Science.gov

Sample records for expenditure panel survey

  1. Dry eye medication use and expenditures: data from the medical expenditure panel survey 2001 to 2006.

    PubMed

    Galor, Anat; Zheng, D Diane; Arheart, Kristopher L; Lam, Byron L; Perez, Victor L; McCollister, Kathryn E; Ocasio, Manuel; McClure, Laura A; Lee, David J

    2012-12-01

    To study dry eye medication use and expenditures from 2001 to 2006 using a nationally representative sample of US adults. This study retrospectively analyzed dry eye medication use and expenditures of participants of the 2001 to 2006 Medical Expenditure Panel Survey, a nationally representative subsample of the National Health Interview Survey. After adjusting for survey design and for inflation using the 2009 inflation index, data from 147 unique participants aged 18 years or older using the prescription medications Restasis and Blephamide were analyzed. The main outcome measures were dry eye medication use and expenditures from 2001 to 2006. Dry eye medication use and expenditures increased between the years 2001 and 2006, with the mean expenditure per patient per year being $55 in 2001 to 2002 (n=29), $137 in 2003 to 2004 (n=32), and $299 in 2005 to 2006 (n=86). This finding was strongly driven by the introduction of topical cyclosporine emulsion 0.05% (Restasis; Allergan, Irvine, CA). In analysis pooled over all survey years, demographic factors associated with dry eye medication expenditures included gender (female: $244 vs. male: $122, P<0.0001), ethnicity (non-Hispanic: $228 vs. Hispanic: $106, P<0.0001), and education (greater than high school: $250 vs. less than high school: $100, P<0.0001). We found a pattern of increasing dry eye medication use and expenditures from 2001 to 2006. Predictors of higher dry eye medication expenditures included female gender, non-Hispanic ethnicity, and greater than a high school education.

  2. Determinants and trends in dental expenditures in the adult US population: Medical Expenditure Panel Survey 1996-2006.

    PubMed

    Christian, B; Chattopadhyay, A

    2014-06-01

    To estimate dental expenditures in 2006, to analyse dental expenditures by potential explanatory factors for 2006 and to explore trends in dental expenditures from 1996-2006. Medical Expenditure Panel Survey (MEPS) data were used. T-tests and analysis of variance were used to test for significance. Multivariable linear regression analysis was conducted to identify independent predictors of dental expenditures. The trend analysis was conducted for the 11-year period, 1996-2006, on adults aged 25 years and older. Expenditures were inflation adjusted to 2006 dollars using the annual average Consumer Price Index. Data were analysed using the MEPS query tool and SASv9.2. In the 2006 MEPS sample, 8,001 adults had dental expenditures and when weighted represented about 93 million non-institutionalised adult US civilians. The mean dental expenditures for this weighted sample were $611 (sd 1,309), median $233 (inter-quartile range 466). As expected, in 2006, dental expenditures increased with age. Those adults who reported their self-perceived health status as 'excellent' were observed to have lowest dental expenditures in this category. After adjusting for other variables in the multivariable linear regression analysis of dental expenditures, age, race/ethnicity, income, geographic location, perceived health status and dental insurance coverage remained significant. Dental expenditures for 2006 were $611 (mean) and $233 (median). The time-trend showed substantial but non-uniform annual changes in real dental expenditures between 1996 and 2006.

  3. The insurance effect on prescription drug expenditures among the elderly: findings from the 1997 Medical Expenditure Panel Survey.

    PubMed

    Curtis, Lesley H; Law, Amy W; Anstrom, Kevin J; Schulman, Kevin A

    2004-05-01

    Despite continuing debate over a prescription drug benefit for the Medicare program, there has been relatively little research estimating the potential cost of providing such a benefit. The objective of this study was to estimate the effect of prescription drug insurance on outpatient prescription drug expenditures among the elderly. We studied respondents aged > or =65 years to the 1997 Medical Expenditure Panel Survey, a representative survey of the U.S. noninstitutionalized population. Survey-weighted linear regression models were used to estimate the probability of any expenditures and total expenditures while controlling for sociodemographic characteristics, chronic conditions, and health status. We used prescription drug insurance status and outpatient prescription drug expenditures. An estimated 34 million elderly people filled 630 million prescriptions in 1997. Thirty-seven percent did not have prescription drug insurance. Total prescription drug expenditures exceeded $23 billion. Persons without prescription drug insurance spent slightly less than $7 billion; those with insurance spent more than $16 billion. After controlling for health status, comorbidity, and demographic characteristics, prescription drug insurance increased expenditures by $183 per person. The marginal increase in total expenditures of extending the average observed benefit to those currently uninsured is $2.3 billion (95% confidence interval, $1.2-3.5 billion). Proposals for a Medicare drug benefit provide high copayments to protect against insurance effects and to address uncertainty in cost estimates of the proposed benefit. By quantifying the insurance effect on expenditures among the elderly, the data reported here could reduce uncertainty in the budget estimation process.

  4. Trends in health care expenditure among US adults with heart failure: The Medical Expenditure Panel Survey 2002-2011.

    PubMed

    Echouffo-Tcheugui, Justin B; Bishu, Kinfe G; Fonarow, Gregg C; Egede, Leonard E

    2017-04-01

    Population-based national data on the trends in expenditures related to heart failure (HF) are scarce. Assessing the time trends in health care expenditures for HF in the United States can help to better define the burden of this condition. Using 10-year data (2002-2011) from the national Medical Expenditure Panel Survey (weighted sample of 188,708,194US adults aged ≥18years) and a 2-part model (adjusting for demographics, comorbidities, and time); we estimated adjusted mean and incremental medical expenditures by HF status. The costs were direct total health care expenditures (out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources) from various sources (office-based visits, hospital outpatient, emergency department, inpatient hospital, pharmacy, home health care, and other medical expenditures). Compared with expenditures for individuals without HF ($5511 [95% CI 5405-5617]), individuals with HF had a 4-fold higher mean expenditures of ($23,854 [95% CI 21,733-25,975]). Individuals with HF had $3446 (95% CI 2592-4299) higher direct incremental expenditures compared with those without HF, after adjusting for demographics and comorbidities. Among those with HF, costs continuously increased by $5836 (28% relative increase), from $21,316 (95% CI 18,359-24,272) in 2002/2003 to $27,152 (95% CI 20,066-34,237) in 2010/2011, and inpatient costs ($11,318 over the whole period) were the single largest component of total medical expenditure. The estimated unadjusted total direct medical expenditures for US adults with HF were $30 billion/y and the adjusted total incremental expenditure was $5.8 billion/y. Heart failure is costly and over a recent 10-year period, and direct expenditure related to HF increased markedly, mainly driven by inpatient costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Sex differences in healthcare expenditures among adults with diabetes: evidence from the medical expenditure panel survey, 2002-2011.

    PubMed

    Williams, Joni S; Bishu, Kinfe; Dismuke, Clara E; Egede, Leonard E

    2017-04-11

    The evidence assessing differences in medical costs between men and women with diabetes living in the United States is sparse; however, evidence suggests women generally have higher healthcare expenditures compared to men. Since little is known about these differences, the aim of this study was to assess differences in out-of-pocket (OOP) and total healthcare expenditures among adults with diabetes. Data were used from 20,442 adults (≥18 years of age) with diabetes from the 2002-2011 Medical Expenditure Panel Survey. Dependent variables were OOP and total direct expenditures for multiple health services (prescription, office-based, inpatient, outpatient, emergency, dental, home healthcare, and other services). The independent variable was sex. Covariates included sociodemographic characteristics, comorbid conditions, and time. Sample demographics were summarized. Mean OOP and total direct expenditures for health services by sex status were analyzed. Regression models were performed to assess incremental costs of healthcare expenditures by sex among adults with diabetes. Fifty-six percent of the sample was composed of women. Unadjusted mean OOP costs were higher for women for prescriptions ($1177; 95% CI $1117-$1237 vs. $959; 95% CI $918-$1000; p < 0.001) compared to men. Unadjusted mean total direct expenditures were also higher for women for prescriptions ($3797; 95% CI $3660-$3934 vs. $3334; 95% CI $3208-$3460; p < 0.001) and home healthcare ($752; 95% CI $646-$858 vs. $397; 95% CI $332-$462; p < 0.001). When adjusting for covariates, higher OOP and total direct costs persisted for women for prescription services (OOP: $156; 95% CI $87-$225; p < 0.001 and total: $184; 95% CI $50-$318; p = 0.007). Women also paid > $50 OOP for office-based visits (p < 0.001) and > $55 total expenditures for home healthcare (p = 0.041) compared to men after adjustments. Our findings show women with diabetes have higher OOP and total direct

  6. The capacity of the Medical Expenditure Panel Survey to inform the Affordable Care Act.

    PubMed

    Cohen, Steven B; Cohen, Joel W

    2013-05-01

    The Affordable Care Act (ACA) was enacted with major provisions to expand health insurance coverage, control health care costs, and improve the health care delivery system. Essential data resources will be required for effective program planning, administration, and management, in addition to facilitating evaluations of program performance. The Medical Expenditure Panel Survey (MEPS) is one of the core data resources that has been used to inform several provisions of the ACA. This paper provides a summary of the capacity of the MEPS to inform program planning, implementation, and evaluations of program performance for several components of the ACA.

  7. A Flexible Model for Correlated Medical Costs, with Application to Medical Expenditure Panel Survey Data

    PubMed Central

    Chen, Jinsong; Liu, Lei; Shih, Ya-Chen T.; Zhang, Daowen; Severini, Thomas A.

    2016-01-01

    We propose a flexible model for correlated medical cost data with several appealing features. First, the mean function is partially linear. Second, the distributional form for the response is not specified. Third, the covariance structure of correlated medical costs has a semiparametric form. We use extended generalized estimating equations to simultaneously estimate all parameters of interest. B-splines is used to estimate unknown functions, and a modification to Akaike Information Criterion is proposed for selecting knots in spline bases. We apply the model to correlated medical costs in the Medical Expenditure Panel Survey (MEPS) dataset. Simulation studies are conducted to assess the performance of our method. PMID:26403805

  8. A flexible model for correlated medical costs, with application to medical expenditure panel survey data.

    PubMed

    Chen, Jinsong; Liu, Lei; Shih, Ya-Chen T; Zhang, Daowen; Severini, Thomas A

    2016-03-15

    We propose a flexible model for correlated medical cost data with several appealing features. First, the mean function is partially linear. Second, the distributional form for the response is not specified. Third, the covariance structure of correlated medical costs has a semiparametric form. We use extended generalized estimating equations to simultaneously estimate all parameters of interest. B-splines are used to estimate unknown functions, and a modification to Akaike information criterion is proposed for selecting knots in spline bases. We apply the model to correlated medical costs in the Medical Expenditure Panel Survey dataset. Simulation studies are conducted to assess the performance of our method.

  9. Employment and Disability: Evidence From the 1996 Medical Expenditures Panel Survey

    PubMed Central

    Findley, Patricia A.; Sambamoorthi, Usha

    2007-01-01

    The relationship between employment and disability has gained national attention, as the ability to maintain employment is inconsistent among those with limitations. This cross-sectional study of employment among individuals (N = 1691, age 21–62 years) with self-reported limitations in the 1996 Medical Expenditures Panel Survey seeks to identify predictors of employment despite physical and/or cognitive limitations. Two predictive models of employment including 10 variables are explored; 1 included insurance (χ2 = 3856.85, p ≤ 0.00) and the other removed the insurance variable (χ2 = 280.21, p ≤ 0.00). Individuals with limitations who are employed are more likely to have a college-level education, have better physical and mental health perceptions and have private insurance. This analysis demonstrates that people do work despite reported activity, functional or sensory limitations and that socioeconomic factors are crucial in why someone is able to attain employment. PMID:15055500

  10. Evaluating direct medical expenditures estimation methods of adults using the medical expenditure panel survey: an example focusing on head and neck cancer.

    PubMed

    Coughlan, Diarmuid; Yeh, Susan T; O'Neill, Ciaran; Frick, Kevin D

    2014-01-01

    To inform policymakers of the importance of evaluating various methods for estimating the direct medical expenditures for a low-incidence condition, head and neck cancer (HNC). Four methods of estimation have been identified: 1) summing all health care expenditures, 2) estimating disease-specific expenditures consistent with an attribution approach, 3) estimating disease-specific expenditures by matching, and 4) estimating disease-specific expenditures by using a regression-based approach. A literature review of studies (2005-2012) that used the Medical Expenditure Panel Survey (MEPS) was undertaken to establish the most popular expenditure estimation methods. These methods were then applied to a sample of 120 respondents with HNC, derived from pooled data (2003-2008). The literature review shows that varying expenditure estimation methods have been used with MEPS but no study compared and contrasted all four methods. Our estimates are reflective of the national treated prevalence of HNC. The upper-bound estimate of annual direct medical expenditures of adult respondents with HNC between 2003 and 2008 was $3.18 billion (in 2008 dollars). Comparable estimates arising from methods focusing on disease-specific and incremental expenditures were all lower in magnitude. Attribution yielded annual expenditures of $1.41 billion, matching method of $1.56 billion, and regression method of $1.09 billion. This research demonstrates that variation exists across and within expenditure estimation methods applied to MEPS data. Despite concerns regarding aspects of reliability and consistency, reporting a combination of the four methods offers a degree of transparency and validity to estimating the likely range of annual direct medical expenditures of a condition. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.

  11. Chronic Pain and Health Care Spending: An Analysis of Longitudinal Data from the Medical Expenditure Panel Survey

    PubMed Central

    Stockbridge, Erica L; Suzuki, Sumihiro; Pagán, José A

    2015-01-01

    Objective To estimate average incremental health care expenditures associated with chronic pain by health care service category, expanding on prior research that focused on specific pain conditions instead of general pain, excluded low levels of pain, or did not incorporate pain duration. Data Source Medical Expenditure Panel Survey (MEPS) data (2008–2011; N = 26,671). Study Design Differences in annual expenditures for adults at different levels of pain that interferes with normal work, as measured by the SF-12, were estimated using recycled predictions from two-part logit-generalized linear regression models. Principal Findings “A little bit” of chronic pain-related interference was associated with a $2,498 increase in total adjusted expenditures over no pain interference (p < .0001) and a $1,008 increase over nonchronic pain interference (p = .0001). Moderate and severe chronic pain-related interference was associated with a $3,707 and $5,804 increase in expenditures over no pain interference and a $2,218 and $4,315 increase over nonchronic interference, respectively (p < .0001). Expenditure increases were most pronounced for inpatient and hospital outpatient expenditures compared to other types of health care expenditures. Conclusions Chronic pain limitations are associated with higher health care expenditures. Results underscore the substantial cost of pain to the health care system. PMID:25424348

  12. Chronic pain and health care spending: an analysis of longitudinal data from the Medical Expenditure Panel Survey.

    PubMed

    Stockbridge, Erica L; Suzuki, Sumihiro; Pagán, José A

    2015-06-01

    To estimate average incremental health care expenditures associated with chronic pain by health care service category, expanding on prior research that focused on specific pain conditions instead of general pain, excluded low levels of pain, or did not incorporate pain duration. Medical Expenditure Panel Survey (MEPS) data (2008-2011; N = 26,671). Differences in annual expenditures for adults at different levels of pain that interferes with normal work, as measured by the SF-12, were estimated using recycled predictions from two-part logit-generalized linear regression models. "A little bit" of chronic pain-related interference was associated with a $2,498 increase in total adjusted expenditures over no pain interference (p < .0001) and a $1,008 increase over nonchronic pain interference (p = .0001). Moderate and severe chronic pain-related interference was associated with a $3,707 and $5,804 increase in expenditures over no pain interference and a $2,218 and $4,315 increase over nonchronic interference, respectively (p < .0001). Expenditure increases were most pronounced for inpatient and hospital outpatient expenditures compared to other types of health care expenditures. Chronic pain limitations are associated with higher health care expenditures. Results underscore the substantial cost of pain to the health care system. © Health Research and Educational Trust.

  13. Work-related injuries among Hispanic construction workers-evidence from the medical expenditure panel survey.

    PubMed

    Dong, Xiuwen Sue; Men, Yurong; Ringen, Knut

    2010-06-01

    Although a large number of Hispanic workers have entered the construction industry, few studies have estimated non-fatal work-related injuries for Hispanic construction workers at a national level. This study examines work-related injury conditions among Hispanic construction workers and assesses disparities between Hispanic and white, non-Hispanic workers. Pooled data were analyzed from a large national population survey, the Medical Expenditure Panel Survey (MEPS), between 1996 and 2002. More than 7,000 construction workers were identified from the MEPS data including 1,833 Hispanic workers and 4,533 white, non-Hispanic workers. Univariate and multivariate analyses were conducted using SAS-callable SUDAAN. Hispanic workers differ from white, non-Hispanic workers in demographic and socioeconomic status. After controlling for major risk factors, Hispanic construction workers were more likely than their white, non-Hispanic counterparts to suffer non-fatal work-related injury conditions (OR = 1.28, 95% CI: 1.00-1.64). This study provides important evidence concerning Hispanic workers' safety on construction sites. Enhanced safety and health programs for Hispanic construction workers and improved occupational injury data systems are recommended. 2010 Wiley-Liss, Inc.

  14. The Medical Expenditure Panel Survey (MEPS) experiences with cancer survivorship supplement.

    PubMed

    Yabroff, K Robin; Dowling, Emily; Rodriguez, Juan; Ekwueme, Donatus U; Meissner, Helen; Soni, Anita; Lerro, Catherine; Willis, Gordon; Forsythe, Laura P; Borowski, Laurel; Virgo, Katherine S

    2012-12-01

    The prevalence of cancer survivorship in the USA is expected to increase in the future because the US population is increasing in size and is aging and because survival following diagnosis is improving for many types of cancer. Medical care costs associated with cancer are also projected to increase dramatically. However, currently available data for estimating medical care costs and other important aspects of the burden of cancer, including time spent receiving medical care, productivity loss due to morbidity for patients and their families, and financial hardship, are limited, particularly in the population under the age of 65. We describe selected publicly available data sources for estimating the burden of cancer in the USA and a new collaborative effort to improve the quality of these data: the nationally representative Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement. Data from this effort can be used to address key gaps in cancer survivorship research related to medical care costs, employment patterns, financial hardship, and other aspects of the burden of illness for cancer survivors and their families. Research using the MEPS Experiences with Cancer Survivorship Supplement can inform efforts by health care policy makers, healthcare systems, providers, and employers to improve the cancer survivorship experience in the USA.

  15. The relationship of disability and employment for veterans from the 2010 Medical Expenditure Panel Survey (MEPS).

    PubMed

    Smith, Diane L

    2015-06-05

    Veterans with disabilities, especially those with posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) have difficulty obtaining and maintaining competitive employment. To determine if there are significant differences in employment between veterans with and without disability, between veterans with a disability and nonveterans with a disability, and to investigate the association of veteran status and disability with employment. Chi square analyses were conducted on data obtained from the 2010 Medical Expenditure Panel Survey to determine if significant differences in employment occurred between veterans with disabilities, veterans without disabilities and nonveterans with disabilities. Multivariate regression analyses were used to determine how veteran status and disability are associated with employment. Significant differences in employment were found between veterans with and without a disability; however, no significant differences existed in employment between veterans and nonveterans with a disability. Multivariate analysis showed that veteran status (aOR=1.80), having any disability (aOR=7.29), social disability (aOR=3.47) or a cognitive disability (aOR=3.16) were associated with not being employed. Veterans with disabilities are more likely not to be employed than veteran populations without disabilities. Veterans; however have unique disabilities, different than nonveterans with disabilities, that need to be addressed, such as social and cognitive disabilities resulting from TBI and PTSD. Future research should focus on evaluating the effectiveness of employment programs and policies designed to address the unique issues faced by veterans with disabilities.

