National Health Spending In 2011: Overall Growth Remains Low, But Some Payers And Services Show Signs Of Acceleration

Hartman, Micah; Martin, Anne; Benson, Joseph; Catlin, Aaron

doi:10.1377/hlthaff.2012.1206

Cited by 97 publications

(69 citation statements)

References 3 publications

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“…4,9,10 In 2011, US healthcare expenditures reached $2.7 trillion dollars ($8680/person). 11 The relationship between health literacy, healthcare utilization and associated expenditures is of particular importance for the US economy. Studies [12][13][14][15][16] on this issue have typically used validated scales to directly measure health literacy for individuals rather than assess community-level indicators of health literacy.…”

Section: Introductionmentioning

confidence: 99%

Health Literacy Impact on National Healthcare Utilization and Expenditure

Rasu

Bawa

Suminski

et al. 2015

Int J Health Policy Manag

170

137

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Background: Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Methods: Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS <226) and above basic (HLS ≥226). Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA ® 11.0 statistical software. Results: The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from [2005][2006][2007][2008]. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P < .05). The extrapolated national estimates show that the annual costs for prescription alone for adults with LHL possibly associated with basic and below basic health literacy could potentially reach about $172 billion. Conclusion: Health literacy is inversely associated with healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare utilization and expendituresspending more on prescriptions compared to individuals with above basic HLL. Public health strategies promoting appropriate education among individuals with LHL may help to improve health outcomes and reduce unnecessary healthcare visits and costs. Implications for policy makers• Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. •We found that individuals with below basic or basic compared to above basic health literacy incurred more healthcare visits, have greater total healthcare expenditures. • Adults with basic or below basic health literacy incurred greater costs for prescription ($3362) than adults w...

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Section: Introductionmentioning

confidence: 99%

Health Literacy Impact on National Healthcare Utilization and Expenditure

Rasu

Bawa

Suminski

et al. 2015

Int J Health Policy Manag

170

137

View full text Add to dashboard Cite

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“…4 It is estimated that the cost to hospitals for training a resident averages $100 000 or more per year. 5 For most teaching hospitals in the United States, the largest source of GME funding is from the Centers for Medicare and Medicaid Services (CMS), but for pediatric training programs that are based at a children's hospital the major sources of GME funding are the Children's Hospital Graduate Medical Education (CHGME) Payment Program and Medicaid.…”

Section: Current Sources Of Gme Fundingmentioning

confidence: 99%

Financing Graduate Medical Education to Meet the Needs of Children and the Future Pediatrician Workforce

Rimsza¹,

Hotaling²,

Simon³

et al. 2016

Pediatrics

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The American Academy of Pediatrics (AAP) believes that an appropriately financed graduate medical education (GME) system is critical to ensuring that sufficient numbers of trained pediatricians are available to provide optimal health care to all children. A shortage of pediatric medical subspecialists and pediatric surgical specialists currently exists in the United States, and this shortage is likely to intensify because of the growing numbers of children with chronic health problems and special health care needs. It is equally important to maintain the supply of primary care pediatricians. The AAP, therefore, recommends that children’s hospital GME positions funded by the Health Resources and Services Administration be increased to address this escalating demand for pediatric health services. The AAP also recommends that GME funding for pediatric physician training provide full financial support for all years of training necessary to meet program requirements. In addition, all other entities that gain from GME training should participate in its funding in a manner that does not influence curriculum, requirements, or outcomes. Furthermore, the AAP supports funding for training innovations that improve the health of children. Finally, the AAP recommends that all institutional recipients of GME funding allocate these funds directly to the settings where training occurs in a transparent manner.

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“…More recently, lower enrollment growth and lower utilization have been reported for some services. In recent years, the collective impact of these and other mechanisms has been associated with a reduction in the rate of growth of health care expenses in the United States [4] [5].…”

Section: Introductionmentioning

confidence: 99%

Identification of At-Risk Inpatient Hospital Populations at the Community Level

Lagoe¹,

Lagoe²

2014

OJN

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This study focused on hospital populations which account for large amounts of health care utilization at the community level in the metropolitan area of Syracuse, New York. It demonstrated that, between the two largest hospital inpatient services, adult medicine patients accounted for a larger number of excess hospital patient days than adult surgery over a two-year period. Adult medicine stays increased while adult surgery stays declined. Adult medicine also accounted for a larger number of excess inpatient days, an average daily census of 52.7 patients in 2013, although adult medicine outliers comprised only 2.4 -2.5 percent of discharges while adult surgery patients comprised 4.4 -4.5 percent of discharges for these services. Adult medicine readmissions accounted for 79 -81 percent of these adverse events for the combined hospital during the two-year period. Adult medicine complications accounted for 60 -62 percent of complications in the two hospitals for which data were available. These data clearly demonstrate the challenges that adult medicine patients carry for providers as they attempt to improve the efficiency and outcomes of care in local communities. In the United States, payer reimbursement for the care of these patients frequently does not match the resources required as funding emphasizes surgical specialties and healthier patients. In metropolitan areas such as Syracuse, where local populations are aging or declining, the expenses of caring for these patients can become a major challenge for community providers.

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National Health Spending In 2011: Overall Growth Remains Low, But Some Payers And Services Show Signs Of Acceleration

Cited by 97 publications

References 3 publications

Health Literacy Impact on National Healthcare Utilization and Expenditure

Health Literacy Impact on National Healthcare Utilization and Expenditure

Financing Graduate Medical Education to Meet the Needs of Children and the Future Pediatrician Workforce

Identification of At-Risk Inpatient Hospital Populations at the Community Level

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