State-Level Health Care Expenditures Associated With Disability

Abstract

Objective Given the growth in national disability-associated health care expenditures (DAHE) and the changes in health insurance–specific DAHE distribution, updated estimates of state-level DAHE are needed. The objective of this study was to update state-level estimates of DAHE. Methods We combined data from the 2013-2015 Medical Expenditure Panel Survey, 2013-2015 Behavioral Risk Factor Surveillance System, and 2014 National Health Expenditure Accounts to calculate state-level DAHE for US adults in total, per adult, and per (adult) person with disability (PWD). We adjusted expenditures to 2017 prices and assessed changes in DAHE from 2003 to 2015. Results In 2015, DAHE were $868 billion nationally (range, $1.4 billion in Wyoming to $102.8 billion in California) accounting for 36% of total health care expenditures (range, 29%-41%). From 2003 to 2015, total DAHE increased by 65% (range, 35%-125%). In 2015, DAHE per PWD were highest in the District of Columbia ($27 839) and lowest in Alabama ($12 603). From 2003 to 2015, per-PWD DAHE increased by 13% (range, −20% to 61%) and per-capita DAHE increased by 28% (range, 7%-84%). In 2015, Medicare DAHE per PWD ranged from $10 067 in Alaska to $18 768 in New Jersey. Medicaid DAHE per PWD ranged from $9825 in Nevada to $43 365 in the District of Columbia. Nonpublic–health insurer per-PWD DAHE ranged from $7641 in Arkansas to $18 796 in Alaska. Conclusion DAHE are substantial and vary by state. The public sector largely supports the health care costs of people with disabilities. State policy makers and other stakeholders can use these results to inform the development of public health programs that support and provide ongoing health care to people with disabilities.

Post-COVID conditions and healthcare utilization among adults with and without disabilities—2021 Porter Novelli FallStyles survey

“… 29 Adults with disabilities have more underlying chronic conditions, social vulnerability factors 6 , and pandemic-related behavioral or mental health changes 12 , 7 than adults without disabilities, and associated increased care needs and expenditures for social services. 9 They experience greater challenges than adults without disabilities in accessing health care services 30 (e.g., testing, vaccination, nonpharmaceutical interventions, clinic visits) and might be at higher risk for undiagnosed SARS-CoV-2, leading to missed cases, 13 e.g., PCC in adults with intellectual disabilities. 31 Adults with disabilities have been shown to have a lower likelihood of having received COVID-19 vaccination, attributed to difficulties obtaining a COVID-19 vaccine or (less likely) vaccine hesitancy.…”

“…The estimated 61 million adults in the United States with disabilities 5 who experienced challenges to accessing health care and social services before the pandemic 6 remain medically underserved during the pandemic. 7 They report disparities in access to health care, testing, and vaccines 8 , among other psychosocial stressors 9 , and may require additional resources, technical assistance, and disability accommodations if they develop PCC. Many long-term symptoms reported by people with disabilities, such as fatigue or shortness of breath, are similar to those reported from PCC, but distinguishing symptoms resulting from underlying disabilities from PCC symptoms is important.…”

Functional Limitations and Perceived Neighborhood Walkability Among Urban Dwelling Older Adults

“…We assessed FLs by considering a participant's difficulty in performing three activities without using special equipment ( 27 ): (1) “walking one-quarter mile;” (2) “climbing 10 steps;” and (3) “stooping, bending, or kneeling.” The original response comprised limited (1), not limited (2), or unknown if limited (3). Based on the previous studies in the United States ( 28 , 29 ), we coded the responses as limited (1) if a respondent reported any difficulty with one or more functional activities or not limited (0) if a respondent reported no difficulty.…”

“…The original response comprised limited (1), not limited (2), or unknown if limited (3). Based on the previous studies in the United States (28,29), we coded the responses as limited (1) if a respondent reported any difficulty with one or more functional activities or not limited (0) if a respondent reported no difficulty.…”

Rehabilitation and functional capacity in the health of the 21st century

“…Ese aumento de prevalencia de discapacidad tiene su reflejo en el porcentaje de gasto sanitario dedicado a la asistencia sanitaria a la discapacidad y sus consecuencias, que ha aumentado sustancialmente en la última década en países como EE.UU. 19 . Los costes indirectos por jornadas laborales perdidas por discapacidad a consecuencia de las enfermedades más prevalentes alcanzan cifras que alcanzan el nivel macroeconómico 20 , 21 .…”