  16. Chronic Disease Prevalence and Medicare Advantage Market Penetration: Findings From the Medical Expenditure Panel Survey.

    PubMed

    Howard, Steven W; Bernell, Stephanie Lazarus; Casim, Faizan M; Wilmott, Jennifer; Pearson, Lindsey; Byler, Caitlin M; Zhang, Zidong

    2015-01-01

    By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary's portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS) Household Component data to construct an aggregate index that captures multiple diagnoses in one outcome measure (Chronic Disease Severity Index [CDSI]). The MEPS data for 8089 Medicare beneficiaries are merged with MA market penetration data from Centers for Medicare and Medicaid Services (CMS). Ordinary least squares regressions are run with SAS 9.3 to model the effects of MA market penetration on CDSI. The results suggest that each percentage increase in MA market penetration is associated with a greater than 2-point decline in CDSI (lower burden of cardiometabolic chronic disease). Spill-over effects may be driving improvements in the cardiometabolic health of beneficiary populations in counties with elevated levels of MA market penetration.

  17. Chronic condition combinations and health care expenditures and out-of-pocket spending burden among adults, Medical Expenditure Panel Survey, 2009 and 2011.

    PubMed

    Meraya, Abdulkarim M; Raval, Amit D; Sambamoorthi, Usha

    2015-01-29

    Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions. We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden. Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P < .001). In adjusted models, adults with all 4 conditions had higher expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04). Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers.

  18. Private dental and prescription-drug coverage in children: data from the medical expenditure panel survey.

    PubMed

    Chen, Alex Y

    2004-01-01

    Most studies on health insurance have examined primarily basic medical insurance coverage; few have looked at supplemental insurance and/or dental-insurance coverage. Prescription-drug and dental-insurance coverage are becoming increasingly important due to continued increase in health care costs and changes in cost-sharing structure of health plans. This study examined prescription-drug coverage and dental-insurance coverage in the context of overall insurance coverage. This study utilized the Household Component File from the 2000 Medical Expenditure Panel Survey (MEPS), a national survey on medical care conducted by the Agency for Healthcare Research and Quality (AHRQ). Univariate and bivariate analyses were performed to provide estimates on children's prescription-drug and dental-insurance coverage. Multivariate logistic regression analyses were conducted to identify demographic and socioeconomic factors that influence coverage. In 2000, 68.5% of US children had private insurance, 22.2% had public insurance, and 9.3% were uninsured. Among children with private insurance, only 56.9% had dental-insurance coverage and 76.3% had prescription-drug coverage. Family income level, maternal education, and race were significant predictors of dental insurance and prescription-drug coverage. Although significant strides have been made to insure US children, a large percentage of children still do not have comprehensive coverage. Even among privately insured children, many are without dental or prescription-drug coverage. Those who were poor, minority, and with low maternal education had lower likelihood of dental and prescription-drug coverage.

  19. Direct costs of adult chronic rhinosinusitis by using 4 methods of estimation: Results of the US Medical Expenditure Panel Survey.

    PubMed

    Caulley, Lisa; Thavorn, Kednapa; Rudmik, Luke; Cameron, Chris; Kilty, Shaun J

    2015-12-01

    Chronic rhinosinusitis (CRS) is an inflammatory disease that affects 2% to 16% of the US population. Despite its increasing prevalence, there are currently limited data in the literature evaluating the economic burden of this disease. This study aimed to determine the direct health care costs of CRS from the perspective of the US government. A prevalence-based approach was used to estimate cost of illness for CRS from the 2011 Medical Expenditure Panel Survey database by using a 4-part model: (1) an estimated sum of all health care expenditures, (2) an attribution model for disease-specific estimation of expenditures, (3) an estimation based on a propensity score model, and (4) estimated disease-specific expenditure by using a linear regression-based approach. A disease prevalence of 3.5% was used. The mean CRS-specific annual expenditure was $5955 (95% CI, $5087-$6823) by using method 1 compared with $5560 (95% CI, $4689-$6431) by using method 2 and $5560 (95% CI, $4653-$6467) by using method 3. The annual expenditure, as estimated by using method 4, was $5589 (95% CI, $4986-$6192). Ambulatory expenses accounted for the largest proportion of expenditures, followed by prescription and in-hospital expenses. This study provided a range of estimates of the direct medical expenditures associated with CRS. We demonstrated that the economic burden attributable to this disease was an estimated $60.2 to $64.5 billion US dollars in 2011, with a wide variation in the total and incremental direct expenditures depending on the type of estimation model used and the prevalence assumed. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. An evaluation of health care expenditures in Crohn's disease using the United States Medical Expenditure Panel Survey from 2003 to 2013.

    PubMed

    Bounthavong, Mark; Li, Meng; Watanabe, Jonathan H

    Previous estimates of the economic burden of Crohn's disease (CD) varied widely from $2.0 to $18.2 billion per year (adjusted to 2015 $US). However, these estimates do not reflect recent changes in pharmaceutical treatment options and guidelines. The goal of this study was to update cost estimates of Crohn's disease based on a representative sample of the US population from the most recent 11 years (2003-2013) of the Medical Expenditure Panel Survey (MEPS). A secondary aim described expenditure trends in respondents with and without Crohn's disease pre-post FDA approvals of new biologics and the American College of Gastroenterology Crohn's disease treatment guidelines. Average annual expenditures (total, prescription, inpatient, and outpatient) were evaluated using a pooled cross-sectional design. Respondent data from the most recent 11 years (2003-2013) of MEPS were analyzed. Two-part generalized linear models with power-link were used to estimate the average annual expenditures per patient adjusted to multiple covariates. Confidence intervals (CI) were estimated using bootstrap methods. Difference-in-differences estimations were performed to compare the changes in health care expenditures pre-post FDA approvals of new biologics and the American College of Gastroenterology Crohn's disease treatment guidelines. The annual aggregate economic burden of CD was $6.3 billion in the US. Respondents with CD had higher total (+$6442; 95% CI: $4864 to $8297), prescription (+$3283; 95% CI: $2289 to $4445), inpatient (+$1764; 95% CI: $748 to $3551), and outpatient (+$1191; 95% CI: $592 to $2160) expenditures compared to respondents without CD. In the difference-in-differences estimation, respondents with CD had significantly higher total (P = 0.001) and prescription (P < 0.001) expenditures compared with respondents without CD. Although inpatient and outpatient expenditures were higher in respondents with CD, they were not statistically significant. Respondents with CD

  1. Incremental direct medical expenditures associated with anxiety disorders for the U.S. adult population: evidence from the Medical Expenditure Panel Survey.

    PubMed

    Shirneshan, Elaheh; Bailey, Jim; Relyea, George; Franklin, Brandi E; Solomon, David K; Brown, Lawrence M

    2013-10-01

    Data from the 2009 and 2010 Medical Expenditure Panel Survey (MEPS) were used to estimate the annual incremental healthcare expenditures associated with anxiety disorders, for the ambulatory adult population of the U.S. Individuals 18 years and older, who reported a diagnosis of, or had a medical event associated with anxiety disorder(s), were classified as anxiety population. Multivariate regression analyses, using generalized linear models, were conducted to calculate incremental costs associated with anxiety disorders. 8.74% of adult respondents reported being diagnosed with anxiety disorder(s). The annual overall healthcare expenditure associated with anxiety disorders was estimated at $1657.52 per person (SE: $238.83; p<0.001). Inpatient visits, prescription medications, and office-based visits together accounted for almost 93% of the overall cost. Given the prevalence of self-reported anxiety disorders in MEPS, their total direct medical expenditure is estimated at approximately $33.71 billion in 2013 US dollars, meaning this category of mental illnesses absorbs a significant portion of the U.S. healthcare resources. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Trends of medical expenditures and quality of life in US adults with diabetes: the medical expenditure panel survey, 2002-2011.

    PubMed

    Campbell, Jennifer A; Bishu, Kinfe G; Walker, Rebekah J; Egede, Leonard E

    2017-04-13

    Studies indicate a relationship between cost and quality of life (QOL) in diabetes care, however, the interaction is complex and the relationship is not well understood. The aim of this study was to 1) examine the relationship of quartiles of QOL on cost amongst U.S. adults with diabetes, 2) investigate how the relationship may change over time, and 3) examine the incremental effect of QOL on cost while controlling for other relevant covariates. Data from 2002-2011 Medical Expenditure Panel Survey (MEPS) was used to examine the association between QOL and medical expenditures among adults with diabetes (aged ≥18 years) N = 20,442. Unadjusted means were computed to compare total healthcare expenditure and the out-of-pocket expenses by QOL quartile categories. QOL measures were Physical Component Summary (PCS) and Mental Component Summary (MCS) derived from the Short-Form 12. A two-part model was then used to estimate adjusted incremental total healthcare expenditure and out-of-pocket expenses adjusting for relevant covariates. Differences between the highest and lowest quartiles totaled $11,801 for total expenditures and $989 for out-of-pocket expenses. Over time, total expenditures remained stable, while out-of-pocket expenses decreased, particularly for the lowest quartile of physical component of QOL. Similar trends were seen in the mental component, however, differences between quartiles were smaller (average $5,727 in total expenses; $287 in out-of-pocket). After adjusting for covariates, those in the highest quartile of physical component of QOL spent $7,500 less, and those in the highest quartile of mental component spent $3,000 less than those in the lowest quartiles. A clear gradient between QOL and cost with increasing physical and mental QOL associated with lower expenditures and out-of-pocket expenses was found. Over a 10-year time period those with the highest physical QOL had significantly less medical expenditures compared to those with the

  3. Impact of Out-of-Pocket Expenditure on Physical Therapy Utilization for Nonspecific Low Back Pain: Secondary Analysis of the Medical Expenditure Panel Survey Data.

    PubMed

    Dolot, Janet; Viola, Deborah; Shi, Qiuhu; Hyland, Matthew

    2016-02-01

    Physical therapy decreases low back pain, improves function, and may lead to decreased use of medical services. However, factors predicting physical therapy utilization for patients with low back pain are not well understood. The purpose of this study was to identify the impact of out-of-pocket expenditure on physical therapy utilization for US adults with nonspecific low back pain. This study was a secondary analysis of retrospective Medical Expenditure Panel Survey data. The participants were US adults with nonspecific low back pain. The outcome variable was the number of visits per episode of care. The research variable was out-of-pocket expenditure. Covariate variables were Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) component scores. Descriptive statistics and multiple linear regression analyses were performed. Three hundred fourteen adults met the inclusion criteria and submitted SF-12 scores, representing nearly 4 million adults. Out-of-pocket expenditure, physical component score, and the age-insurance category "18-64 years with public coverage only for all of the year or uninsured all of the year" negatively predicted visits per episode of care in the final regression model. Limitations of the study included use of a nonexperimental design, lack of information about symptom severity and content of physical therapy, and SF-12 scores were not taken coincidental with the episode of care. Out-of-pocket expenditure negatively predicts physical therapy utilization. More research is needed to identify all factors influencing physical therapy utilization so that effective health policies may be developed. © 2016 American Physical Therapy Association.

  4. Are there racial disparities in psychotropic drug use and expenditures in a nationally representative sample of men in the United States? Evidence from the Medical Expenditure Panel Survey.

    PubMed

    Pierre, Geraldine; Thorpe, Roland J; Dinwiddie, Gniesha Y; Gaskin, Darrell J

    2014-01-01

    This article sought to determine whether racial disparities exist in psychotropic drug use and expenditures in a nationally representative sample of men in the United States. Data were extracted from the 2000-2009 Medical Expenditure Panel Survey, a longitudinal survey that covers the U.S. civilian noninstitutionalized population. Full-Year Consolidated, Medical Conditions, and Prescribed Medicines data files were merged across 10 years of data. The sample of interest was limited to adult males aged 18 to 64 years, who reported their race as White, Black, Hispanic, or Asian. This study employed a pooled cross-sectional design and a two-part probit generalized linear model for analyses. Minority men reported a lower probability of psychotropic drug use (Black=-4.3%, 95% confidence interval [CI]=[-5.5, -3.0]; Hispanic=-3.8%, 95% CI=[-5.1, -2.6]; Asian=-4.5%, 95% CI=[-6.2, -2.7]) compared with White men. After controlling for demographic, socioeconomic, and health status variables, there were no statistically significant race differences in drug expenditures. Consistent with previous literature, racial and ethnic disparities in the use of psychotropic drugs present problems of access to mental health care and services.

  5. Favorable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs and Resource Utilization: The 2012 Medical Expenditure Panel Survey.

    PubMed

    Valero-Elizondo, Javier; Salami, Joseph A; Ogunmoroti, Oluseye; Osondu, Chukwuemeka U; Aneni, Ehimen C; Malik, Rehan; Spatz, Erica S; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Blaha, Michael J; Veledar, Emir; Nasir, Khurram

    2016-03-01

    The American Heart Association's 2020 Strategic Goals emphasize the value of optimizing risk factor status to reduce the burden of morbidity and mortality. In this study, we aimed to quantify the overall and marginal impact of favorable cardiovascular risk factor (CRF) profile on healthcare expenditure and resource utilization in the United States among those with and without cardiovascular disease (CVD). The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS). Direct and indirect costs were calculated for all-cause healthcare resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias, or heart failure), ascertained by International Classification of Diseases, Ninth Edition, Clinical Modification codes, and CRF profile (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity, and obesity). Two-part econometric models were used to study expenditure data. The final study sample consisted of 15 651 MEPS participants (58.5±12 years, 54% female). Overall, 5921 (37.8%) had optimal, 7002 (44.7%) had average, and 2728 (17.4%) had poor CRF profile, translating to 54.2, 64.1, and 24.9 million adults in United States, respectively. Significantly lower health expenditures were noted with favorable CRF profile across CVD status. Among study participants with established CVD, overall healthcare expenditures with optimal and average CRF profile were $5946 and $3731 less compared with those with poor CRF profile. The respective differences were $4031 and $2560 in those without CVD. Favorable CRF profile is associated with significantly lower medical expenditure and healthcare utilization among individuals with and without established CVD. © 2016 American Heart Association, Inc.

  6. National Trends in Statin Use and Expenditures in the US Adult Population From 2002 to 2013: Insights From the Medical Expenditure Panel Survey.

    PubMed

    Salami, Joseph A; Warraich, Haider; Valero-Elizondo, Javier; Spatz, Erica S; Desai, Nihar R; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Khera, Amit; Blaha, Michael J; Blumenthal, Roger S; Lloyd-Jones, Donald; Nasir, Khurram

    2017-01-01

    Statins remain a mainstay in the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). To detail the trends in use and total and out-of-pocket (OOP) expenditures associated with statins in a representative US adult population from 2002 to 2013. This retrospective longitudinal cohort study was conducted from January 2002 to December 2013. Demographic, medical condition, and prescribed medicine information of adults 40 years and older between 2002 and 2013 were obtained from the Medical Expenditure Panel Survey database. Estimated trends in statin use, total expenditure, and OOP share among the general adult population, those with established ASCVD, and those at risk for ASCVD. Costs were adjusted to 2013 US dollars using the Gross Domestic Product Index. From 2002 to 2013, more than 157 000 Medical Expenditure Panel Survey participants were eligible for the study (mean [SD] age, 57.7 [39.9] years; 52.1% female). Overall, statin use among US adults 40 years of age and older in the general population increased 79.8% from 21.8 million individuals (17.9%) in 2002-2003 (134 million prescriptions) to 39.2 million individuals (27.8%) in 2012-2013 (221 million prescriptions). Among those with established ASCVD, statin use was 49.8% and 58.1% in 2002-2003 and 2012-2013, respectively, and less than one-third were prescribed as a high-intensity dose. Across all subgroups, statin use was significantly lower in women (odds ratio, 0.81; 95% CI, 0.79-0.85), racial/ethnic minorities (odds ratio, 0.65; 95% CI, 0.61-0.70), and the uninsured (odds ratio, 0.33; 95% CI, 0.30-0.37). The proportion of generic statin use increased substantially, from 8.4% in 2002-2003 to 81.8% in 2012-2013. Gross domestic product-adjusted total cost for statins decreased from $17.2 billion (OOP cost, $7.6 billion) in 2002-2003 to $16.9 billion (OOP cost, $3.9 billion) in 2012-2013, and the mean annual OOP costs for patients decreased from $348 to $94. Brand-name statins were used by

  7. The Burden of Obesity on Diabetes in the United States: Medical Expenditure Panel Survey, 2008 to 2012.

    PubMed

    Leung, Man Yee Mallory; Carlsson, Nils P; Colditz, Graham A; Chang, Su-Hsin

    2017-01-01

    Diabetes is one of the most prevalent and costly chronic diseases in the United States. To analyze the risk of developing diabetes and the annual cost of diabetes for a US general population. Data from the Medical Expenditure Panel Survey, 2008 to 2012, were used to analyze 1) probabilities of developing diabetes and 2) annual total health care expenditures for diabetics. The age-, sex-, race-, and body mass index (BMI)-specific risks of developing diabetes were estimated by fitting an exponential survival function to age at first diabetes diagnosis. Annual health care expenditures were estimated using a generalized linear model with log-link and gamma variance function. Complex sampling designs in the Medical Expenditure Panel Survey were adjusted for. All dollar values are presented in 2012 US dollars. We observed a more than 6 times increase in diabetes risks for class III obese (BMI ≥ 40 kg/m(2)) individuals compared with normal-weight individuals. Using age 50 years as an example, we found a more than 3 times increase in annual health care expenditures for those with diabetes ($13,581) compared with those without diabetes ($3,954). Compared with normal-weight (18.5 ≤ BMI < 25 kg/m(2)) individuals, class II obese (35 ≤ BMI < 40 kg/m(2)) and class III obese (BMI ≥ 40 kg/m(2)) individuals incurred an annual marginal cost of $628 and $756, respectively. The annual health care expenditure differentials between those with and without diabetes of age 50 years were the highest for individuals with class II ($12,907) and class III ($9,703) obesity. This article highlights the importance of obesity on diabetes burden. Our results suggested that obesity, in particular, class II and class III (i.e., BMI ≥ 35 kg/m(2)) obesity, is associated with a substantial increase in the risk of developing diabetes and imposes a large economic burden. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All

  8. Disparities in the Reporting and Treatment of Health Conditions in Children: An Analysis of the Medical Expenditure Panel Survey

    PubMed Central

    Guevara, James P; Mandell, David S; Rostain, Anthony L; Zhao, Huaqing; Hadley, Trevor R

    2006-01-01

    Objectives To determine whether racial and ethnic disparities in health care use differ for physical and behavioral health conditions. Data Sources Secondary analysis of the 1996–1997 Medical Expenditure Panel Survey. Study Design Retrospective cohort study of children aged 2–18 years old who were members of participating households. Children were categorized as Hispanic, black, or white. Differences in caregiver-reported behavioral and physical health conditions and services use were compared, and estimates were weighted to reflect the complex sampling scheme. Principal Findings Of eligible children weighted to represent over 44 million in each year, 13–15 percent were Hispanic, 14 percent black, and 68–70 percent white. After adjusting for potential confounding, Hispanic and black children were less likely to report externalizing behavioral conditions than white children. Black but not Hispanic children were more likely than white children to report asthma. In addition, Hispanic and black children were less likely to report ambulatory visits, and black children were less likely to report receiving a prescription medication than white children. There were no differences in reported emergency room visits or hospitalizations. Interactions between race and various health conditions, health status, insurance, and income were not significant. Conclusions In this nationally representative sample, we identified racial and ethnic disparities in the reporting of health conditions and the use of discretionary health services. Disparities differed between those with behavioral conditions and those with physical conditions. These disparities were not explained by traditional measures including the presence of health conditions, health status, insurance, and family income, and suggest that national surveys such as Medical Expenditure Panel Survey may benefit from the inclusion of additional explanatory measures. PMID:16584463

  9. The Impact of Increased Tax Subsidies on the Insurance Coverage of Self-Employed Families: Evidence from the 1996-2004 Medical Expenditure Panel Survey

    ERIC Educational Resources Information Center

    Selden, Thomas M.

