Slide Presentation from the AHRQ 2008 Annual Conference
On September 9, 2008, Jessica Banthin, made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (717 KB).
Slide 1
Financial Burdens for Health Care
Jessica Banthin, Ph.D.
Didem Bernard, Ph.D.
September 9, 2008
Slide 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.
Slide 3
Data: Medical Expenditure Panel Survey (MEPS)
- 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: http://www.meps.ahrq.gov
Slide 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.
Slide 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 out-of-pocket (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.
Slide 6
The line graph shows the percent of individuals spending 10% or more of family income on out of pocket expenditures from 2001-2005.
- 2001: 15.9%
- 2002: 17.2%
- 2003: 18.9%
- 2004: 17.9%
- 2005: 19.1%
Slide 7
The line graph shows the percent of individuals spending 10% or more of family income by insurance status from 2001-2005.
- Private Employer-sponsored Insurance (ESI):
- 2001: 14.7
- 2002: 16.0
- 2003: 17.8
- 2004: 17.0
- 2005: 18.6
- Private Non-Group:
- 2001: 39.0
- 2002: 49.1
- 2003: 55.3
- 2004: 52.7
- 2005: 52.9
- Public:
- 2001: 18.0
- 2002: 18.0
- 2003: 19.5
- 2004: 15.8
- 2005: 16.5
- Uninsured All Year:
- 2001: 13.9
- 2002: 13.7
- 2003: 13.5
- 2004: 14.0
- 2005: 15.0
Slide 8
The line graph shows the percent of individuals spending 10% or more of family income by poverty status from 2201-2005.
- Poor (<100%):
- 2001: 30.3
- 2002: 31.4
- 2003: 33.6
- 2004: 28.1
- 2005: 29.0
- Low Income (<200%):
- 2001: 22.9
- 2002: 21.4
- 2003: 24.2
- 2004: 23.8
- 2005: 21.9
- Lo-Middle (<300%):
- 2001: 20.3
- 2002: 22.9
- 2003: 25.1
- 2004: 21.1
- 2005: 23.4
- Hi-Middle (<400%):
- 2001: 14.3
- 2002: 17.0
- 2003: 19.0
- 2004: 16.3
- 2005: 21.9
- High Income (400%+):
- 2001: 7.2
- 2002: 8.2
- 2003: 9.0
- 2004: 10.2
- 2005: 11.3
Slide 9
The line graph shows the percent of individuals spending 10% or more of family income by age/gender from 2001-2005.
- Less than 18:
- 2001: 15.4
- 2002: 16.8
- 2003: 18.2
- 2004: 16.0
- 2005: 17.6
- Males 19-34:
- 2001: 9.0
- 2002: 10.6
- 2003: 11.5
- 2004: 10.6
- 2005: 12.1
- Females 19-34:
- 2001: 13.6
- 2002: 15.0
- 2003: 16.9
- 2004: 14.9
- 2005: 16.7
- Males 35-49:
- 2001: 14.0
- 2002: 15.0
- 2003: 16.0
- 2004: 14.9
- 2005: 16.9
- Females 35-49:
- 2001: 16.5
- 2002: 16.9
- 2003: 18.9
- 2004: 18.4
- 2005: 19.5
- Males 50-64:
- 2001: 21.5
- 2002: 22.6
- 2003: 25.3
- 2004: 25.4
- 2005: 25.8
- Females 50-64:
- 2001: 26.6
- 2002: 27.9
- 2003: 30.7
- 2004: 30.3
- 2005: 30.2
Slide 10
The line graph shows the percent of individuals spending 10% or more of family income by insurance status and chronic condition from 2001-2005.
- INSRD_CHR:
- 2001: 19.79
- 2002: 21.52
- 2003: 24.84
- 2004: 23.08
- 2005: 24.42
- INSRD_NON:
- 2001: 13.2
- 2002: 14.32
- 2003: 15.1
- 2004: 13.73
- 2005: 15.31
- UNINSRD_CHR:
- 2001: 25.43
- 2002: 25.77
- 2003: 25.28
- 2004: 25.63
- 2005: 26.67
- UNINSRD_NON:
- 2001: 8.82
- 2002: 8.15
- 2003: 8.23
- 2004: 8.56
- 2005: 9.32
Slide 11
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%
Slide 12
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.
Current as of January 2009
Internet Citation:
Financial Burdens for Health Care. Slide Presentation from the AHRQ 2008 Annual Conference (Text Version). January 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualmtg08/090908slides/Banthin.htm