income families a decade ago may now affect middle-income families
Public health insurance coverage continues to play an important role for working families with children
The Medicare Part D prescription drug benefit has modestly boosted drug use and reduced average out-of-pocket expenses
Emergency department bills exceed payments over 9-year period

Research Activities, June 2008:
Antidepressants and therapy may be cost-effective for patients with medically unexplained symptoms
Many cost-of-illness studies do not include all costs of a particular injury or illness, and may be misleading
A collaborative approach to diabetes care in community health centers can cost-effectively improve that care
Children from low-income communities are five times more likely to have untreated cavities
Premiums rise 18 percent for nonemployer health insurance

Research Activities, May 2008:
Trio of factors affects low-income parents' ability to purchase health care for their families
Hospital treatment costs for violence top $2 billion annually

Research Activities, April 2008:
Modest health care quality gains outpaced by spending
Cost-effectiveness of primary care treatment of sinusitis depends on individual, societal, and payer's perspectives
Consultations on major surgeries bring higher costs and longer stays but not care improvements

Research Activities, March 2008:
Most employers review but do not use quality data when selecting health care plans
Sensitization to indoor allergens is not linked to increased asthma problems among inner-city adults
Hospitalists can reduce hospital stays and costs for children with common pediatric conditions like asthma

Research Activities, February 2008:
Age, gender, and location are keys to predicting patient fall injuries in hospitals
Financial incentives to physicians and long-term care facilities may foster adoption of computerized drug systems
Three-tier formularies increase cost sharing for retirees in generous plans, with little effect on continued drug use

Research Activities, January 2008:
Studies examine pharmacy workload and medication errors and cost savings of hospital barcode medication systems
Successful epilepsy surgery reduces health care costs
Journal supplement explores alternative research approaches to test drug safety and effectiveness

Research Activities, December 2007:
Many underinsured U.S. children are not getting needed vaccines due to the current vaccine financing system
Many seniors will pay double the monthly copay for angiotensin receptor blockers under the Medicare Part D drug plan compared with their previous plans

Research Activities, November 2007:
AHRQ expands therapeutics education and research centers and adds new topics: Health IT, economics, and formularies
Study documents the health costs of being a woman
End-of-life care expenditures and use among Medicare colorectal cancer patients differ more by age than gender
Evidence of benefit is lacking for many common ways of treating osteoarthritis of the knee
Insurers save with incentive-based formularies, but consumers pay more out of pocket

Research Activities, October 2007:
Studies examine medication adherence and group medical visits among persons with high blood pressure
Educational outreach to individual physicians to improve antihypertensive drug prescribing can reduce drug costs

Research Activities, September 2007:
Domestic violence victims have higher health care use and costs than other women, even long after the abuse has ended
Physicians seem to manage potential conflicts with managed care financial arrangements to retain patient trust

Research Activities, August 2007:
Price competition induced by HMOs and other managed care plans in California has not diminished hospital quality of care
Acute respiratory distress syndrome leads to poor outcomes and high care costs, even after treatment with inhaled nitric oxide
Pertussis vaccination in adults can be cost-effective depending on incidence rates
Providing combination medication for elderly patients following a heart attack can save both lives and money
Financial pressures on hospitals in the 1990s led to less investment in care resources and poorer quality of care
Education, income, and wealth all affect medical care expenditures among Medicare managed care members

Research Activities, July 2007:
The Medicare short stay transfer policy reduced hospital incentives to discharge orthopedic surgery patients early
Supportive housing may be a feasible and appropriate model of care for chronically homeless persons

Research Activities, June 2007:
Incentives combined with peer counseling are a cost-effective way to get adolescents to adhere to a tuberculosis control program

Research Activities, May 2007:
Report issued to Congress on electronic prescribing to cut errors and costs
A study of one managed behavioral health care organization does not show a shift in treatment costs to drugs and primary care
U.S. health care spending has become less concentrated among the top spenders in the past decade
Transfer of health care funding from California State to counties maintained commitment to social service spending for the indigent
Regionalizing stroke care to high-volume hospitals may not improve stroke outcomes or lower costs for some regions

Research Activities, April 2007:
High out-of-pocket costs for antiretroviral therapy are linked to more treatment failures among HIV-infected patients in Botswana

Research Activities, March 2007:
Studies highlight the interaction between managed care and market forces and their impact on quality of care
Urban influence codes reveal more about children's patterns of health care use and coverage
Specific primary care office systems and quality improvement strategies may substantially affect the cost of diabetes care
The financial burden of health care for people under age 65 increased between 1996 and 2003

Research Activities, February 2007:
Newer class of antidepressants is similar in effectiveness, but side effects differ
Modest levels of cost-sharing for emergency department care decrease emergency department visits without worsening health
Employer-sponsored insurance coverage of smoking cessation treatments could save employers and insurers money

Research Activities, January 2007:
Missed opportunities: Too few Americans are being screened or counseled to prevent colorectal cancer, obesity, and other conditions
Increased use of prescription medicines is changing health care spending patterns
Medicare payment reforms sparked changes in use of home health care services among the elderly

Research Activities, December 2006:
Both hospitals and Medicare would gain financially by improving patient safety
The cost of treating diabetes surges