    2009-01-01

    The share of health insurance premiums that self-employed workers can deduct when computing federal income taxes rose from 30 percent in 1996 to 100 percent in 2003. Data from the 1996-2004 Medical Expenditure Panel Survey are used to show that the increased tax subsidy was associated with substantial increases in private coverage among…

  10. The medical home, preventive care screenings, and counseling for children: evidence from the Medical Expenditure Panel Survey.

    PubMed

    Romaire, Melissa A; Bell, Janice F

    2010-01-01

    Little is known about the role of the medical home in promoting essential preventive health care services in the general pediatric population. This study examined associations between having a medical home and receipt of health screenings and anticipatory guidance. We conducted a cross-sectional analysis of the 2004-2006 Medical Expenditure Panel Survey (MEPS). Our sample included 21 055 children aged 0 to 17 years who visited a health care provider in the year prior to the survey. A binary indicator of the medical home was developed from 22 questions in MEPS, reflecting 4 of the 7 American Academy of Pediatrics' recommended components of the medical home: accessible, family-centered, comprehensive, and compassionate care. Multivariable logistic regression was used to examine the association between the medical home and receipt of specific health screenings and anticipatory guidance, controlling for confounding variables. Approximately 49% of our study sample has a medical home. The medical home, defined when the usual source of care is a person or facility, is significantly associated with 3 health screenings (ie, weight, height, and blood pressure) and several anticipatory guidance topics (ie, advice about dental checkups, diet, exercise, car and bike safety), with odds ratios ranging from 1.26 to 1.54. The medical home is associated with increased odds of children receiving some health screenings and anticipatory guidance. The medical home may provide an opportunity to improve the delivery of these services for children. Copyright 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Disparities in Health Care Access and Receipt of Preventive Services by Disability Type: Analysis of the Medical Expenditure Panel Survey

    PubMed Central

    Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M

    2014-01-01

    Objective To examine differences in access to health care and receipt of clinical preventive services by type of disability among working-age adults with disabilities. Data Source Secondary analysis of Medical Expenditure Panel Survey (MEPS) data from 2002 to 2008. Study Design We conducted cross-sectional logistic regression analyses comparing people with different types of disabilities on health insurance status and type; presence of a usual source of health care; delayed or forgone care; and receipt of dental checkups and cancer screening. Data Collection We pooled annualized MEPS data files across years. Our analytic sample consisted of adults (18–64 years) with physical, sensory, or cognitive disabilities and nonmissing data for all variables of interest. Principal Findings Individuals with hearing impairment had better health care access and receipt than people with other disability types. People with multiple types of limitations were especially likely to have health care access problems and unmet health care needs. Conclusions There are differences in health care access and receipt of preventive care depending on what type of disability people have. More in-depth research is needed to identify specific causes of these disparities and assess interventions to address health care barriers for particular disability groups. PMID:24962662

  12. Racial/Ethnic Disparities in Primary Care Quality Among Type 2 Diabetes Patients, Medical Expenditure Panel Survey, 2012

    PubMed Central

    Hu, Ruwei; Shi, Leiyu; Liang, Hailun; Haile, Geraldine Pierre

    2016-01-01

    Introduction Racial and ethnic disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications and mortality rates, and the quality of diabetes care among Americans. We explored racial and ethnic disparities in primary care quality among Americans with type 2 diabetes. Methods We analyzed data on adults with type 2 diabetes derived from the household component of the 2012 Medical Expenditure Panel Survey. Multiple regression and multivariate logistic regressions were used to examine the association between race/ethnicity and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, and clusters of confounding factors were added sequentially. Results Preliminary findings indicated differences in primary care quality between racial/ethnic minorities and whites across measures of first contact, longitudinality, comprehensiveness, and coordination. After controlling for confounding factors, these differences were no longer apparent; all racial/ethnic categories showed similar rates of primary care quality according to the 4 primary care domains of interest in the study. Conclusion Results indicate equitable primary care quality for type 2 diabetes patients across 4 key domains of primary care after controlling for socioeconomic characteristics. Additional research is necessary to support these findings, particularly when considering smaller racial/ethnic groups and investigating outcomes related to diabetes. PMID:27490365

  13. Polypharmacy and Health-Related Quality of Life Among US Adults With Arthritis, Medical Expenditure Panel Survey, 2010–2012

    PubMed Central

    Dwibedi, Nilanjana; Sambamoorthi, Usha

    2016-01-01

    Introduction Our objective was to determine the relationship between polypharmacy (treatment with prescription drugs from 6 or more drug classes concurrently) and health-related quality of life (HRQoL) among US adults with arthritis. Methods We conducted a retrospective cohort study that used 2-year longitudinal data from the Medical Expenditure Panel Survey to analyze a cohort of 6,132 adults aged over 21 years with arthritis. Measures of HRQoL were the summary scores from the mental component summary (MCS) and physical component summary (PCS) of the 12-item short-form health survey. Unadjusted and adjusted regression models were used to evaluate the association between polypharmacy and HRQoL measures. We used SAS, version 9.4, (SAS Institute Inc) to conduct all analyses. Results In unadjusted analyses, adults with arthritis taking prescription drugs from 6 or more drug classes concurrently had significantly lower MCS and PCS scores (β, −3.11, P < .001 and β, −10.26, P < .001, respectively) than adults taking prescription drugs from fewer than 6. After controlling for the demographic characteristics, number of mental and physical chronic conditions, and baseline MCS and PCS scores, adults taking prescription drugs from 6 or more drug classes concurrently had significantly lower PCS scores (β, −1.68, P < .001), than those taking prescription drugs from fewer than 6. However, no significant difference in MCS scores was found between adults taking prescription drugs from 6 or more drug classes concurrently and those taking prescription drugs from fewer than 6 (β, −0.27, P = .46). Conclusion Polypharmacy is significantly associated with lower PCS scores among adults with arthritis. Because polypharmacy can lead to drug–drug and drug–disease interactions, health care providers need to consider the risk and adopt a cautious approach in prescribing multiple drugs to manage chronic conditions and in choosing therapies to improve HRQoL among adults with

  14. Depression as a psychosocial consequence of occupational injury in the US working population: findings from the medical expenditure panel survey

    PubMed Central

    2013-01-01

    Background Empirical evidence describing the psychosocial consequences of occupational injury is still limited. The effect of occupational injury on depression might pose unique challenges in workers compared with other kinds of injury. This study aimed to assess the differential impact of workplace injury compared with non-workplace injury on depression over time, and to identify the potential risk factors associated with post-injury depression in the US working population. Methods Using pooled panel data from the Medical Expenditure Panel Survey 2000–2006, a total of 35,155 workers aged 18–64 years who had been followed for about 18 months in each panel were analyzed. Injuries in the 4–5 months before baseline, and subsequent depression incidence during follow-up, were identified using ICD-9 codes for the medical conditions captured in personal interviews. A discrete time-proportional odds model was used. Results A total of 5.5% of workers with occupational injury at baseline reported depression at follow-up, compared with 4.7% of workers with non-occupational injury and 3.1% of workers without injuries. Those with occupational injuries had more severe injuries and required longer treatment, compared with those with non-occupational injuries. Only 39% of workers with workplace injuries were paid Workers’ Compensation (WC). The association between injury and depression appeared to be stronger for workplace injury, and the adjusted odds ratio for depression was 1.72 for those with occupational injury (95% CI: 1.27–2.32), and 1.36 for those with non-occupational injury (95% CI: 1.07–1.65) compared with the no-injury group, after controlling for relevant covariates. Occupational injury was associated with higher odds of developing depression over time. WC as a source of medical payment was associated with 33% higher odds of developing depression (95% CI: 1.01–1.74). Part-time work, shorter job tenure, and long working hours were independently

  15. Identifying Episodes of Back Pain Using Medical Expenditures Panel Survey (MEPS) Data: Patient Experience, Use of Services, and Chronicity

    PubMed Central

    Monica, Smith

    2010-01-01

    Objective To explore the correspondence between “episodes of pain” and “episodes of care” for individuals with back pain. Data Source Secondary analysis of Medical Expenditures Panel Survey (MEPS) 2-year longitudinal data. Study Design Individual use and utilization of back pain services were examined across ambulatory settings and providers, and linked to MEPS medical condition data to identify individuals with back pain who do not use, or who delay or discontinue utilization of health services for back pain. Data Collection/Extraction Methods Episodes-of-care and episodes-of-pain were approximated through round-by-round temporal mapping of MEPS back pain utilization events data and medical conditions data. Principal Findings Of 10,193 individuals with back pain, approximately one fifth did not actively seek care for their back pain. Utilization of services for back pain (episodes-of-care) does not always correspond with an individual’s full experience of back pain (episodes-of-pain). Upwards of 20% of MEPS respondents who use services for some back pain episodes, reported additional episodes for which they do not use services. Conclusions These findings suggest that other longitudinal studies based only on data that reflect service use, e.g., claims data, may incorrectly infer the nature of back pain and back pain episodes. Many individuals report ongoing back pain that continues beyond their episodes-of-care, and many individuals with persistent back pain may use prescription drugs, medical services, and other health services only intermittently. PMID:21036278

  16. Patient characteristics associated with multiple pharmacy use in the U.S. population: Findings from the Medical Expenditure Panel Survey.

    PubMed

    Look, Kevin A

    2015-01-01

    Multiple pharmacy use (MPU) is an important safety and quality issue, as it results in fragmented patient care. However, few studies have examined patient characteristics predicting the use of multiple pharmacies, and the findings have been inconsistent. To identify patient characteristics associated with MPU using national data. Data were obtained from the 2011 U.S. Medical Expenditure Panel Survey. The dependent variable was MPU, or the use of more than one pharmacy. The Andersen Behavioral Model of Health Service Use was used to guide the selection of independent variables, which were categorized as predisposing, enabling, and medical need related characteristics. Multivariable logistic regression analysis was conducted to identify the relationships between predisposing, enabling, and need variables and MPU in a hierarchical fashion. Point estimates were weighted to the U.S. non-institutionalized population, and to adjust standard errors to account for the complex survey design. MPU was common, with a national prevalence of 41.3%. Individuals aged 40-64 and adults 65 and older were significantly less likely to use multiple pharmacies as patients aged 18-39 years (40-64 years OR: 0.67, CI: 0.58-0.77; ≥65 years OR: 0.49, CI: 0.41-0.58). Females were significantly more likely to use multiple pharmacies than males (OR: 1.16, CI: 1.05-1.29). Individuals lacking health insurance were more likely to use multiple pharmacies as individuals with private health insurance (OR: 1.42, CI: 1.16-1.73); in contrast, individuals having drug insurance were more likely to use multiple pharmacies (OR: 1.25, CI: 1.06-1.47) relative to those without drug insurance. Any mail order use was the strongest predictor of MPU (OR: 6.94, CI: 5.90-8.18). Pharmacists and other health care providers need to be aware that their patients may be using multiple pharmacies, especially younger patients, those lacking access to health insurance, or those using mail order pharmacies. The findings from

  17. Poverty and severe psychiatric disorder in the U.S.: evidence from the Medical Expenditure Panel Survey.

    PubMed

    Vick, Brandon; Jones, Kristine; Mitra, Sophie

    2012-06-01

    Previous studies have shown that persons with severe psychiatric disorders are more likely to be poor and face disparities in education and employment outcomes. Poverty rates, the standard measure of poverty, give no information on how far below the poverty line this group falls. This paper compares the poverty rate, poverty depth (distance from the poverty line) and poverty severity (inequality of incomes below the poverty line) of households with and without a working-age member with severe psychiatric disorder in the United States using data from the 2007 Medical Expenditure Panel Survey (MEPS). First, we perform multivariate analysis of the association between severe disorder and poverty depth using MEPS data. Second, we calculate poverty rates, depth, and severity for the subgroup of households having a member with disorder and compare to the subgroup of households without such a member. In multivariate regressions, the presence of a household member with severe psychiatric disorder predicts a 52-percentage point increase in poverty depth and 3.10 times the odds of being poor. Poverty rate, depth, and severity are significantly greater for households of persons with disorder. Mean total incomes are lower for households of persons with severe disorder compared to other households while mean health expenditures are similar. Severe psychiatric disorder is associated with greater depth of poverty and likelihood of being poor. We identify groups who are the most disadvantaged according to severity of income poverty among households with severe psychiatric disorder. These include households whose head has no high school education, who has been without work for the entire year, and who is black or Hispanic. While these characteristics are related to poverty for the overall sample, they correlate to heightened poverty severity when combined with severe disorder. Families face less severity than single persons but poverty rate, depth, and severity increase for both

  18. Clarifying the Predictive Value of Family-Centered Care and Shared Decision Making for Pediatric Healthcare Outcomes Using the Medical Expenditure Panel Survey.

    PubMed

    Lindly, Olivia J; Zuckerman, Katharine E; Mistry, Kamila B

    2017-02-01

    To estimate (1) family-centered care (FCC) and shared decision-making (SDM) prevalence, and (2) associations of FCC and SDM (FCC/SDM) with health care outcomes among U.S. children. The Medical Expenditure Panel Survey Household Component (MEPS-HC), a nationally representative survey of the noninstitutionalized, civilian population. Secondary analyses of prospectively collected data on 15,764 U.S. children were conducted to examine FCC/SDM prevalence in year 1 and associations of FCC/SDM in year 1 with health services utilization, medical expenditures, and unmet health care needs in year 2. We combined four MEPS-HC longitudinal files from 2007 to 2011. FCC/SDM prevalence in year 1 varied from 38.6 to 93.7 percent, and it was lower for composites with more stringent scoring approaches. FCC/SDM composites with stringent scoring approaches in year 1 were associated with reduced unmet needs in year 2. FCC/SDM, across all year 1 composites, was not associated with health services utilization or medical expenditures in year 2. FCC/SDM year 1 subcomponents describing consensus building and mutual agreement were consistently associated with unmet health care needs in year 2. FCC/SDM composites with stringent scoring approaches measuring consensus building and mutual agreement may have the greatest utility for pediatric health care quality improvement efforts. © Health Research and Educational Trust.

  19. Aging Baby Boomers and the Rising Cost of Chronic Back Pain: Secular Trend Analysis of Longitudinal Medical Expenditures Panel Survey Data for Years 2000 to 2007

    PubMed Central

    Smith, Monica; Davis, Matthew A.; Stano, Miron; Whedon, James M.

    2013-01-01

    Objectives The purposes of this study were to analyze data from the longitudinal Medical Expenditures Panel Survey (MEPS) to evaluate the impact of an aging population on secular trends in back pain and chronicity and to provide estimates of treatment costs for patients who used only ambulatory services. Methods Using the MEPS 2-year longitudinal data for years 2000 to 2007, we analyzed data from all adult respondents. Of the total number of MEPS respondent records analyzed (N = 71 838), we identified 12 104 respondents with back pain and further categorized 3842 as chronic cases and 8262 as nonchronic cases. Results Secular trends from the MEPS data indicate that the prevalence of back pain has increased by 29%, whereas chronic back pain increased by 64%. The average age among all adults with back pain increased from 45.9 to 48.2 years; the average age among adults with chronic back pain increased from 48.5 to 52.2 years. Inflation-adjusted (to 2010 dollars) biennial expenditures on ambulatory services for chronic back pain increased by 129% over the same period, from $15.6 billion in 2000 to 2001 to $35.7 billion in 2006 to 2007. Conclusion The prevalence of back pain, especially chronic back pain, is increasing. To the extent that the growth in chronic back pain is caused, in part, by an aging population, the growth will likely continue or accelerate. With relatively high cost per adult with chronic back pain, total expenditures associated with back pain will correspondingly accelerate under existing treatment patterns. This carries implications for prioritizing health policy, clinical practice, and research efforts to improve care outcomes, costs, and cost-effectiveness and for health workforce planning. PMID:23380209

  20. Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys.

    PubMed

    Fischer, Alexander H; Shin, Daniel B; Margolis, David J; Takeshita, Junko

    2017-09-27

    Eczema is a common chronic inflammatory disease of the skin. Studies suggest differences in disease prevalence and severity by race/ethnicity. Our knowledge of health care utilization for eczema among different racial/ethnic groups remains limited. To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States. We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, and Hispanic white individuals under the age of 18 years with caregiver-reported eczema (N = 2043) pooled from the 2-year longitudinal cohorts of the 2001-2013 Medical Expenditure Panel Surveys. Health care utilization outcomes were evaluated over the 2-year follow-up period by race/ethnicity using multivariable regression. Among all children with eczema, non-Hispanic blacks were less likely than whites to report an ambulatory visit for eczema (adjusted odds ratio [ORadj] 0.69; 95% confidence interval [CI] 0.51-0.92). Among those with ≥1 ambulatory visit for eczema, non-Hispanic blacks reported more visits (adjusted incidence rate ratio [IRRadj] 1.68; 95% CI 1.10-2.55) and prescriptions (IRRadj 1.22; 95% CI 1.01-1.46) than whites and were more likely than whites to report a dermatology visit (ORadj 1.82; 95% CI 1.06-3.14) for eczema. We used caregiver- or self-reported data. Our findings suggest disparities in health care utilization for eczema among non-Hispanic black children despite utilization patterns suggestive of more severe disease. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Estimating health expenditure shares from household surveys

    PubMed Central

    Brooks, Benjamin PC; Hanlon, Michael

    2013-01-01

    Abstract Objective To quantify the effects of household expenditure survey characteristics on the estimated share of a household’s expenditure devoted to health. Methods A search was conducted for all country surveys reporting data on health expenditure and total household expenditure. Data on total expenditure and health expenditure were extracted from the surveys to generate the health expenditure share (i.e. fraction of the household expenditure devoted to health). To do this the authors relied on survey microdata or survey reports to calculate the health expenditure share for the particular instrument involved. Health expenditure share was modelled as a function of the survey’s recall period, the number of health expenditure items, the number of total expenditure items, the data collection method and the placement of the health module within the survey. Data exists across space and time, so fixed effects for territory and year were included as well. The model was estimated by means of ordinary least squares regression with clustered standard errors. Findings A one-unit increase in the number of health expenditure questions was accompanied by a 1% increase in the estimated health expenditure share. A one-unit increase in the number of non-health expenditure questions resulted in a 0.2% decrease in the estimated share. Increasing the recall period by one month was accompanied by a 6% decrease in the health expenditure share. Conclusion The characteristics of a survey instrument examined in the study affect the estimate of the health expenditure share. Those characteristics need to be accounted for when comparing results across surveys within a territory and, ultimately, across territories. PMID:23825879

  2. Pollution Abatement and Control Expenditures Survey (PACE)

    EPA Pesticide Factsheets

    The Pollution Abatement Costs and Expenditures (PACE) survey is the most comprehensive national source of pollution abatement costs and expenditures related to environmental protection for the manufacturing sector of the United States. The PACE survey collects facility-level data on pollution abatement capital expenditures and operating costs associated with compliance to local, state, and federal regulations and voluntary or market-driven pollution abatement activities.

