Percent Increase In Expenditures Research Articles

Medical expenditures in patients with high risk of diabetes: Effects of BMI, hypertension, and health-related quality of life.

To evaluate the health-related quality of life (HRQOL) of patients with diabetes and persons at high risk of developing diabetes and the association between HRQOL scores and subsequent medical expenditures in these persons. Data came from the Medical Expenditure Panel Survey. Body mass index (BMI) and hypertension were used to identify risk of diabetes. Burden was assessed by comparing SF-12 physical (PCS) and mental (MCS) summary scores in patients with diabetes and those at risk of having diabetes to the age- and gender-adjusted PCS and MCS of those with normal BMI and no hypertension. Associations between PCS and MCS and medical expenditures were modeled using a two-part model that controlled for clinical and demographic factors. Percent increase in expenditure associated with PCS and MCS differences was evaluated as the ratio of estimated expenditure, holding other factors fixed. Diabetes risk factors were associated with up to 9-point lower PCS and 3-point lower MCS score. Overall, 1-, 2-, 5-, and 10-point lower PCS scores were associated with 2.9%, 5.8%, 15.0%, and 31.8% higher expenditures, and lower MCS scores were associated with 1.3%, 2.6%, 6.5%, and 13.5% higher expenditures, respectively. The reported associations can help clinicians and researchers interpret the magnitude of HRQOL score differences.

Household Debt and Local Public Finances

In the wake of the Great Recession, steep declines in state and local government expenditures and employment were a large and persistent source of economic weakness. The business cycle was also characterized by large increases and decreases in household debt. We estimate the extent to which variation in local government revenues and expenditures can be explained by variation in the expansion of household debt from 2002 to 2007, and the contraction thereafter. We merge individual credit balance data with municipal financial data from the Census of Governments. Using Census block indicators, we are able to place approximately 12 million credit bureau records into over 6,000 cities and 4,500 school districts. Our results indicate that a one percent additional increase in mortgage debt caused a 0.15 percent increase in local governments’ own revenue and a 0.17 to 0.21 percent increase in expenditures. These relationships were evident during the expansion and contraction of mortgage debt. We also find evidence linking non-mortgage debt to municipal finances.

Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly

AbstractWe examine the effect of gaining prescription drug insurance, as a result of Medicare Part D, on use of prescription drugs and other medical services for a nationally representative sample of Medicare beneficiaries. Given the heightened importance of prescription drugs for those with chronic illness, we provide separate estimates for elderly in poorer health. We find that Medicare Part D significantly reduced socioeconomic and geographic disparities in prescription drug insurance among the elderly. Gaining prescription drug insurance through Medicare Part D was associated with a 30 percent increase in the number of annual prescriptions and a 40 percent increase in expenditures on prescription drugs for both the general population of the elderly and the elderly in poorer health. We find little evidence that prescription drug insurance was strongly associated with the use of outpatient and inpatient services, although our investigation of these associations was limited by a lack of statistical power.

Dairy-borne Disease Outbreak and Milk Demand: A Study Using Outbreak Surveillance Data

We utilize the outbreak surveillance data from the Centers for Disease Control and Prevention (CDC) to examine whether consumer demand is impacted by the outbreak of food-borne disease. An additional person sickened due to the ingestion of tainted cheese products at home is found to decrease per capita milk demand in New York State by 0.13 percent (or 0.07 pound), while milk-and ice cream-borne disease outbreaks, occurring at home or in public places, are found to have no impact on fluid milk demand. Our results imply the existence of word-of-mouth effects, which cannot be tested by the popular information/media index approach used to measure food-borne disease outbreaks. We also find that a 7 percent increase in generic advertising expenditures or a 10 percent increase in expenditures on non-advertising marketing activities can offset the negative influence of one ill person in cheese-borne disease outbreaks at home, while holding other demand factors constant.