Research Activities, November 2006:
Fungal infections in immunocompromised children dramatically increase mortality rate, length of hospital stay, and costs
Physicians view some financial incentives as encouraging and others as discouraging services to patients
Pay-for-performance incentives were adopted by half of U.S. HMOs, but their use depends on health plan type and physician payment arrangements
HMOs do not appear to adversely affect the health of the near-elderly and may benefit those with chronic health conditions

Research Activities, October 2006:
Use of pediatric hospitalists decreases hospital costs and stays without adversely affecting clinicians or parents
Prescription drug benefits limits for Medicare beneficiaries are associated with less use of prescription drugs, worse clinical outcomes, and higher hospitalization costs
Patients with more chronic conditions increase hospital costs
Medical malpractice laws capping damage payments appear to lower State health care expenditures by 3 to 4 percent

Research Activities, September 2006:
Financial incentives to physicians and hospitals to improve quality of care seem ineffective
Health insurance coverage for mental health specialists is still lower than for other medical visits

Research Activities, August 2006:
Obesity surgery complication rates are higher over time
Studies highlight the value of the Medical Expenditure Panel Survey to inform trends in care costs, coverage, use, and access
Job-related health insurance premiums vary widely between States

Research Activities, July 2006:
High-quality/low-cost hospital performance is linked to organizational characteristics and market forces
Some adults with diabetes face high health care expenditures

Research Activities, June 2006:
Medicaid spending on outpatient drugs more than doubled in recent years
Increasing cervical cancer screening intervals is cost-effective for women with three consecutive normal Pap smears
Insuring adults in late middle age may reduce the costs of paying for health problems later

Research Activities, May 2006
Disadvantaged groups infected with hepatitis C can be effectively treated when health care providers collaborate
Study examines national trends in the costs of bariatric surgery

Research Activities, April 2006
Higher insurance premiums and expanded Medicaid eligibility have reduced family coverage in employer-related health plans

Research Activities, March 2006
Fewer visits to the doctor contribute to the higher mortality rates among black Medicare patients in Tennessee
Ventilator-associated pneumonia is a serious and costly side effect of mechanical ventilation
The cost-effectiveness threshold for medical interventions may depend on the context of the circumstances
SCHIP significantly decreases uninsurance and increases public insurance for children in low-income families

Research Activities, February 2006:
Low-income Hispanics and blacks use alternative health care as a substitute for conventional care
People with diabetes take less diabetes medication when costs increase
Expansion in public health insurance for children lessens the financial burden of health care for low-income families
Employer-offered health coverage affects plan uptake by workers, but has less effect on overall worker and family coverage rates

Research Activities, January 2006:
Implantable pacemakers are cost-effective in preventing sudden death in people without a life-threatening cardiac arrhythmia

Research Activities, December 2005:
Study strengthens argument against implementing rollbacks in the State Children's Health Insurance Program

Research Activities, November 2005:
Studies detail the impact of costs on drug and health care use

Research Activities, October 2005:
Medicare expenditures among residents of assisted living facilities are similar to those of community-dwelling elderly

Research Activities, September 2005:
Out-of-pocket health care expenses pose a significant financial burden for low-income families with children
Ethics consultations can reduce nonbeneficial treatments and costs among dying patients

Research Activities, August 2005:
Routine pertussis vaccination of adolescents would be beneficial and reasonably cost effective
Study calls for reform of policies that reject candidates for cardiac transplantation due to lack of insurance or finances

Research Activities, July 2005:
Chiropractic care is more expensive but not more effective than medical care for the treatment of low back pain

Research Activities, June 2005:
Physician supply increases in States with caps on malpractice lawsuit awards, with the greatest impact in rural areas
Photodynamic therapy is a cost-effective treatment option for patients with high-grade dysplasia in Barrett's esophagus
Maryland Medicaid saved millions of dollars by ending reimbursement of dentists for treating adult dental emergencies

Research Activities, May 2005:
Prolonging clopidogrel therapy from 1 month to 1 year after coronary angioplasty with stent placement is cost effective
Children with special health care needs generally use more health services and have higher costs than other children

Research Activities, April 2005:
Researchers compare medications for stroke prevention in patients with atrial fibrillation
Study fails to establish cost-effectiveness of using palivizumab to prevent RSV infection in preterm infants
Many Medicaid-insured schizophrenia patients are prescribed multiple long-term antipsychotics
Nursing home quality of care may suffer if budget shortfalls force States to freeze or reduce Medicaid rates
Costs of rehabilitative care can be reduced to reimbursement levels with little effect on patient function

Research Activities, March 2005:
Preventing diabetes complications could save $2.5 billion annually
Women 65 and older used more medications and spent more for them than same-age men during the period 1999 to 2001
Rural workers have less employment-related health insurance for several reasons, including low wages and smaller employers

Research Activities, February 2005:
New study sheds light on substantial injuries and deaths due to motorcycle accidents
Adoption of medical innovation, which is driving much of health care costs, is largely outside the control of health plans
Study documents cost-effectiveness of targeted chlamydia screening
Policies that have a deductible inserted in the middle instead of at the front expose enrollees to more risk
Policies are being considered to extend medical malpractice tort reforms to the nursing home sector

Research Activities, January 2005:
Appropriately targeting thrombolytic therapy for heart attack patients has the potential to save both lives and money
During the mid-1990s, Medicare HMOs in California reduced inpatient use beyond that attributable to favorable selection