  3. Differences in health services utilization and costs between antihypertensive medication users versus nonusers in adults with diabetes and concomitant hypertension from Medical Expenditure Panel Survey pooled years 2006 to 2009.

    PubMed

    Davis-Ajami, Mary Lynn; Wu, Jun; Fink, Jeffrey C

    2014-01-01

    To compare population-level baseline characteristics, individual-level utilization, and costs between antihypertensive medication users versus nonusers in adults with diabetes and concomitant hypertension. This longitudinal retrospective observational research used Medical Expenditure Panel Survey household component pooled years 2006 to 2009 to analyze adults 18 years or older with nongestational diabetes and coexistent essential hypertension. Two groups were created: 1) antihypertensive medication users and 2) no antihypertensive pharmacotherapy. We examined average annualized health care costs and emergency department and hospital utilization. Accounting for Medical Expenditure Panel Survey's complex survey design, all analyses used longitudinal weights. Logistic regressions examined the likelihood of utilization and anytihypertensive medication use, and log-transformed multiple linear regression models assessed costs and antihypertensive medication use. Of the 3261 adults identified with diabetes, 66% (n = 2137) had concomitant hypertension representing 38.7 million individuals during 2006 to 2009. Significantly, the 16% (n = 338) no antihypertensive pharmacotherapy group showed greater mean nights hospitalized (3.6 vs. 1.7, P = 0.0120), greater all-cause hospitalization events per 1000 patient months (41 vs. 24, P = 0.0.007), and lower mean diabetes-related and hypertension-related ambulatory visits. After adjusting for confounders, non-antihypertensive medication users showed 1.64 odds of hospitalization, 29% lower total, and 27% lower average annualized medical expenses compared with antihypertensive medication users. In adults with diabetes and coexistent hypertension, we observed significantly greater hospitalizations and lower costs for the non antihypertensive pharmacotherapy group versus those using antihypertensive medications. The short-term time horizon greater hospitalizations with lower expenses among non-antihypertensive medication users with

  4. A comparison of estimates of statewide pleasure trip volume and expenditures derived from telephone versus mail surveys

    Treesearch

    Dae-Kwan Kim; Daniel M. Spotts; Donald F. Holecek

    1998-01-01

    This paper compares estimates of pleasure trip volume and expenditures derived from a regional telephone survey to those derived from the TravelScope mail panel survey. Significantly different estimates emerged, suggesting that survey-based estimates of pleasure trip volume and expenditures, at least in the case of the two surveys examined, appear to be affected by...

  5. Macro determinants of Iranian provincial healthcare expenditures from 2006 to 2013: evidence from panel data

    PubMed Central

    Rezaei, Satar; Fallah, Razieh; Moradi, Khalil; Delavari, Somayeh; Moradi, Siavash Doost; Matin, Behzad Karami

    2015-01-01

    Introduction During the last few decades, healthcare expenditures (HCEs) have increased significantly in Iran and throughout the world. Understanding the determinants of such increases is essential to health policymakers in finding the best policies to manage healthcare costs. This study aimed to determine the impact of some of the key explanatory variables on household healthcare expenditures across the provinces of Iran. Methods A panel data econometric model was used to determine the main factors that affected household healthcare expenditures (HHCEs) across the provinces of Iran from March 21, 2006 to February 19, 2013. The data on household healthcare expenditures per capita, number of physicians per 10,000 population, the degree of urbanization, the proportion of the population that was 65 or older, household income per capita, and literacy rate were obtained from the Household Expenditure and Income Survey (HEIS) data in the Statistical Center of Iran. F-Limer and Hausman tests were used to choose the panel data, and Stata V.12 was used to analyze the data. Results Our findings indicated that income per capita, physicians per 10,000 population, and the degree of urbanization had significant impacts on healthcare expenditures. Also, the results of the study showed the elasticity of income, physicians, urbanization, proportion of the population 65 or older, and the literacy rate were 0.25 (p < 0.002), 0.37 (p < 0.001), 5.01 (p < 0.001), −0.1 (p < 0.73), and −1.02 (p < 0.082), respectively. Conclusion The results of the study indicated that the income elasticity of healthcare expenditures was less than 1; health expenditures were considered to be a “necessity good” across the provinces of Iran during the period that was studied. In addition, there were some other factors that affected healthcare expenditures that were not considered in the study, such as the advancement of new technology and the costs of dying. However, it is recommended that future

  6. Health Care Use, Health Behaviors, and Medical Conditions Among Individuals in Same-Sex and Opposite-Sex Partnerships: A Cross-Sectional Observational Analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011.

    PubMed

    Blosnich, John R; Hanmer, Janel; Yu, Lan; Matthews, Derrick D; Kavalieratos, Dio

    2016-06-01

    Prior research documents disparities between sexual minority and nonsexual minority individuals regarding health behaviors and health services utilization. However, little is known regarding differences in the prevalence of medical conditions. To examine associations between sexual minority status and medical conditions. We conducted multiple logistic regression analyses of the Medical Expenditure Panel Survey (2003-2011). We identified individuals who reported being partnered with an individual of the same sex, and constructed a matched cohort of individuals in opposite-sex partnerships. A total of 494 individuals in same-sex partnerships and 494 individuals in opposite-sex partnerships. Measures of health risk (eg, smoking status), health services utilization (eg, physician office visits), and presence of 15 medical conditions (eg, cancer, diabetes, arthritis, HIV, alcohol disorders). Same-sex partnered men had nearly 4 times the odds of reporting a mood disorder than did opposite-sex partnered men [adjusted odds ratio (aOR)=3.96; 95% confidence interval (CI), 1.85-8.48]. Compared with opposite-sex partnered women, same-sex partnered women had greater odds of heart disease (aOR=2.59; 95% CI, 1.19-5.62), diabetes (aOR=2.75; 95% CI, 1.10-6.90), obesity (aOR=1.92; 95% CI, 1.26-2.94), high cholesterol (aOR=1.89; 95% CI, 1.03-3.50), and asthma (aOR=1.90; 95% CI, 1.02-1.19). Even after adjusting for sociodemographics, health risk behaviors, and health conditions, individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of ≥3 physician visits in the last year compared with opposite-sex partnered individuals. A combination of individual-level, provider-level, and system-level approaches are needed to reduce disparities in medical conditions and health care utilization among sexual minority individuals.

  7. School Expenditure and School Performance: Evidence from New South Wales Schools Using a Dynamic Panel Analysis

    ERIC Educational Resources Information Center

    Pugh, G.; Mangan, J.; Blackburn, V.; Radicic, D.

    2015-01-01

    This article estimates the effects of school expenditure on school performance in government secondary schools in New South Wales, Australia over the period 2006-2010. It uses dynamic panel analysis to exploit time series data on individual schools that only recently has become available. We find a significant but small effect of expenditure on…

  8. School Expenditure and School Performance: Evidence from New South Wales Schools Using a Dynamic Panel Analysis

    ERIC Educational Resources Information Center

    Pugh, G.; Mangan, J.; Blackburn, V.; Radicic, D.

    2015-01-01

    This article estimates the effects of school expenditure on school performance in government secondary schools in New South Wales, Australia over the period 2006-2010. It uses dynamic panel analysis to exploit time series data on individual schools that only recently has become available. We find a significant but small effect of expenditure on…

  9. 75 FR 52507 - Proposed Information Collection; Comment Request; Annual Capital Expenditures Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ... Census Bureau Proposed Information Collection; Comment Request; Annual Capital Expenditures Survey AGENCY... 2012 Annual Capital Expenditures Survey (ACES). The annual survey collects data on fixed assets and depreciation, sales and receipts, capitalized computer software, and capital expenditures for new and...

  10. Recognizing the importance of chronic disease in driving healthcare expenditure in Tanzania: analysis of panel data from 1991 to 2010.

    PubMed

    Counts, Christopher J; Skordis-Worrall, Jolene

    2016-05-01

     Despite the growing chronic disease burden in low- and middle-income countries, there are significant gaps in our understanding of the financial impact of these illnesses on households. As countries make progress towards universal health coverage, specific information is needed about how chronic disease care drives health expenditure over time, and how this spending differs from spending on acute disease care.  A 19-year panel dataset was constructed using data from the Kagera Health and Development Surveys. Health expenditure was modelled using multilevel regression for three different sub-populations of households: (1) all households that spent on healthcare, (2) households affected by chronic disease and (3) households affected by acute disease. Explanatory variables were identified from a review of the health expenditure literature, and all variables were analysed descriptively.  Households affected by chronic disease spent 22% more on healthcare than unaffected households. Catastrophic expenditure and zero expenditure are both common in chronic disease-affected households. Expenditure predictors were different between households affected by chronic disease and those unaffected. Expenditure over time is highly heterogeneous and household-dependent.  The financial burden of healthcare is greater for households affected by chronic disease than those unaffected. Households appear unable to sustain high levels of expenditure over time, likely resulting in both irregular chronic disease treatment and impoverishment. The Tanzanian government's current efforts to develop a National Health Financing Strategy present an important opportunity to prioritize policies that promote the long-term financial protection of households by preventing the catastrophic consequences of chronic disease care payments. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  11. Use of Internet panels to conduct surveys.

    PubMed

    Hays, Ron D; Liu, Honghu; Kapteyn, Arie

    2015-09-01

    The use of Internet panels to collect survey data is increasing because it is cost-effective, enables access to large and diverse samples quickly, takes less time than traditional methods to obtain data for analysis, and the standardization of the data collection process makes studies easy to replicate. A variety of probability-based panels have been created, including Telepanel/CentERpanel, Knowledge Networks (now GFK KnowledgePanel), the American Life Panel, the Longitudinal Internet Studies for the Social Sciences panel, and the Understanding America Study panel. Despite the advantage of having a known denominator (sampling frame), the probability-based Internet panels often have low recruitment participation rates, and some have argued that there is little practical difference between opting out of a probability sample and opting into a nonprobability (convenience) Internet panel. This article provides an overview of both probability-based and convenience panels, discussing potential benefits and cautions for each method, and summarizing the approaches used to weight panel respondents in order to better represent the underlying population. Challenges of using Internet panel data are discussed, including false answers, careless responses, giving the same answer repeatedly, getting multiple surveys from the same respondent, and panelists being members of multiple panels. More is to be learned about Internet panels generally and about Web-based data collection, as well as how to evaluate data collected using mobile devices and social-media platforms.

  12. Use of Internet Panels to Conduct Surveys

    PubMed Central

    Hays, Ron D.; Liu, Honghu; Kapteyn, Arie

    2015-01-01

    Use of internet panels to collect survey data is increasing because it is cost-effective, enables access to large and diverse samples quickly, takes less time than traditional methods to obtain back for analysis, and the standardization of data collection process makes studies easy to replicate. A variety of probability-based panels have been created including Telepanel/CentERpanel, Knowledge Networks (now GFK KnowledgePanel®), the American Life Panel, the LISS Panel, and the Understanding American Study panel. Despite the advantage of having a known denominator (sampling frame), the probability-based internet panels often have low recruitment participation rates and some have argued that there is little practical difference between opting out of a probability sample and opting into a non-probability (convenience) internet panel. This paper provides an overview of both probability-based and convenience panels, discussing potential benefits and cautions for each method, and summarizing approaches used to weight panel respondents to better represent the underlying population. Challenges in using internet panel data such as false answers, careless responses, giving the same answer repeatedly, getting multiple surveys from the same respondent, and panelists being members of multiple panels are discussed. There is more to be learned about internet panels generally and web-based data collection along with opportunities to evaluate data collected using mobile devices and social media platforms. PMID:26170052

  13. Estimating the Relationship between Economic Growth and Health Expenditures in ECO Countries Using Panel Cointegration Approach.

    PubMed

    Hatam, Nahid; Tourani, Sogand; Homaie Rad, Enayatollah; Bastani, Peivand

    2016-02-01

    Increasing knowledge of people about health leads to raising the share of health expenditures in government budget continuously; although governors do not like this rise because of budget limitations. This study aimed to find the association between health expenditures and economic growth in ECO countries. We added health capital in Solow model and used the panel cointegration approach to show the importance of health expenditures in economic growth. For estimating the model, first we used Pesaran cross-sectional dependency test, after that we used Pesaran CADF unit root test, and then we used Westerlund panel cointegration test to show if there is a long-term association between variables or not. After that, we used chaw test, Breusch-Pagan test and Hausman test to find the form of the model. Finally, we used OLS estimator for panel data. Findings showed that there is a positive, strong association between health expenditures and economic growth in ECO countries. If governments increase investing in health, the total production of the country will be increased, so health expenditures are considered as an investing good. The effects of health expenditures in developing countries must be higher than those in developed countries. Such studies can help policy makers to make long-term decisions.

  14. The temporal association of excessive health expenditure with suicidal ideation among primary income earners: a cross-sectional design using the Korean Welfare Panel Survey (KoWePS)

    PubMed Central

    Shin, Jaeyong; Choi, Jae Woo; Jang, Sung-in; Choi, Young; Lee, Sang Gyu; Ihm, Tae Hwan; Park, Eun-Cheol

    2015-01-01

    Objective Excessive health expenditure (EHE) is a global issue for households suffering from high-cost medical conditions, low incomes and limited insurance coverage. After the international financial crisis of 2008, EHE became a social problem in developed countries. Such economic crisis might induce severe mental stress, resulting in suicidal ideation. Methods We used the Korean Welfare Panel Study (KoWePS) from 2011 to 2013 and selected primary income earners, who were defined as practical and economic representatives of households; the total number of analysed samples was 4247 of 5717 households in the database. We only included households that had never experienced EHE before 2011. To examine the temporal relationship between EHE and suicidal ideation, we conducted a logistic regression analysis. Results Among 4247 participants, 146 (3.4%) experienced suicidal ideation, whereas 4101 (96.6%) did not. One scale of depression score (OR=1.28, CI 1.23 to 1.34, p<0.001) was associated with increased suicidal ideation. Such ideation was influenced to a greater extent by a recent EHE above 10% of disposable income (OR=1.91, CI 1.16 to 3.15, p=0.012) than by either a remote EHE (OR=1.29, CI 0.71 to 2.32) or one in 2011 and 2012 (OR=1.67, CI 1.01 to 2.78, p=0.048). Conclusions In this study, more recent EHE resulted in more suicidal ideation. In conclusion, we suggest that recent household EHE might be considered as an important factor to prevent suicidal ideation and to improve the mental health of individuals. PMID:26082463

  15. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis

    PubMed Central

    Sheng, Binwu; Feng, Chaoling; Zhang, Donglan; Spitler, Hugh; Shi, Lu

    2017-01-01

    Background: The link between body weight status and spinal diseases has been suggested by a number of cross-sectional and cohort studies with a limited range of patient populations. No population-representative samples have been used to examine the link between obesity and spinal diseases. The present study is based on a nationally representative sample drawn from the Medical Expenditure Panel Survey. Methods: Using the cross-sectional sample of the 2014 Medical Expenditure Panel Study, we built four weighted logistic regression analyses of the associations between body weight status and the following four spinal diseases: low back pain, spondylosis, other cervical disorders and intervertebral disc disorder (IDD). Each respondent’s body weight status was used as the key independent variable with three categories: normal/underweight, overweight, and obese. We controlled for marital status, gender, age, smoking status, household income, health insurance coverage, educational attainment and the use of health services for other major categories of diseases. Results: A total sample of 23,048 respondents was used in our analysis. Overweight and obese respondents, as compared to normal/underweight respondents, were more likely to develop lower back problems (Overweight: logged odds = 0.218, p < 0.01; Obese: logged odds = 0.395, p < 0.001) and IDD (Overweight: logged odds = 0.441, p < 0.05; Obese: logged odds = 0.528, p < 0.001). The associations between bodyweight status and spondylitis were statistically insignificant (Overweight: logged odds = 0.281, p = 0.442; Obese: logged odds = 0.680, p = 0.104). The associations between body weight status and other cervical disorders (Overweight: logged odds = −0.116, p = 0.304; Obese: logged odds = −0.160, p = 0.865) were statistically insignificant. Conclusions: As the first study using a national sample to study bodyweight and spinal diseases, our paper supports the hypothesis that obesity adds to the burden of low back

  16. Effects of depression on the subsequent year's healthcare expenditures among older adults: two-year panel study.

    PubMed

    Choi, Sunha; Hasche, Leslie; Nguyen, Duy

    2015-06-01

    This study investigated changes in depression status over 2 years and examined whether having depression in Year 1 is associated with greater healthcare expenditures in Year 2 among community-dwelling older adults. This study analyzed the Medical Expenditure Panel Survey (Panel 13, 2008-2009) for a nationally representative sample of 1,740 older adults (65+). The two self-reported depression measures used were the ICD-9-CM (depression) and Patient Health Questionnaire-2 (potential depression, scores 3 or higher). Using the combined two-part models, additional healthcare costs at Year 2 associated with the Year 1 depression status were calculated by the service type after adjusting for predisposing, enabling, and need covariates assessed at Year 2. Over 7.9% of older adults reported depression and an additional 6.5% presented with potential depression. The ICD-9 depression status was relatively stable; 84% continued reporting depression during Year 2. Those with depression at Year 1 spent $3,855 more on total healthcare, $1,053 more on office-based visits, and $929 more on prescription drugs during Year 2 compared with non-depressed people after controlling for other covariates, including healthcare needs (p < .05). While potential depression was less persistent (31.1% remained potentially depressed at Year 2), potential depression was associated with lower socio-economic status and greater healthcare expenditures from home health services and emergency department visits during Year 2. These results indicate the importance of monitoring depression in older adults, considering its impacts on the increases in healthcare expenditures in the following year even after controlling for co-occurring health conditions.

  17. Panel Conditioning in the General Social Survey

    ERIC Educational Resources Information Center

    Halpern-Manners, Andrew; Warren, John Robert; Torche, Florencia

    2017-01-01

    Does participation in one wave of a survey have an effect on respondents' answers to questions in subsequent waves? In this article, we investigate the presence and magnitude of "panel conditioning" effects in one of the most frequently used data sets in the social sciences: the General Social Survey (GSS). Using longitudinal records…

  18. Latent Causal Structures in Panel Surveys.

    ERIC Educational Resources Information Center

    Wolfle, Lee M.; Robertshaw, Dianne

    Since measurement errors exist in panel surveys, LISREL (a procedure for controlling measurement error by the analysis of covariance structures) was used in this investigation to determine the stability of the social-psychological concept of locus of control expectancy change with the aquisition of post secondary education. The National…

  19. Out-of-Pocket Spending for Ambulatory Physical Therapy Services From 2008 to 2012: National Panel Survey.

    PubMed

    Chevan, Julia; Riddle, Daniel L; Reed, Shelby D

    2015-12-01

    Out-of-pocket (OOP) expenditures are incurred as insurers and employers shift some of the burden of health care costs onto consumers. As cost-sharing increases, OOP expenditures could be a barrier to physical therapy care. The purposes of this study were: (1) to identify factors associated with any OOP physical therapy spending and (2) to identify factors associated with higher spending among individuals incurring OOP costs. The study was a retrospective analysis using the 4 most recently available panels of data from the Medical Expenditure Panel Survey (MEPS) encompassing 2008-2012. A data file containing episodes of physical therapy care for 2,189 people was created. Logistic regression was used to identify factors related to having an OOP expenditure. A multivariable generalized linear model was used to identify factors related to mean OOP expenditures. On average, an episode of care encompassed 9.9 visits, with mean total expenditures of $1,708 (median: $792). Fifty-four percent of episodes of care had an OOP expenditure. For individuals with OOP expenditures, the mean OOP expenditure for an episode of care was $351 (median: $144). Being female or non-Hispanic and having a higher income were associated with higher odds of incurring an OOP expenditure, whereas being in worse general health, >65 years of age, or nonwhite and having public funding were associated with lower odds of incurring an OOP expenditure. Amounts of OOP spending were higher in urban areas and in all census geographic regions relative to the Northeast region. Estimates are based on household-reported survey data, limited to ambulatory care, and do not include institutionalized individuals. At 54%, the proportion of individuals with OOP expenditures for physical therapy is lower than for general medical care. Several predictors were found of having OOP expenditures and of the magnitude of those expenditures. © 2015 American Physical Therapy Association.

