Reports from the Field: Patients with chronic conditions spend more for health care
Patients with chronic conditions spend up to five times more than individuals without a chronic condition, a new study shows.
The study, "Out of Pocket Medical Spending for Care of Chronic Conditions" was published in the November/December issue of Health Affairs.
The out of pocket expenditures typically are because of nonexistent or inadequate health insurance coverage, says Gerard Anderson, PhD, national program director for the Partnership for Solutions, which supported the study, and professor of health policy and management and international health at the Johns Hopkins Bloomberg School of Public Health.
"It is no surprise that people who are sicker tend to pay more for health care, but just how much more out of their own pocket is quite significant. The magnitude of out-of-pocket expenditures is staggering," Anderson says.
The study reveals there are significant consequences for the more than 41% of the population who have chronic conditions such as diabetes, heart disease, hypertension, and arthritis, many of whom have to pay a considerable portion of their income on medical services. Large out-of-pocket expenditures for medical services have been shown to impede access to care, affect health status and quality-of-life, and leave insufficient income for other necessities, Anderson says.
Of the 108 million individuals with chronic conditions, approximately 26 million had two chronic conditions and another 20 million had three or more.
Out-of-pocket spending increased with age and varied by insurance coverage. Out-of-pocket expenditures were highest for non-elderly persons with no insurance and for elderly persons covered only by Medicare.
`Both elderly and non-elderly Medicaid beneficiaries had the lowest out-of-pocket expenditures.
Prescription drugs were the largest out-of-pocket spending category for elderly persons with chronic conditions and increased dramatically for both elderly and non-elderly persons as the number of chronic conditions increased.
Twenty-eight million families (26% of all families) spent more than $1,000 on out-of-pocket medical care and 5.4 million families (5% of all families) spent more than $3,000.
Coinsurance payments and gaps in health insurance coverage are the main reasons for the higher out-of-pocket expenditures, the researchers concluded.
"Chronic conditions have a significant impact on out-of-pocket direct medical spending for the more than two out of every five Americans with a chronic condition. This is money people no longer have for other necessities — for rent, for college, for heating and cooling bills, clothes, even food. Policymakers should account for the existing burdens on people with chronic conditions and their families when considering changes in benefit coverage and cost sharing requirements," Anderson says.
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