  20. Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel

    PubMed Central

    2016-01-01

    Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis. PMID:26955233

  1. Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel.

    PubMed

    Lee, Jeong-Eun; Shin, Hyung-Ik; Do, Young Kyung; Yang, Eun Joo

    2016-03-01

    Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.

  2. Predictors of high out-of-pocket healthcare expenditure: an analysis using Bangladesh household income and expenditure survey, 2010.

    PubMed

    Molla, Azaher Ali; Chi, Chunhuei; Mondaca, Alicia Lorena Núñez

    2017-01-31

    Predictors of high out-of-pocket household healthcare expenditure are essential for creating effective health system finance policy. In Bangladesh, 63.3% of health expenditure is out-of-pocket and born by households. It is imperative to know what determines household health expenditure. This study aims to investigate the predicting factors of high out-of-pocket household healthcare expenditure targeting to put forward policy recommendations on equity in financial burden. Bangladesh household income and expenditure survey 2010 provides data for this study. Predictors of high out-of-pocket household healthcare expenditure were analyzed using multiple linear regressions. We have modeled non-linear relationship using logarithmic form of linear regression. Heteroscedasticity and multicollinearity were checked using Breusch-Pagan/Cook-Weishberg and VIF tests. Normality of the residuals was checked using Kernel density curve. We applied required adjustment for survey data, so that standard errors and parameters estimation are valid. Presence of chronic disease and household income were found to be the most influential and statistically significant (p < 0.001) predictors of high household healthcare expenditure. Households in rural areas spend 7% less than urban dwellers. The results show that a 100% increase in female members in a family leads to a 2% decrease in household health expenditure. Household income, health shocks in families, and family size are other statistically significant predictors of household healthcare expenditure. Proportion of elderly and under-five members in the family show some positive influence on health expenditure, though statistically nonsignificant. The findings call for emphasizing prevention of chronic diseases, as it is a strong predictor of household health expenditure. Innovative insurance scheme needs to be devised to prevent household from being impoverished due to health shocks in the family. Policy makers are urged to design an

  3. Smoking Behavior and Healthcare Expenditure in the United States, 1992–2009: Panel Data Estimates

    PubMed Central

    Lightwood, James; Glantz, Stanton A.

    2016-01-01

    Background Reductions in smoking in Arizona and California have been shown to be associated with reduced per capita healthcare expenditures in these states compared to control populations in the rest of the US. This paper extends that analysis to all states and estimates changes in healthcare expenditure attributable to changes in aggregate measures of smoking behavior in all states. Methods and Findings State per capita healthcare expenditure is modeled as a function of current smoking prevalence, mean cigarette consumption per smoker, other demographic and economic factors, and cross-sectional time trends using a fixed effects panel data regression on annual time series data for each the 50 states and the District of Columbia for the years 1992 through 2009. We found that 1% relative reductions in current smoking prevalence and mean packs smoked per current smoker are associated with 0.118% (standard error [SE] 0.0259%, p < 0.001) and 0.108% (SE 0.0253%, p < 0.001) reductions in per capita healthcare expenditure (elasticities). The results of this study are subject to the limitations of analysis of aggregate observational data, particularly that a study of this nature that uses aggregate data and a relatively small sample size cannot, by itself, establish a causal connection between smoking behavior and healthcare costs. Historical regional variations in smoking behavior (including those due to the effects of state tobacco control programs, smoking restrictions, and differences in taxation) are associated with substantial differences in per capita healthcare expenditures across the United States. Those regions (and the states in them) that have lower smoking have substantially lower medical costs. Likewise, those that have higher smoking have higher medical costs. Sensitivity analysis confirmed that these results are robust. Conclusions Changes in healthcare expenditure appear quickly after changes in smoking behavior. A 10% relative drop in smoking in every

  4. Health Care Expenditure and GDP in African Countries: Evidence from Semiparametric Estimation with Panel Data

    PubMed Central

    Lv, Zhike; Zhu, Huiming

    2014-01-01

    A large body of literature studies on the relationship between health care expenditure (HCE) and GDP have been analyzed using data intensively from developed countries, but little is known for other regions. This paper considers a semiparametric panel data analysis for the study of the relationship between per capita HCE and per capita GDP for 42 African countries over the period 1995–2009. We found that infant mortality rate per 1,000 live births has a negative effect on per capita HCE, while the proportion of the population aged 65 is statistically insignificant in African countries. Furthermore, we found that the income elasticity is not constant but varies with income level, and health care is a necessity rather than a luxury for African countries. PMID:24741366

  5. How relevant is environmental quality to per capita health expenditures? Empirical evidence from panel of developing countries.

    PubMed

    Yahaya, Adamu; Nor, Norashidah Mohamed; Habibullah, Muzafar Shah; Ghani, Judhiana Abd; Noor, Zaleha Mohd

    2016-01-01

    Developing countries have witnessed economic growth as their GDP keeps increasing steadily over the years. The growth led to higher energy consumption which eventually leads to increase in air pollutions that pose a danger to human health. People's healthcare demand, in turn, increase due to the changes in the socioeconomic life and improvement in the health technology. This study is an attempt to investigate the impact of environmental quality on per capital health expenditure in 125 developing countries within a panel cointegration framework from 1995 to 2012. We found out that a long-run relationship exists between per capita health expenditure and all explanatory variables as they were panel cointegrated. The explanatory variables were found to be statistically significant in explaining the per capita health expenditure. The result further revealed that CO2 has the highest explanatory power on the per capita health expenditure. The impact of the explanatory power of the variables is greater in the long-run compared to the short-run. Based on this result, we conclude that environmental quality is a powerful determinant of health expenditure in developing countries. Therefore, developing countries should as a matter of health care policy give provision of healthy air a priority via effective policy implementation on environmental management and control measures to lessen the pressure on health care expenditure. Moreover more environmental proxies with alternative methods should be considered in the future research.

  6. Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey.

    PubMed

    Brinda, Ethel Mary; Andrés, Antonio Rodríguez; Andrés, Rodriguez Antonio; Enemark, Ulrika

    2014-03-05

    Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Increasing age, female gender, obesity and functional disability increased the adults' out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head's occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer's visits were significantly associated with high catastrophic health expenditures. We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health expenditures. We propose that investment in social welfare

  7. Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey

    PubMed Central

    2014-01-01

    Background Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. Methods We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Results Increasing age, female gender, obesity and functional disability increased the adults’ out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p < 0.001) and spent less on health (p < 0.001), despite having higher levels of disability. Large household size, household head’s occupation as a manual laborer, household member with chronic illness, domestic violence against women and traditional healer’s visits were significantly associated with high catastrophic health expenditures. Conclusion We observed that the prevalence of inequalities in socioeconomic factors played a significant role in determining the nature of both out-of-pocket and catastrophic health

  8. Explaining health care expenditure variation: large-sample evidence using linked survey and health administrative data.

    PubMed

    Ellis, Randall P; Fiebig, Denzil G; Johar, Meliyanni; Jones, Glenn; Savage, Elizabeth

    2013-09-01

    Explaining individual, regional, and provider variation in health care spending is of enormous value to policymakers but is often hampered by the lack of individual level detail in universal public health systems because budgeted spending is often not attributable to specific individuals. Even rarer is self-reported survey information that helps explain this variation in large samples. In this paper, we link a cross-sectional survey of 267 188 Australians age 45 and over to a panel dataset of annual healthcare costs calculated from several years of hospital, medical and pharmaceutical records. We use this data to distinguish between cost variations due to health shocks and those that are intrinsic (fixed) to an individual over three years. We find that high fixed expenditures are positively associated with age, especially older males, poor health, obesity, smoking, cancer, stroke and heart conditions. Being foreign born, speaking a foreign language at home and low income are more strongly associated with higher time-varying expenditures, suggesting greater exposure to adverse health shocks. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Catastrophic health expenditure according to employment status in South Korea: a population-based panel study

    PubMed Central

    Choi, Jae Woo; Kim, Tae Hyun; Jang, Sung In; Jang, Suk Yong; Kim, Woo-Rim; Park, Eun Cheol

    2016-01-01

    Objectives Catastrophic health expenditure (CHE) means that the medical spending of a household exceeds a certain level of capacity to pay. Previous studies of CHE have focused on benefits supported by the public sector or high medical cost incurred by treating diseases in South Korea. This study examines variance of CHE in these households according to changes in employment status. We also determine whether a relationship exists according to income level. Design A longitudinal study. Setting We used the Korean Welfare Panel Study (KOWEPS) conducted by the Korea Institute. Participants The data came from 5335 households during 2009–2012. Outcome measure CHE, defined as health expenditures that were 40% greater than the ability of the household to pay. Results Households with people who experienced changes in job status from employed to unemployed (OR 2.79, 95% CI 2.06 to 3.78) or were unemployed with no status change (OR 1.57, 95% CI 1.28 to 1.92) were more likely to incur CHE than those containing people who were consistently employed. In addition, low-income families with members who had either lost a job (OR 3.52, 95% CI 2.44 to 5.10) or were already unemployed (OR 1.67, 95% CI 1.29 to 2.16) were more likely to incur CHE than those with family members with a consistent job. Conclusions Given the insecure employment status of people with low income, they are more likely to face barriers in obtaining needed health services. Meeting their healthcare needs is an important consideration. PMID:27456329

  10. Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey

    PubMed Central

    Saikia, Nandita; Moradhvaj; Bora, Jayanta Kumar

    2016-01-01

    Background While the gender disparity in health and mortality in various stages of life in India is well documented, there is limited evidence on female disadvantage in health-care expenditure (HCE). Aims Examine the gender difference in HCE in short-term and major morbidity in India, and understand the role of factors underlying the difference. Data and Methods Using two rounds of nationally representative panel data—the India Human Development Survey (IHDS) 2004–2005 and 2011–2012 (IHDS I & II)—we calculate morbidity prevalence rate and mean HCE by gender, and examine the adjusted effect of gender on major morbidity-related HCE by using a two-part regression model. Further, we performed Oaxaca-Blinder decomposition of the gender gap in HCE in major morbidity to understand the contribution of demographic and socio-economic factors. Results Health-care expenditure on females was systematically lower than on males across all demographic and socio-economic groups. Multivariate analysis confirms that female HCE is significantly lower than male HCE even after controlling demographic and socio-economic factors (β = -0.148, p = 0.000, CI:-0.206–0.091). For both short-term and major morbidity, a female disadvantage on HCE increased from IHDS I to IHDS II. For instance, the male–female gap in major morbidity related expenditure increased from INR 1298 to INR 4172. A decomposition analysis of gender gap in HCE demonstrates that about 48% of the gap is attributable to differences in demographic and socio-economic factors (endowment effect), whereas 50% of the gap is due to the differential effect of the determinants (coefficient effect). Interpretation Indians spend less on female health care than on male health care. Most of the gender gap in HCE is not due to differential distribution of factors affecting HCE. PMID:27391322

  11. Quality-quantity decomposition of income elasticity of U.S. hospital care expenditure using state-level panel data.

    PubMed

    Chen, Weiwei; Okunade, Albert; Lubiani, Gregory G

    2014-11-01

    Economic theory suggests that income growth could lead to changes in consumption quantity and quality as the spending on a commodity changes. Similarly, the volume and quality of healthcare consumption could rise with incomes because of demographic changes, usage of innovative medical technologies, and other factors. Hospital healthcare spending is the largest component of aggregate US healthcare expenditures. The novel contribution of our paper is estimating and decomposing the income elasticity of hospital care expenditures (HOCEXP) into its quantity and quality components. By using a 1999-2008 panel dataset of the 50 US states, results from the seemingly unrelated regressions model estimation reveal the income elasticity of HOCEXP to be 0.427 (std. error=0.044), with about 0.391 (calculated std. error=0.044) arising from care quality improvements and 0.035 (std. error=0.050) emanating from the rise in usage volume. Our novel research findings suggest the following: (i) the quantity part of hospital expenditure is inelastic to income change; (ii) almost the entire income-induced rise in hospital expenditure comes from care quality changes; and (iii) the 0.427 income elasticity of HOCEXP, the largest component of total US healthcare expenditure, makes hospital care a normal commodity and a much stronger technical necessity than aggregate healthcare. Policy implications are discussed.

  12. Do Increased Resources Increase Educational Attainment during a Period of Rising Expenditure? Evidence from English Secondary Schools Using a Dynamic Panel Analysis

    ERIC Educational Resources Information Center

    Pugh, Geoff; Mangan, Jean; Gray, John

    2011-01-01

    This article estimates the effects of school expenditure on school performance at Key Stage 4 in England, over the period 2003-07 during which real per pupil expenditure increased rapidly. It adds to previous investigations by using dynamic panel analysis to: exploit time series data on individual schools that only recently has become available;…

  13. Do Increased Resources Increase Educational Attainment during a Period of Rising Expenditure? Evidence from English Secondary Schools Using a Dynamic Panel Analysis

    ERIC Educational Resources Information Center

    Pugh, Geoff; Mangan, Jean; Gray, John

    2011-01-01

    This article estimates the effects of school expenditure on school performance at Key Stage 4 in England, over the period 2003-07 during which real per pupil expenditure increased rapidly. It adds to previous investigations by using dynamic panel analysis to: exploit time series data on individual schools that only recently has become available;…

  14. 77 FR 75408 - Proposed Information Collection; Comment Request; Economic Expenditure Survey of Wreckfish...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Economic Expenditure Survey of Wreckfish Fishermen in the U.S. South Atlantic Region AGENCY: National Oceanic...

  15. Life years lost and lifetime health care expenditures associated with diabetes in the U.S., National Health Interview Survey, 1997-2000.

    PubMed

    Leung, Man-Yee Mallory; Pollack, Lisa M; Colditz, Graham A; Chang, Su-Hsin

    2015-03-01

    This study analyzed the lifetime health care expenditures and life years lost associated with diabetes in the U.S. Data from the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey from 1997 to 2000, and the NHIS Linked Mortality Public-use Files with a mortality follow-up to 2006 were used to estimate age-, race-, sex-, and BMI-specific risk of diabetes, mortality, and annual health care expenditures for both patients with diabetes and those without diabetes. A Markov model populated by the risk and cost estimates was used to compute life years and total lifetime health care expenditures by age, race, sex, and BMI classifications for patients with diabetes and without diabetes. Predicted life expectancy for patients with diabetes and without diabetes demonstrated an inverted U shape across most BMI classifications, with highest life expectancy being for the overweight. Lifetime health care expenditures were higher for whites than blacks and for females than males. Using U.S. adults aged 50 years as an example, we found that diabetic white females with a BMI >40 kg/m(2) had 17.9 remaining life years and lifetime health expenditures of $185,609, whereas diabetic white females with normal weight had 22.2 remaining life years and lifetime health expenditures of $183,704. Our results show that diabetes is associated with large decreases in life expectancy and large increases in lifetime health care expenditures. In addition to decreasing life expectancy by 3.3 to 18.7 years, diabetes increased lifetime health care expenditures by $8,946 to $159,380 depending on age-race-sex-BMI classification groups. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  16. Comparison of the effects of public and private health expenditures on the health status: a panel data analysis in eastern mediterranean countries.

    PubMed

    Homaie Rad, Enayatollah; Vahedi, Sajad; Teimourizad, Abedin; Esmaeilzadeh, Firooz; Hadian, Mohamad; Torabi Pour, Amin

    2013-08-01

    Health expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR). In this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran's CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects. The results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR). The relationship for public health expenditures was significant, but for private health expenditures was not. The study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples.

  17. Comparison of the Effects of Public and Private Health Expenditures on the Health Status: A Panel Data Analysis in Eastern Mediterranean Countries

    PubMed Central

    Homaie Rad, Enayatollah; Vahedi, Sajad; Teimourizad, Abedin; Esmaeilzadeh, Firooz; Hadian, Mohamad; Torabi Pour, Amin

    2013-01-01

    Background: Health expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR). Methods: In this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran’s CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects. Results: The results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR). The relationship for public health expenditures was significant, but for private health expenditures was not. Conclusion: The study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples. PMID:24596857

  18. Distribution of Illness and Medical Expenditure: A Survey in Two Villages in Rural Beijing

    PubMed Central

    Song, Jie; Ji, Hong; Shia, Benchang; Ma, Shuangge

    2013-01-01

    Background The main goal of this study is to examine the distributions of illness conditions and resulting medical expenditures and their associated factors. To achieve this goal, an in-house survey was conducted in August of 2012 in rural Beijing, the capital city of China. Results The survey was conducted in Nanjianchang and Beijianchang, which are two villages 20 KM away from Miyun, a satellite city of Beijing. Data was collected on 346 households, which included 834 members. Variables measured included household characteristics, household head characteristics, illness conditions, and medical expenditures. Illness conditions and corresponding expenditure were measured for inpatient treatment, outpatient treatment, and self-treatment separately. Multivariate analysis suggested that the presence of inpatient treatment was associated with household head characteristics including age, gender, and education. The presence of a high level of outpatient treatment was associated with household head characteristics including gender and education. The presence of a high level of self-treatment was significantly associated with household size. In the analysis of overall out-of-pocket (OOP) medical expenditure, only age of household head was borderline significant. In the analysis of OOP inpatient expenditure, age and gender of household head were borderline significant. The OOP outpatient expenditure was associated with household size, presence of members older than 60, household head's gender, marital status, and occupation. The OOP self-treatment expenditure was not associated with any household characteristic. Conclusions For the surveyed households, medical expenditure made up a considerable proportion of the total consumption. This study suggested that the presence of illness conditions and resulting OOP medical expenditure were associated with certain household and household head characteristics. Such results may help identify the subgroup that is the most affected by

  19. Robust analysis of the determinants of healthcare expenditure growth: evidence from panel data for low-, middle- and high-income countries.

    PubMed

    Younsi, Moheddine; Chakroun, Mohamed; Nafla, Amine

    2016-10-01

    This paper examines the determinants of healthcare expenditure for low-, middle- and high-income countries, and it quantifies their influences in order to assess policies for achieving universal health coverage. We elaborate two models, a fixed-effect model and the dynamic panel model, to estimate the factors associated with the total health expenditure growth as well as its major components for 167 countries over the period of 1993-2013. The panel data on total health expenditure per capita and its components were taken from the World Development Indicators. Overall, our results showed that total health expenditure per capita is rising in all countries over time as a result of rising incomes. However, our estimates showed that the income elasticity of health expenditure ranged from 0.75 to 0.96 in the fixed-effect static panel model, while in the dynamic panel model, it was smaller and ranged from 0.16 to 0.47. Our empirical findings indicate that development assistance for health reduced government domestic spending on health but increased total government health spending. Our results also indicate that the trend in health expenditure growth is significantly depending with the country's economic development. In addition, out-of-pocket expenditure is powerfully influenced by a country's capacity to increase general government revenues and social insurance contributions. Knowledge of factors associated to health expenditure might help policy makers to make wise judgments, plan health reforms and allocate resources efficiently. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Effect of involvement level on mail panel survey response rates

    Treesearch

    Mark E. Havitz; Dennis R. Howard

    1995-01-01

    A panel survey of golfers, skiers and windsurfers was conducted using mail questionnaires which were distributed three times over the course of a calendar year; in-season, off-season, and preseason. Respondents' levels of enduring activity involvement were measured using Laurent and Kapferer's (1985) Involvement Profile scale. No support was found for the...

  1. 76 FR 18517 - Proposed Information Collection; Comment Request; Survey: Expenditures Incurred by Recipients of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... Bureau of Economic Analysis Proposed Information Collection; Comment Request; Survey: Expenditures Incurred by Recipients of Biomedical Research and Development Awards From the National Institutes of Health... e-mail at dhynek@doc.gov . FOR FURTHER INFORMATION CONTACT: Steven Payson, Chief of Research...

  2. A Survey of Out-of-Pocket Expenditures for Children with Autism Spectrum Disorder in Israel

    ERIC Educational Resources Information Center

    Raz, Raanan; Lerner-Geva, Liat; Leon, Odelia; Chodick, Gabriel; Gabis, Lidia V.

    2013-01-01

    We describe a survey of children with ASD aged 4-10 years. The main dependent variables were out-of-pocket expenditures for health services and hours of therapy. Multivariable logistic regression models were used in order to find independent predictors for service utilization. Parents of 178 of the children (87%) agreed to participate. The average…

  3. 78 FR 65971 - Proposed Information Collection; Comment Request; Marine Recreational Fishing Expenditure Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-04

    ... Recreational Fishing Expenditure Survey AGENCY: National Oceanic and Atmospheric Administration (NOAA... goods such as fishing gear, boats, vehicles, and second homes. The second part, planned for 2016, will ask anglers about the expenses incurred on their most recent marine recreational fishing trip. As...

  4. 76 FR 4635 - Proposed Information Collection; Comment Request; Economic Expenditure Survey of Golden Crab...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Economic Expenditure Survey of Golden Crab Fishermen in the U.S. South Atlantic Region AGENCY: National Oceanic...

  5. 77 FR 21086 - Patents External Quality Survey (formerly Customer Panel Quality Survey)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... United States Patent and Trademark Office Patents External Quality Survey (formerly Customer Panel Quality Survey) ACTION: Proposed collection; comment request. SUMMARY: The United States Patent and...@uspto.gov . Include ``0651- 0057 Patents External Quality Survey comment'' in the subject line of...

  6. Is household smoking status associated with expenditure on food at restaurants, alcohol, gambling and insurance? Results from the 1998–99 Household Expenditure Survey, Australia

    PubMed Central

    Siahpush, M; Borland, R; Scollo, M

    2004-01-01

    Aim: To examine how household expenditure on food at restaurants, alcohol, gambling and insurance vary between smoking and non-smoking households. Design: Cross sectional survey of households from private dwellings, conducted by the Australian Bureau of Statistics (ABS), using a stratified multistage area sample design. Setting: Australia, 1998–99. Participants: Nationally representative sample of households (n = 6892). Main outcome measures: Expenditure on meals at restaurants, alcohol, alcoholic beverages at licensed premises, gambling, and insurance. Results: The odds of reporting expenditure on restaurant food and health insurance were 20% and 40% smaller for smoking than non-smoking households, respectively. The odds of reporting expenditure on alcohol (not including expenditure at licensed premises), drinking at licensed premises, and gambling were 100%, 50%, and 40% greater for smoking than for non-smoking households, respectively. Conclusions: The study suggests that smokers are more likely to engage in risky behaviour. Implementing smoking bans in licensed premises and gambling venues can provide an opportunity to reduce smoking prevalence. Quitting or cutting down smoking can provide opportunities for expenditure on other products or services, and enhance standards of living. PMID:15564627

  7. Overweight in adolescents: implications for health expenditures.

    PubMed

    Monheit, Alan C; Vistnes, Jessica P; Rogowski, Jeannette A

    2009-03-01

    We consider a compelling research question raised by the growing prevalence of overweight among adolescents: do overweight adolescents incur greater health care expenditures than adolescents of normal weight? To address this question, we use data from the Medical Expenditure Panel Survey (MEPS) and estimate a two-part, generalized linear model (GLM) of health spending. Considering separate models by gender, we find that overweight females incur $790 more in annual expenditures than those of normal weight but we find no expenditure differences by bodyweight for males. We find that mental health spending is associated with part of the disparity in expenditures for adolescent females but establishing causality between mental health problems and weight-related health expenditure differences is challenging.

  8. A comparison of Australian families' expenditure on active and screen-based recreation using the ABS Household Expenditure Survey 2003/04.

    PubMed

    Aitken, Robert; King, Lesley; Bauman, Adrian

    2008-06-01

    This study aimed to investigate how much households with dependent children spend on active recreation (physical activity) compared with screen-based (sedentary) recreation, according to their household socioeconomic and demographic characteristics. The study analysed data from the 2003-04 Australian Bureau of Statistics Household Expenditure Survey, which collected information on household expenditure from a representational cross-section of private dwellings across Australia. In 2003-04, Australian households with dependent children spent an average of 1.5% and 3.3% of their weekly disposable income on active and screen recreation respectively, and 24.9% of their total active and screen recreation expenditure on active recreation. There was significant variation across household characteristics, with higher income and socioeconomic status households, and families with more than one dependent child more likely to spend a larger portion of their recreation budget on active recreation instead of screen recreation. Overall, Australian families spend more money on screen recreation items than they do on active recreation, although there are strong economic and cultural gradients in their patterns of expenditure on both active and screen recreation. This suggests that while the costs of active recreation may be a barrier to participation for some families, there are also social and cultural values influencing recreational choices. For the first time, specific information on Australian families' expenditure on active and screen recreation is available. These results contribute to identifying cultural and economic barriers influencing families' health-related behaviours and their participation in organised physical activity.

  9. A Note on Improving Process Efficiency in Panel Surveys with Paradata

    ERIC Educational Resources Information Center

    Kreuter, Frauke; Müller, Gerrit

    2015-01-01

    Call scheduling is a challenge for surveys around the world. Unlike cross-sectional surveys, panel surveys can use information from prior waves to enhance call-scheduling algorithms. Past observational studies showed the benefit of calling panel cases at times that had been successful in the past. This article is the first to experimentally assign…

  10. Meaningful Use of Electronic Health Records and Medicare Expenditures: Evidence from a Panel Data Analysis of U.S. Health Care Markets, 2010-2013.

    PubMed

    Lammers, Eric J; McLaughlin, Catherine G

    2017-08-01

    To determine if recent growth in hospital and physician electronic health record (EHR) adoption and use is correlated with decreases in expenditures for elderly Medicare beneficiaries. American Hospital Association (AHA) General Survey and Information Technology Supplement, Health Information Management Systems Society (HIMSS) Analytics survey, SK&A Information Services, and the Centers for Medicare & Medicaid Services (CMS) Chronic Conditions Data Warehouse Geographic Variation Database for 2010 through 2013. Fixed effects model comparing associations between hospital referral region (HRR) level measures of hospital and physician EHR penetration and annual Medicare expenditures for beneficiaries with one of four chronic conditions. Calculated hospital penetration rates as the percentage of Medicare discharges from hospitals that satisfied criteria analogous to Meaningful Use (MU) Stage 1 requirements and physician rates as the percentage of physicians using ambulatory care EHRs. An increase in the hospital penetration rate was associated with a small but statistically significant decrease in total Medicare and Medicare Part A acute care expenditures per beneficiary. An increase in physician EHR penetration was also associated with a significant decrease in total Medicare and Medicare Part A acute care expenditures per beneficiary as well as a decrease in Medicare Part B expenditures per beneficiary. For the study population, we estimate approximately $3.8 billion in savings related to hospital and physician EHR adoption during 2010-2013. We also found that an increase in physician EHR penetration was associated with an increase in lab test expenses. Health care markets that had steeper increases in EHR penetration during 2010-2013 also had steeper decreases in total Medicare and acute care expenditures per beneficiary. Markets with greater increases in physician EHR had greater declines in Medicare Part B expenditures per beneficiary. © Health Research and

  11. Selection bias of Internet panel surveys: a comparison with a paper-based survey and national governmental statistics in Japan.

    PubMed

    Tsuboi, Satoshi; Yoshida, Honami; Ae, Ryusuke; Kojo, Takao; Nakamura, Yosikazu; Kitamura, Kunio

    2015-03-01

    To investigate the selection bias of an Internet panel survey organized by a commercial company. A descriptive study was conducted. The authors compared the characteristics of the Internet panel survey with a national paper-based survey and with national governmental statistics in Japan. The participants in the Internet panel survey were composed of more women, were older, and resided in large cities. Regardless of age and sex, the prevalence of highly educated people in the Internet panel survey was higher than in the paper-based survey and the national statistics. In men, the prevalence of heavy drinkers among the 30- to 49-year-old population and of habitual smokers among the 20- to 49-year-old population in the Internet panel survey was lower than what was found in the national statistics. The estimated characteristics of commercial Internet panel surveys were quite different from the national statistical data. In a commercial Internet panel survey, selection bias should not be underestimated. © 2012 APJPH.

  12. Cigarette prices, cigarette expenditure and smoking-induced deprivation: findings from the International Tobacco Control Mexico survey

    PubMed Central

    Siahpush, Mohammad; Thrasher, James F; Yong, Hua H; Cummings, K Michael; Fong, Geoffrey T; de Miera, Belén Saenz; Borland, Ron

    2015-01-01

    Aim Mexico implemented annual tax increases between 2009 and 2011. We examined among current smokers the association of price paid per cigarette and daily cigarette expenditure with smoking-induced deprivation (SID) and whether the association of price or expenditure with SID varies by income. Methods We used data (n = 2410) from three waves of the International Tobacco Control Mexico survey (ie, 2008, 2010, 2011) and employed logistic regression to estimate the association of price paid per cigarette and daily cigarette expenditure with the probability of SID (‘In the last 6 months, have you spent money on cigarettes that you knew would be better spent on household essentials like food?’). Results Price paid per cigarette increased from Mex $1.24 in 2008, to Mex$1.36 in 2010, to Mex$1.64 in 2011. Daily cigarette expenditure increased from Mex $6.9, to Mex$7.6 and to Mex$8.4 in the 3 years. There was no evidence of an association between price and SID. However, higher expenditure was associated with a higher probability of SID. There was no evidence that the association of price or expenditure with SID varied by income. Conclusion Tax increases in Mexico have resulted in smokers paying more and spending more for their cigarettes. Those with higher cigarette expenditure experience more SID, with no evidence that poorer smokers are more affected. PMID:22923478

  13. Cigarette prices, cigarette expenditure and smoking-induced deprivation: findings from the International Tobacco Control Mexico survey.

    PubMed

    Siahpush, Mohammad; Thrasher, James F; Yong, Hua H; Cummings, K Michael; Fong, Geoffrey T; de Miera, Belén Saenz; Borland, Ron

    2013-07-01

    Mexico implemented annual tax increases between 2009 and 2011. We examined among current smokers the association of price paid per cigarette and daily cigarette expenditure with smoking-induced deprivation (SID) and whether the association of price or expenditure with SID varies by income. We used data (n=2410) from three waves of the International Tobacco Control Mexico survey (ie, 2008, 2010, 2011) and employed logistic regression to estimate the association of price paid per cigarette and daily cigarette expenditure with the probability of SID ('In the last 6 months, have you spent money on cigarettes that you knew would be better spent on household essentials like food?'). Price paid per cigarette increased from Mex$1.24 in 2008, to Mex$1.36 in 2010, to Mex$1.64 in 2011. Daily cigarette expenditure increased from Mex$6.9, to Mex$7.6 and to Mex$8.4 in the 3 years. There was no evidence of an association between price and SID. However, higher expenditure was associated with a higher probability of SID. There was no evidence that the association of price or expenditure with SID varied by income. Tax increases in Mexico have resulted in smokers paying more and spending more for their cigarettes. Those with higher cigarette expenditure experience more SID, with no evidence that poorer smokers are more affected.

  14. Impact of Illness and Medical Expenditure on Household Consumptions: A Survey in Western China

    PubMed Central

    Fang, Kuangnan; Jiang, Yefei; Shia, BenChang; Ma, Shuangge

    2012-01-01

    Background The main goal of this study is to examine the associations between illness conditions and out-of-pocket medical expenditure with other types of household consumptions. In November and December of 2011, a survey was conducted in three cities in western China, namely Lan Zhou, Gui Lin and Xi An, and their surrounding rural areas. Results Information on demographics, income and consumption was collected on 2,899 households. Data analysis suggested that the presence of household members with chronic diseases was not associated with characteristics of households or household heads. The presence of inpatient treatments was significantly associated with the age of household head (p-value 0.03). The level of per capita medical expense was significantly associated with household size, presence of members younger than 18, older than 65, basic health insurance coverage, per capita income, and household head occupation. Adjusting for confounding effects, the presence of chronic diseases was negatively associated with the amount of basic consumption (p-value 0.02) and the percentage of basic consumption (p-value 0.01), but positively associated with the percentage of insurance expense (p-value 0.02). Medical expenditure was positively associated with all other types of consumptions, including basic, education, saving and investment, entertainment, insurance, durable goods, and alcohol/tobacco. It was negatively associated with the percentage of basic consumption, saving and investment, and insurance. Conclusions Early studies conducted in other Asian countries and rural China found negative associations between illness conditions and medical expenditure with other types of consumptions. This study was conducted in three major cities and surrounding areas in western China, which had not been well investigated in published literature. The observed consumption patterns were different from those in early studies, and the negative associations were not observed. This

  15. Impact of illness and medical expenditure on household consumptions: a survey in western China.

    PubMed

    Fang, Kuangnan; Jiang, Yefei; Shia, Benchang; Ma, Shuangge

    2012-01-01

    The main goal of this study is to examine the associations between illness conditions and out-of-pocket medical expenditure with other types of household consumptions. In November and December of 2011, a survey was conducted in three cities in western China, namely Lan Zhou, Gui Lin and Xi An, and their surrounding rural areas. Information on demographics, income and consumption was collected on 2,899 households. Data analysis suggested that the presence of household members with chronic diseases was not associated with characteristics of households or household heads. The presence of inpatient treatments was significantly associated with the age of household head (p-value 0.03). The level of per capita medical expense was significantly associated with household size, presence of members younger than 18, older than 65, basic health insurance coverage, per capita income, and household head occupation. Adjusting for confounding effects, the presence of chronic diseases was negatively associated with the amount of basic consumption (p-value 0.02) and the percentage of basic consumption (p-value 0.01), but positively associated with the percentage of insurance expense (p-value 0.02). Medical expenditure was positively associated with all other types of consumptions, including basic, education, saving and investment, entertainment, insurance, durable goods, and alcohol/tobacco. It was negatively associated with the percentage of basic consumption, saving and investment, and insurance. Early studies conducted in other Asian countries and rural China found negative associations between illness conditions and medical expenditure with other types of consumptions. This study was conducted in three major cities and surrounding areas in western China, which had not been well investigated in published literature. The observed consumption patterns were different from those in early studies, and the negative associations were not observed. This study may complement the existing

  16. Trends of out-of-pocket expenditure for influenza in China Health and Nutrition Survey during 1989-2006.

    PubMed

    Liu, Jinan; Shi, Lizheng; Khan, Mahmud; Xu, Lingzhong; Wang, Liya

    2012-02-01

    To examine the trends of out-of-pocket expenditure for influenza during 1989-2006 in China. Data were extracted from the China Health and Nutrition Survey (CHNS) during 1989-2006 (in seven waves). A fixed effect model with robust standard errors was employed to examine trends of out-of-pocket expenditure (adjusted to 2006 Chinese RMB). The out-of-pocket expenditure increased from 11.92 RMB in 1989 to 50.75 RMB in 2006. The final sample for fixed effect model was 23,050 households. Income elasticity of out-of-pocket expenditure was 1.6%. Using 1989 as reference, the predicted increase was 242.23% [95% confidence interval (CI): 225.79-259.50%] in 2006; it was 143.54% in city hospitals [95% CI: 130.43-157.40%] compared to village clinics. Adjusted for inflation and income elasticity, Chinese households experienced an increase of more than double the out-of-pocket expenditure during 1989-2006. The expenditure was higher in higher-level facilities. Policy implications include the government fixed-budget financing to health providers could contribute to the rapidly increased financial burden; a referral system should be rebuilt; private health providers may play an important role in containing healthcare price in China.

  17. Methods for Estimating Medical Expenditures Attributable to Intimate Partner Violence

    ERIC Educational Resources Information Center

    Brown, Derek S.; Finkelstein, Eric A.; Mercy, James A.

    2008-01-01

    This article compares three methods for estimating the medical cost burden of intimate partner violence against U.S. adult women (18 years and older), 1 year postvictimization. To compute the estimates, prevalence data from the National Violence Against Women Survey are combined with cost data from the Medical Expenditure Panel Survey, the…

  18. Methods for Estimating Medical Expenditures Attributable to Intimate Partner Violence

    ERIC Educational Resources Information Center

    Brown, Derek S.; Finkelstein, Eric A.; Mercy, James A.

    2008-01-01

    This article compares three methods for estimating the medical cost burden of intimate partner violence against U.S. adult women (18 years and older), 1 year postvictimization. To compute the estimates, prevalence data from the National Violence Against Women Survey are combined with cost data from the Medical Expenditure Panel Survey, the…

  19. A survey of Papua New Guinea's health sector financing and expenditure.

    PubMed

    Thomason, J A; Newbrander, W C

    1991-06-01

    As a result of increasing economic constraints in the health sector of Papua New Guinea, the Department of Health embarked upon a major financial policy review program in 1986, which incorporated several studies in key areas. This paper presents the results of one component of the review, a health sector financing and expenditure study, which was undertaken for the 1986 financial year. The study found that: 1) 88% of health sector expenditure was provided by the public sector; 2) over 95% of expenditure was used for recurrent costs and there was poor utilization of overseas aid for capital projects; 3) the balance of expenditure between primary and secondary health was appropriate; 4) there were regional inequities in expenditure; and 5) a disproportionate amount of recurrent expenditure was consumed by personnel costs. The need to increase nongovernment expenditure on health was identified and further investigation of alternative sources of financing the health sector is required.

  20. Personality Measurement and Assessment in Large Panel Surveys*

    PubMed Central

    Roberts, Brent; Jackson, Joshua J.; Duckworth, Angela L.; Von Culin, Katherine

    2013-01-01

    Personality tests are being added to large panel studies with increasing regularity, such as the Health and Retirement Study (HRS). To facilitate the inclusion and interpretation of these tests, we provide some general background on personality psychology, personality assessment, and the validity of personality tests. In this review, we provide background on definitions of personality, the strengths and weaknesses of the self-report approaches to personality testing typically used in large panel studies, and the validity of personality tests for three outcomes: genetics, income, and health. We conclude with recommendations on how to improve personality assessment in future panel studies. PMID:23503719

  1. Estimating micronutrient intakes from Household Consumption and Expenditures Surveys (HCES): an example from Bangladesh.

    PubMed

    Bermudez, Odilia I; Lividini, Keith; Smitz, Marc-Francois; Fiedler, John L

    2012-09-01

    Globally, there is a scarcity of national food consumption data that could help to assess food patterns and nutrient intakes of population groups. Estimates of food consumption patterns and apparent intakes of energy and nutrients could be obtained from national Household Consumption and Expenditures Surveys (HCES). To use the HCES conducted in Bangladesh in 2005 (HIES2005) to estimate apparent intakes of vitamin A, iron, and zinc. Food acquisition data from HIES2005, which surveyed 10,080 households, were transformed into standard measurement units. Intrahousehold food and nutrient distribution was estimated with Adult Male Equivalent (AME) units. Adequacy of intake was assessed by comparing individual nutrient intakes with requirements and was then aggregated by households. The weighted mean energy intake for the population was 2,151 kcal/person/day, with a range among divisions from 1,950 in Barisal to 2,195 in Dhaka division. The apparent intakes of vitamin A and iron were insufficient to satisfy the recommended intakes for more than 80% of the population in Bangladesh, while apparent intakes of zinc, adjusted by bioavailability, satisfied the requirements of approximately 60% of the population. Using the HIES2005, we were able to produce estimates of apparent food consumption and intakes of some key micronutrients for the Bangladeshi population and observed wide differences among divisions. However, the methodological approaches reported here, although feasible and promising, need to be validated with other dietary intake methods.

  2. Should Household Consumption and Expenditures Surveys (HCES) be used for nutritional assessment and planning?

    PubMed

    Murphy, Suzanne; Ruel, Marie; Carriquiry, Alicia

    2012-09-01

    Household Consumption and Expenditures Surveys (HCES) are routinely conducted in several countries on nationally representative samples, often on a regular basis. The HCES have been considered as a potential alternative to more expensive surveys of individuals'food intakes for use in nutritional assessment and in planning programs such as food fortification. HCES gather information on household food availability (purchased, produced, or received as gifts) and use over a given period of time, often the past week or month. To discuss the potential usefulness of HCES consumption data for nutritional assessment and planning for populations of households and individuals within the households. There are several limitations to the HCES, most notably the difficulty of estimating the intrahousehold allocation of foods and therefore of quantifying the actual food intake of individual household members. Another concern is the lack of information on the variability of consumption over time, making it difficult to estimate the distribution of usual consumption, and thus the prevalence of nutrient inadequacies or excesses. Other potential limitations might be addressed by improvements to the HCES questionnaires, such as including information on foods that are available but not consumed and those that are consumed outside the home. Research is needed to better understand both the strengths and the weaknesses of the HCES data when used to assess and plan intakes at the household and individual levels.

  3. Methods of using household consumption and expenditures survey (HCES) data to estimate the potential nutritional impact of fortified staple foods.

    PubMed

    Imhoff-Kunsch, Beth; Flores, Rafael; Dary, Omar; Martorell, Reynaldo

    2012-09-01

    Micronutrient malnutrition, caused largely by inadequate dietary intake, is a global public health problem that adversely affects health, child growth and development, work capacity, and quality of life. Mass fortification of widely consumed edible products has the potential to increase micronutrient intakes and thus alleviate some nutritional deficiencies. Although individual-level data about food consumption patterns are ideal for informing the design of food fortification programs, they are often unavailable. Household Consumption and Expenditures Surveys (HCES) are nationally representative cross-sectional surveys conducted over a 12-month period every 2 to 5 years, primarily to characterize household expenditures. We describe how expenditure data from HCES can serve as a proxy for household food consumption and thus aid in choosing which foods to fortify and in determining how much of a micronutrient to add to that food. We describe methods of using HCES data to characterize apparent food consumption patterns among different strata within a population. There are several limitations of using HCES data to describe apparent food consumption. HCES do not directly capture information about true food intake, but rather describe food expenditures. We assume that purchased foods are not shared with guests, wasted, fed to animals, gifted, or stockpiled for later use. We also assume that foods are allocated within each household based on energy needs. Despite the limitations of using HCES data to estimate apparent food consumption, the dearth of individual-level data about food intake renders HCES data useful in designing food fortification programs.

  4. Main Determinants of Catastrophic Health Expenditures: A Bayesian Logit Approach on Iranian Household Survey Data (2010)

    PubMed Central

    Fazaeli, Ali Akbar; Ghaderi, Hossein; Fazaeli, Amir Abbas; Lotfi, Farhad; Salehi, Masoud; Mehrara, Mohsen

    2015-01-01

    Background: During recent decades, increase in both health care expenditures and improvement of the awareness as well as health expectations have created some problems with regard to finance healthcare expenditures so that the issue of health financing by households has been determined as a major challenge in health sector. According to the definition by the World Health Organization, catastrophic health expenditure is considered if financial contribution for health service is more than 40% of income remaining after subsistence needs have been met. Objectives: The purpose of our study was determination of Main factors on catastrophic health expenditures in Iranian households. Patients and Methods: In this study, using an econometrics Bayesian logit model, determinants of the appearance of catastrophic health expenditure based on household budget data collected in 2010 were evaluated. Results: Among Iranian households, the following groups were more likely to encounter with unsustainable health expenditures: rural households, households with the numbers of the elderly more than 65 years, illiterate householders, unemployed householders, households with some unemployed persons, households in upper rank and households with larger equivalent household size were higher than the average of community could significantly predict catastrophic health expenditures. Conclusions: About 2.1% of households were faced with catastrophic health expenditures in 2010. Thus, the implemented policies could not make considerable and significant change in improving justice in financing in health systems. PMID:25946936

  5. Main determinants of catastrophic health expenditures: a Bayesian logit approach on Iranian household survey data (2010).

    PubMed

    Fazaeli, Ali Akbar; Ghaderi, Hossein; Abbas Fazaeli, Amir; Lotfi, Farhad; Salehi, Masoud; Mehrara, Mohsen

    2015-01-26

    During recent decades, increase in both health care expenditures and improvement of the awareness as well as health expectations have created some problems with regard to finance healthcare expenditures so that the issue of health financing by households has been determined as a major challenge in health sector. According to the definition by the World Health Organization, catastrophic health expenditure is considered if financial contribution for health service is more than 40% of income remaining after subsistence needs have been met. The purpose of our study was determination of Main factors on catastrophic health expenditures in Iranian households. In this study, using an econometrics Bayesian logit model, determinants of the appearance of catastrophic health expenditure based on household budget data collected in 2010 were evaluated. Among Iranian households, the following groups were more likely to encounter with unsustainable health expenditures: rural households, households with the numbers of the elderly more than 65 years, illiterate householders, unemployed householders, households with some unemployed persons, households in upper rank and households with larger equivalent household size were higher than the average of community could significantly predict catastrophic health expenditures. About 2.1% of households were faced with catastrophic health expenditures in 2010. Thus, the implemented policies could not make considerable and significant change in improving justice in financing in health systems.

  6. The adult male equivalent concept and its application to Household Consumption and Expenditures Surveys (HCES).

    PubMed

    Weisell, Robert; Dop, Marie Claude

    2012-09-01

    Knowledge of the amount and quality of food consumed by a population is essential in determining the adequacy of the food availability and supply. Since its founding the Food and Agriculture Organization (FAO) has developed methods for determining food availability and consumption that may be useful to other investigators. Based on FAO's 60 years of experience in conducting Household Consumption and Expenditures Surveys (HCES), to explain and demonstrate the advantages and use of the Adult Male Equivalent (AME) and Equivalent Nutrition Unit (ENU) concepts. The important factors related to the AME and ENU, such as energy requirements, size and composition of the food consumer unit, and attendance at meals, are explained through the examples of two hypothetical families: a family consisting of a father, a mother, a 12-year old daughter, and a 3-year old son plus an adult guest; and a family consisting of a single mother, a 10-year old son, and two daughters, 6 and 4 years of age. The reader is guided through the steps in calculating the AME and ENU. The various scenarios of the composition, size, and attendance at meals of the consumer unit show that the calculated food energy adequacy can range from +2% to -29%. Care and attention must be given to correctly attributing the consumers of the food intake measured or estimated. In addition, use of these concepts allows for a valid comparison of food consumption units of various sizes and compositions.

  7. Recommendations for improving Guatemala's food fortification program based on household income and expenditure survey (HIES) data.

    PubMed

    Fiedler, John L; Helleranta, Meri

    2010-06-01

    Fortification offers great potential for reducing the enormous disease burden of micronutrient deficiencies. The lack of information on food consumption patterns has been a major impediment to the development of fortification programs. In some countries, the absence of this information has been an obstacle to the introduction of fortification. In countries that have fortification, governments are increasingly being challenged to provide evidence that programs are well designed and effective. To examine the usefulness of household income and expenditure surveys (HIES) as a means for addressing this information gap and making fortification programs more evidence-based and more accountable. Data from Guatemala's 2005/6 Living Standards Measurement Survey are used to develop a measure of "apparent food consumption". The measure is used to assess Guatemala's fortification program by analyzing the coverage and the additional micronutrient intake attributable to different food vehicles, combinations of food vehicles, and fortification formulations. There are three key findings. The impact of the wheat flour fortification program is considerably greater than had previously been estimated; the level at which sugar is currently fortified with vitamin A may be excessive and should be reviewed; and fortifying semolina flour (used to make pasta) would extend the benefits of wheat flour fortification to 60,000 households that currently do not benefit from it and would increase the amount of fortified food consumed by 68% of the population. Beneficiaries would include 63% of the extreme poor, and the greatest benefits would go to those wheat flour consumers who currently benefit the least from consuming fortified wheat flour products. HIES data should be used more routinely as a tool in the designing, monitoring, and assessing of fortification programs.

  8. Composite Replacement Panel Strain Survey - Test Results and Data Analysis

    DTIC Science & Technology

    2005-04-01

    curvature about the aircraft longitudinal axis and slight curvature about the aircraft normal. The Part Number for the demonstrator CRP is CRC-ACS-511b...number of the holes in Panel I were elongated in the transverse direction (vertical direction, perpendicular to aircraft longitudinal axis) during... aircraft longitudinal axis) but would be less effective for transverse and shear loads. Further work is required to verify that hole elongation could

  9. Malaria related care-seeking-behaviour and expenditures in urban settings: A household survey in Ouagadougou, Burkina Faso.

    PubMed

    Beogo, Idrissa; Huang, Nicole; Drabo, Maxime K; Yé, Yazoumé

    2016-08-01

    In Sub-Sahara Africa, malaria inflicts a high healthcare expenditure to individuals. However, little is known about healthcare expenditure to individual affected by malaria and determinants of healthcare seeking behaviour in urban settings where private sector is thriving. This study investigated the level and correlates of expenditure among individuals with self-reported malaria episode in Ouagadougou, Burkina Faso. A cross-sectional household survey conducted in August-November 2011 in Ouagadougou covered 8,243 individuals (1,600 households). Using Generalized Estimating Equations, the analysis included 1082 individuals from 715 households, who reported an episode of malaria. Of individuals surveyed, 38.3% sought care from public, 27.4% from private providers, and, 34.2% self-medicated. The median cost for malaria treatment was USD10.1 (4,850.0XOF) with significant different between public, private and self-medication (p<0.001). In public primary care health facilities, the median cost was USD8.4 (4,050.0XOF) for uncomplicated malaria and USD15.2 (7,333.5XOF) for severe malaria. In private-for-profit facilities run by a medical doctor, the median cost was USD30.3 (14,600.0XOF) for uncomplicated malaria and USD 43.0 (20,725.0XOF) for severe malaria. Regardless of the source of care, patients with insurance incurred significantly higher expenditure compared to those without insurance (p<0.001) and medicine accounted for the largest share of the expenditure. The type of provider, having insurance, and the severity of the malaria predict the amount of money spent. The high financial cost of malaria treatment regardless of the providers poses threat to the goal of universal access to malaria interventions, the unique way to achieve elimination goals.

  10. Assessing the need for a new nationally representative household panel survey in the United States

    PubMed Central

    Moffitt, Robert; Schoeni, Robert F.; Brown, Charles; Chase-Lansdale, P. Lindsay; Couper, Mick P.; Diez-Roux, Ana V.; Hurst, Erik; Seltzer, Judith A.

    2015-01-01

    We introduce this special issue on the critical matter of whether the existing household panel surveys in the U.S. are adequate to address the important emerging social science and policy questions of the next few decades. We summarize the conference papers which address this issue in different domains. The papers detail many new and important emerging research questions but also identify key limitations in existing panels in addressing those questions. To address these limitations, we consider the advantages and disadvantages of initiating a new, general-purpose omnibus household panel in the U.S. We also discuss the particular benefits of starting new panels that have specific targeted domains such as child development, population health and health care. We also develop a list of valuable enhancements to existing panels which could address many of their limitations. PMID:26688609

  11. Expenditures on health research in sub-Saharan African countries: results of a questionnaire-based survey

    PubMed Central

    Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

    2014-01-01

    Objective To estimate the sources of funds for health research (revenue) and the uses of these funds (expenditure). Design A structured questionnaire was used to solicit financial information from health research institutions. Setting Forty-two sub-Saharan African countries. Participants Key informants in 847 health research institutions in the 42 sub-Saharan African countries. Main outcome measures Expenditure on health research by institutions, funders and subject areas. Results An estimated total of US$ 302 million was spent on health research by institutions that responded to the survey in the World Health Organization (WHO) African Region for the biennium 2005–2006. The most notable funders for health research activities were external funding, ministries of health, other government ministries, own funds and non-profit institutions. Most types of health research performers spent significant portions of their resources on in-house research, with medical schools spending 82% and government agencies 62%. Hospitals spent 38% of their resources on management, and other institutions (universities, firms, etc.) spent 87% of their resources on capital investment. Research on human immunodeficiency virus/tuberculosis and malaria accounted for 30% of funds, followed by research on other communicable diseases and maternal, perinatal and nutritional conditions (23%). Conclusions Research on major health problems of the Region, such as communicable diseases, accounts for most of the research expenditures. However, the total expenditure is very low compared with other WHO regions. PMID:24914130

  12. The modeling of medical expenditure data from a longitudinal survey using the generalized method of moments (GMM) approach.

    PubMed

    Hass, Zachary; Levine, Michael; Sands, Laura P; Ting, Jeffrey; Xu, Huiping

    2016-07-10

    Medical expenditure data analysis has recently become an important problem in biostatistics. These data typically have a number of features making their analysis rather difficult. Commonly, they are heavily right-skewed, contain a large percentage of zeros, and often exhibit large numbers of missing observations because of death and/or the lack of follow-up. They are also commonly obtained from records that are linked to large longitudinal data surveys. In this manuscript, we suggest a novel approach to modeling these data through the use of generalized method of moments estimation procedure combined with appropriate weights that account for both dropout due to death and the probability of being sampled from among the National Long Term Care Survey (NLTCS) subjects. This approach seems particularly appropriate because of the large number of subjects relative to the length of observation period (in months). We also use a simulation study to compare our proposed approach with and without the use of weights. The proposed model is applied to medical expenditure data obtained from the 2004-2005 NLTCS-linked Medicare database. The results suggest that the amount of medical expenditures incurred is strongly associated with higher number of activities of daily living (ADL) disabilities and self-reports of unmet need for help with ADL disabilities. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Financial burden of household out-of pocket health expenditure in Viet Nam: findings from the National Living Standard Survey 2002-2010.

    PubMed

    Van Minh, Hoang; Kim Phuong, Nguyen Thi; Saksena, Priyanka; James, Chris D; Xu, Ke

    2013-11-01

    In Viet Nam, household direct out-of-pocket (OOP) health expenditure as a share of the total health expenditure has been always high, ranging from 50% to 70%. The high share of OOP expenditure has been linked to different inequity problems such as catastrophic health expenditure (households must reduce their expenditure on other necessities) and impoverishment. This paper aims to examine catastrophic and poverty impacts of household out-of-pocket health expenditure in Viet Nam over time and identify socio-economic indicators associated with them. Data used in this research were obtained from a nationally representative household survey, Viet Nam Living Standard Survey 2002, 2004, 2006, 2008 and 2010. The findings revealed that there were problems in health care financing in Viet Nam - many households encountered catastrophic health expenditure and/or were pushed into poverty due to health care payments. The issues were pervasive over time. Catastrophic expenditure and impoverishment problems were more common among the households who had more elderly people and those located in rural areas. Importantly, the financial protection aspect of the national health insurance schemes was still modest. Given these findings, more attention is needed on developing methods of financial protection in Viet Nam.

  14. Estimation and adjustment of self-selection bias in volunteer panel web surveys

    NASA Astrophysics Data System (ADS)

    Niu, Chengying

    2016-06-01

    By using propensity score matching method of random sample, we matched simple random sample units and volunteer panel Web survey sample units based on the equal or similar propensity score. The unbiased estimators of the population parameters are constructed by using the matching simple random sample, and the self-selection bias is estimated. We propose propensity score weighted and matching sample post stratification weighted methods to estimate the population parameters, and the self-selection bias in volunteer panel Web Surveys are adjusted.

  15. Estimating marginal and incremental effects in the analysis of medical expenditure panel data using marginalized two-part random-effects generalized Gamma models: Evidence from China healthcare cost data.

    PubMed

    Zhang, Bo; Liu, Wei; Hu, Yingyao

    2017-01-01

    Conditional two-part random-effects models have been proposed for the analysis of healthcare cost panel data that contain both zero costs from the non-users of healthcare facilities and positive costs from the users. These models have been extended to accommodate more flexible data structures when using the generalized Gamma distribution to model the positive healthcare expenditures. However, a major drawback with the extended model, which is inherited from the conditional models, is that it is fairly difficult to make direct marginal inference with respect to overall healthcare costs that includes both zeros and non-zeros, or even on positive healthcare costs. In this article, we first propose two types of marginalized two-part random-effects generalized Gamma models (m2RGGMs): Type I m2RGGMs for the inference on positive healthcare costs and Type II m2RGGMs for the inference on overall healthcare costs. Then, the concepts of marginal effect and incremental effect of a covariate on overall and positive healthcare costs are introduced, and estimation of these effects is carefully discussed. Especially, we derive the variance estimates of these effects by following the delta methods and Taylor series approximations for the purpose of making marginal inference. Parameter estimates of Type I and Type II m2RGGMs are obtained through maximum likelihood estimation. An empirical analysis of longitudinal healthcare costs collected in the China Health and Nutrition Survey is conducted using the proposed methodologies.

  16. Panel Conditioning in Longitudinal Studies: Evidence from Labor Force Items in the Current Population Survey

    PubMed Central

    Halpern-Manners, Andrew; Warren, John Robert

    2013-01-01

    Does participating in a longitudinal survey affect respondents’ answers to subsequent questions about their labor force characteristics? In this article, we investigate the magnitude of “panel conditioning” or “time in survey” biases for key labor force questions in the monthly Current Population Survey (CPS). Using linked CPS records for household heads first interviewed between January 2007 and June 2010, our analyses are based on strategic within-person comparisons across survey months and between-person comparisons across CPS rotation groups. We find considerable evidence for panel conditioning effects in the CPS. Panel conditioning downwardly biases the CPS-based unemployment rate, mainly by leading people to remove themselves from its denominator. Across surveys, CPS respondents (claim to) leave the labor force in greater numbers than otherwise equivalent respondents who are participating in the CPS for the first time. The results cannot be attributed to panel attrition or mode effects. We discuss implications for CPS-based research and policy as well as for survey methodology more broadly. PMID:22893185

  17. Changes in the Returns to Schooling 1991-2002: Evidence from the British Household Panel Survey

    ERIC Educational Resources Information Center

    McGuinness, Seamus; Bennett, Jessica

    2009-01-01

    The present paper uses British Household Panel Survey data from 1991 to 2002 to assess the extent to which labour market returns have been influenced by changes in the nature of educational supply. We find that whilst there have been substantial shifts in the returns to schooling over the period, these effects are much more pronounced for younger…

  18. 78 FR 50373 - Proposed Information Collection; Comment Request; Annual Capital Expenditures Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... forecasting, identifying business opportunities, product development, and business planning. Changes from the previous ACES are the elimination of detailed capital expenditures by type of structure and type of... Number: ACE-1(S), ACE-1(M), ACE-1(L) and ACE-2. Type of Review: Regular submission. Affected Public...

  19. No short-term savings in health care expenditures for physically active adults.

    PubMed

    Chevan, Julia; Roberts, Dawn E

    2014-06-01

    The purpose of this study was to investigate the association of physical activity and health care expenditures in a nationally representative sample of non-disabled adults. This was a secondary analysis of data from 8843 adults. Physical activity measures were derived from participants in the 2006 and 2007 National Health Interview Survey. Demographic and expenditure variables came from the Medical Expenditure Panel Survey data files for panels 12 (2007-2008) and 13 (2008-2009). Multivariable regression models were used to determine the association between levels of physical activity participation and total health care expenditures, drug expenditures, and out-of-pocket health care expenditures. Unadjusted data revealed lower health care expenditures among those whose activity level met the CDC guidelines with greater savings apparent among those who exercised above recommended guidelines. However, in the models that adjusted for age, sex, race, income and health status these differences disappeared. In the short-term, the amount of physical activity undertaken by an adult may have little effect on the expenditures for health services, drugs and the money expended directly out-of-pocket. However, given the benefits of physical activity in terms of chronic disease prevention there are very likely long-term expenditure savings to be had. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Reconciling Medical Expenditure Estimates from the MEPS and NHEA, 2007

    PubMed Central

    Bernard, Didem; Cowan, Cathy; Selden, Thomas; Cai, Liming; Catlin, Aaron; Heffler, Stephen

    2012-01-01

    Objective Provide a comparison of health care expenditure estimates for 2007 from the Medical Expenditure Panel Survey (MEPS) and the National Health Expenditure Accounts (NHEA). Reconciling these estimates serves two important purposes. First, it is an important quality assurance exercise for improving and ensuring the integrity of each source's estimates. Second, the reconciliation provides a consistent baseline of health expenditure data for policy simulations. Our results assist researchers to adjust MEPS to be consistent with the NHEA so that the projected costs as well as budgetary and tax implications of any policy change are consistent with national health spending estimates. Data Sources The Medical Expenditure Panel Survey produced by the Agency for Healthcare Research and Quality, and the National Health Center for Health Statistics and the National Health Expenditures produced by the Centers for Medicare & Medicaid Service's Office of the Actuary. Results In this study, we focus on the personal health care (PHC) sector, which includes the goods and services rendered to treat or prevent a specific disease or condition in an individual. The official 2007 NHEA estimate for PHC spending is $1,915 billion and the MEPS estimate is $1,126 billion. Adjusting the NHEA estimates for differences in underlying populations, covered services, and other measurement concepts reduces the NHEA estimate for 2007 to $1,366 billion. As a result, MEPS is $240 billion, or 17.6 percent, less than the adjusted NHEA total. PMID:24800157

  1. Persons with Mental Retardation and Related Conditions in Mental Retardation Facilities: Selected Findings from the 1987 National Medical Expenditure Survey. Project Report 29.

    ERIC Educational Resources Information Center

    Lakin, K. Charlie; And Others

    This report presents statistics on residential facilities for the mentally retarded and on the residents themselves, derived from the Institutional Population Component of the 1987 National Medical Expenditure Survey (NMES). Part 1 presents an overview of the NMES and discusses previous efforts to survey persons residing in mental retardation…

  2. Food Insecurity and Health Care Expenditures in the United States, 2011-2013.

    PubMed

    Berkowitz, Seth A; Basu, Sanjay; Meigs, James B; Seligman, Hilary K

    2017-06-13

    To determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. Nationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). Longitudinal retrospective cohort. A total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS. Their total health care expenditures in 2012 and 2013 were recorded in MEPS. Expenditure data were analyzed using zero-inflated negative binomial regression and adjusted for age, gender, race/ethnicity, education, income, insurance, and residence area. Fourteen percent of individuals reported food insecurity, representing 41,616,255 Americans. Mean annualized total expenditures were $4,113 (standard error $115); 9.2 percent of all individuals had no health care expenditures. In multivariable analyses, those with food insecurity had significantly greater estimated mean annualized health care expenditures ($6,072 vs. $4,208, p < .0001), an extra $1,863 in health care expenditure per year, or $77.5 billion in additional health care expenditure annually. Food insecurity was associated with greater subsequent health care expenditures. Future studies should determine whether food insecurity interventions can improve health and reduce health care costs. © Health Research and Educational Trust.

  3. Health care expenditure burdens among elderly adults: 1987 and 1996.

    PubMed

    Selden, Thomas M; Banthin, Jessica S

    2003-07-01

    Concerns about the health care expenditure burdens of elderly adults underlie the ongoing debate over expanding Medicare benefits and strengthening Medicare+Choice. We examine burdens for this population using data from the 1987 National Medical Expenditure Survey (NMES) and the 1996 Medical Expenditure Panel Survey (MEPS). We estimate how frequently elderly adults live in families whose health expenditures exceed 20% or 40% of their after-tax disposable incomes. Our methodology reduces bias due to errors in income while providing an intuitive measure of exposure to the risk of high burdens. Despite rapid increases in medical care prices, the percentage of elderly adults facing burdens over 20% of disposable income remained essentially constant at 20.9% in 1987 and 22.9% in 1996. The percentage with burdens exceeding 40% of disposable income was 7.3% in 1987 and 7.9% in 1996. High expenditure burdens were more prevalent among elderly adults who were poorer, older, female, higher risk, and covered only by traditional Medicare. Medicaid coverage helped to reduce burdens among the elderly poor, yet incomplete Medicaid take-up in 1996 left approximately 1.3 million elderly adults eligible for Medicaid but covered only by traditional Medicare. Our results highlight the widespread prevalence of high health care expenditure burdens among elderly adults and the varying extent to which insurance coverage helped to protect them from rising health care expenditures between 1987 and 1996.

  4. Household Consumption and Expenditures Surveys (HCES): a primer for food and nutrition analysts in low- and middle-income countries.

    PubMed

    Fiedler, John L; Lividini, Keith; Bermudez, Odilia I; Smitz, Marc-Francois

    2012-09-01

    The dearth of 24-hour recall and observed-weighed food record data--what most nutritionists regard as the gold standard source of food consumption data-has long been an obstacle to evidence-based food and nutrition policy. There have been a steadily growing number of studies using household food acquisition and consumption data from a variety of multipurpose, nationally representative household surveys as a proxy measure to overcome this fundamental information gap. To describe the key characteristics of these increasingly available Household Consumption and Expenditures Surveys (HCES) in order to help familiarize food and nutrition analysts with the strengths and shortcomings of these data and thus encourage their use in low- and middle-income countries; and to identify common shortcomings that can be readily addressed in the near term in a country-by-country approach, as new HCES are fielded, thereby beginning a process of improving the potential of these surveys as sources of useful data for better understanding food- and nutrition-related issues. Common characteristics of key food and nutrition information that is available in HCES and some basic common steps in processing HCES data for food and nutrition analyses are described. The common characteristics of these surveys are documented, and their usefulness in addressing major food and nutrition issues, as well as their shortcomings, is demonstrated. Despite their limitations, the use of HCES data constitutes a generally unexploited opportunity to address the food consumption information gap by using survey data that most countries are already routinely collecting.

  5. Selection of key financial indicators: a literature, panel and survey approach.

    PubMed

    Pink, George H; Daniel, Imtiaz; Hall, Linda McGillis; McKillop, Ian

    2007-01-01

    Since 1998, most hospitals in Ontario have voluntarily participated in one of the largest and most ambitious publicly available performance-reporting initiatives in the world. This article describes the method used to select key financial indicators for inclusion in the report including the literature review, panel and survey approaches that were used. The results for five years of recent data for Ontario hospitals are also presented.

  6. An Experimental Study Using Opt-in Internet Panel Surveys for Behavioral Health Surveillance

    PubMed Central

    Gotway Crawford, Carol A.; Okoro, Catherine A.; Akcin, Haci M.; Dhingra, Satvinder

    2013-01-01

    Objective To present the design and preliminary results of a pilot study to investigate the use of opt-in Internet panel surveys for behavioral health surveillance. Introduction Today, surveyors in both the private and public sectors are facing considerable challenges with random digit dialed (RDD) landline telephone samples. The population coverage rates for landline telephone surveys are being eroded by wireless-only households, portable telephone numbers, telecommunication barriers (e.g., call forwarding, call blocking and pager connections), technological barriers (call-blocking, busy circuits) and increased refusal rates and privacy concerns. Addressing these issues increasingly drives up the costs associated with dual-frame telephone surveys designed to be representative of the target population as well as hinders their ability to be fully representative of the adult population of each state and territory in the United States. In an effort to continue to meet these challenges head on and assist state and territorial public health professionals in the continued collection of data that are representative of their respective populations, novel approaches to behavioral health surveillance need continued examination. Both private and public sector researchers are evaluating the use of Internet opt-in panels to augment dual-frame RDD survey methods. Compared to dual-frame RDD, opt-in Internet panels offer lower costs, quick data collection and dissemination, and the ability to gather additional data on panelists over time. However, as with dual-frame RDD, this mode has similar challenges with coverage error and non-response. Nevertheless, survey methodologists are moving forward and exploring ways to reduce or eliminate biases between the sample and the target population. Methods A collaborative pilot project was designed to assess the feasibility and accuracy of opt-in Internet panel surveys for behavioral health surveillance. This pilot project is a collaboration

  7. Comparing Twitter and Online Panels for Survey Recruitment of E-Cigarette Users and Smokers

    PubMed Central

    Kim, Annice; Murphy, Joe; Bradfield, Brian; Nonnemaker, James; Hsieh, Yuli

    2016-01-01

    Background E-cigarettes have rapidly increased in popularity in recent years, driven, at least in part, by marketing and word-of-mouth discussion on Twitter. Given the rapid proliferation of e-cigarettes, researchers need timely quantitative data from e-cigarette users and smokers who may see e-cigarettes as a cessation tool. Twitter provides an ideal platform for recruiting e-cigarette users and smokers who use Twitter. Online panels offer a second method of accessing this population, but they have been criticized for recruiting too few young adults, among whom e-cigarette use rates are highest. Objective This study compares effectiveness of recruiting Twitter users who are e-cigarette users and smokers who have never used e-cigarettes via Twitter to online panelists provided by Qualtrics and explores how users recruited differ by demographics, e-cigarette use, and social media use. Methods Participants were adults who had ever used e-cigarettes (n=278; male: 57.6%, 160/278; age: mean 34.26, SD 14.16 years) and smokers (n=102; male: 38.2%, 39/102; age: mean 42.80, SD 14.16 years) with public Twitter profiles. Participants were recruited via online panel (n=190) or promoted tweets using keyword targeting for e-cigarette users (n=190). Predictor variables were demographics (age, gender, education, race/ethnicity), e-cigarette use (eg, past 30-day e-cigarette use, e-cigarette puffs per day), social media use behaviors (eg, Twitter use frequency), and days to final survey completion from survey launch for Twitter versus panel. Recruitment method (Twitter, panel) was the dependent variable. Results Across the total sample, participants were recruited more quickly via Twitter (incidence rate ratio=1.30, P=.02) than panel. Compared with young adult e-cigarette users (age 18-24 years), e-cigarette users aged 25 to 34 years (OR 0.01, 95% CI 0.00-0.60, P=.03) and 35 to 44 years (OR 0.01, 95% CI 0.00-0.51, P=.02) were more likely to be recruited via Twitter than panel

  8. Comparing Twitter and Online Panels for Survey Recruitment of E-Cigarette Users and Smokers.

    PubMed

    Guillory, Jamie; Kim, Annice; Murphy, Joe; Bradfield, Brian; Nonnemaker, James; Hsieh, Yuli

    2016-11-15

    E-cigarettes have rapidly increased in popularity in recent years, driven, at least in part, by marketing and word-of-mouth discussion on Twitter. Given the rapid proliferation of e-cigarettes, researchers need timely quantitative data from e-cigarette users and smokers who may see e-cigarettes as a cessation tool. Twitter provides an ideal platform for recruiting e-cigarette users and smokers who use Twitter. Online panels offer a second method of accessing this population, but they have been criticized for recruiting too few young adults, among whom e-cigarette use rates are highest. This study compares effectiveness of recruiting Twitter users who are e-cigarette users and smokers who have never used e-cigarettes via Twitter to online panelists provided by Qualtrics and explores how users recruited differ by demographics, e-cigarette use, and social media use. Participants were adults who had ever used e-cigarettes (n=278; male: 57.6%, 160/278; age: mean 34.26, SD 14.16 years) and smokers (n=102; male: 38.2%, 39/102; age: mean 42.80, SD 14.16 years) with public Twitter profiles. Participants were recruited via online panel (n=190) or promoted tweets using keyword targeting for e-cigarette users (n=190). Predictor variables were demographics (age, gender, education, race/ethnicity), e-cigarette use (eg, past 30-day e-cigarette use, e-cigarette puffs per day), social media use behaviors (eg, Twitter use frequency), and days to final survey completion from survey launch for Twitter versus panel. Recruitment method (Twitter, panel) was the dependent variable. Across the total sample, participants were recruited more quickly via Twitter (incidence rate ratio=1.30, P=.02) than panel. Compared with young adult e-cigarette users (age 18-24 years), e-cigarette users aged 25 to 34 years (OR 0.01, 95% CI 0.00-0.60, P=.03) and 35 to 44 years (OR 0.01, 95% CI 0.00-0.51, P=.02) were more likely to be recruited via Twitter than panel. Smokers aged 35 to 44 years were less

  9. Survey of the Relationship Between Activity Energy Expenditure Metabolic Equivalents and Barrier Factors of Physical Activity in the Elderly in Kashan

    PubMed Central

    Sadrollahi, Ali; Khalili, Zahra; Pour Nazari, Robab; Mohammadi, Majid; Ahmadi Khatir, Maryam; Mossadegh, Najima

    2016-01-01

    Background Physical activity in the elderly is influenced by aspects of aging that cause personal, mental, environmental, and social changes. Increases in factors that are barriers to activity cause physical energy expenditure to decrease. Objectives The aim of the present study was to survey the relationship between energy expenditure in metabolic equivalent units (MET) and factors that are barriers to physical activity in elderly people in Kashan, Iran Methods This is a descriptive analysis done in 2014. The study population was 400 people above 60 years old in medical facilities in Kashan. Multistage sampling was used in 10 clinics in 5 areas of Kashan. The sample size was varied according to gender and elderly population. Contributors were given questionnaires concerning energy expenditure levels in physical activity and factors that are barriers to being active. Results The average age among the study population was 67.6 ± 6.8 years median, and the interquartile range (IQR) of barriers to physical activity among Kashan’s elderly was (8.75) ± 33. Average energy expenditure was 326.21 ± 364.84 based on metabolic equivalent units (MET). In fact, 340 persons (85%) were practically without any active energy expenditure. The most common barrier was the lack of an appropriate place for doing physical activity; 298 (74%) of the participants cited this barrier. The results show the Spearman rank-order correlation is significant (P = 0.038, r = 0.104) between barriers to physical activity and activity energy expenditure in Kashan’s elderly. Conclusions Decreasing barriers to physical activity among the elderly causes physical activities to increase; therefore, energy expenditure is increased. Decreasing social and environmental problems for the elderly is effective in increasing physical activity and energy expenditure. PMID:28191341

  10. Online and Social Media Data As an Imperfect Continuous Panel Survey

    PubMed Central

    2016-01-01

    There is a large body of research on utilizing online activity as a survey of political opinion to predict real world election outcomes. There is considerably less work, however, on using this data to understand topic-specific interest and opinion amongst the general population and specific demographic subgroups, as currently measured by relatively expensive surveys. Here we investigate this possibility by studying a full census of all Twitter activity during the 2012 election cycle along with the comprehensive search history of a large panel of Internet users during the same period, highlighting the challenges in interpreting online and social media activity as the results of a survey. As noted in existing work, the online population is a non-representative sample of the offline world (e.g., the U.S. voting population). We extend this work to show how demographic skew and user participation is non-stationary and difficult to predict over time. In addition, the nature of user contributions varies substantially around important events. Furthermore, we note subtle problems in mapping what people are sharing or consuming online to specific sentiment or opinion measures around a particular topic. We provide a framework, built around considering this data as an imperfect continuous panel survey, for addressing these issues so that meaningful insight about public interest and opinion can be reliably extracted from online and social media data. PMID:26730933

  11. Online and Social Media Data As an Imperfect Continuous Panel Survey.

    PubMed

    Diaz, Fernando; Gamon, Michael; Hofman, Jake M; Kıcıman, Emre; Rothschild, David

    2016-01-01

    There is a large body of research on utilizing online activity as a survey of political opinion to predict real world election outcomes. There is considerably less work, however, on using this data to understand topic-specific interest and opinion amongst the general population and specific demographic subgroups, as currently measured by relatively expensive surveys. Here we investigate this possibility by studying a full census of all Twitter activity during the 2012 election cycle along with the comprehensive search history of a large panel of Internet users during the same period, highlighting the challenges in interpreting online and social media activity as the results of a survey. As noted in existing work, the online population is a non-representative sample of the offline world (e.g., the U.S. voting population). We extend this work to show how demographic skew and user participation is non-stationary and difficult to predict over time. In addition, the nature of user contributions varies substantially around important events. Furthermore, we note subtle problems in mapping what people are sharing or consuming online to specific sentiment or opinion measures around a particular topic. We provide a framework, built around considering this data as an imperfect continuous panel survey, for addressing these issues so that meaningful insight about public interest and opinion can be reliably extracted from online and social media data.

  12. The AIME Statewide Survey of School Library Media Centers: Expenditures & Collections.

    ERIC Educational Resources Information Center

    Callison, Daniel; Knuth, Rebecca

    1994-01-01

    This report is based on an Indiana statewide survey of school library media center collections, budgets, and services which was sponsored by the Association for Indiana Media Educators (AIME). Completed and usable surveys were received from 823 public and private school library media programs representing 44% of the total possible school library…

  13. Affordability of the Health Expenditures of Insured Americans Before the Affordable Care Act.

    PubMed

    Nyman, John A; Trenz, Helen M

    2016-02-01

    Central to the Affordable Care Act is the notion of affordability and the role of health insurance in making otherwise unaffordable health care affordable. We used data from the 1996 to 2008 versions of the Medical Expenditure Panel Survey to estimate the portion of overall health care expenditures by insured respondents that would otherwise have been beyond their disposable incomes and assets. We found that about one third of insured expenditures would have been unaffordable, with a much higher percentage among publicly insured individuals. This result suggests that one of the main functions of insurance is to cover expenses that insured individuals would not otherwise be able to afford.

  14. Correlation Results for a Mass Loaded Vehicle Panel Test Article Finite Element Models and Modal Survey Tests

    NASA Technical Reports Server (NTRS)

    Maasha, Rumaasha; Towner, Robert L.

    2012-01-01

    High-fidelity Finite Element Models (FEMs) were developed to support a recent test program at Marshall Space Flight Center (MSFC). The FEMs correspond to test articles used for a series of acoustic tests. Modal survey tests were used to validate the FEMs for five acoustic tests (a bare panel and four different mass-loaded panel configurations). An additional modal survey test was performed on the empty test fixture (orthogrid panel mounting fixture, between the reverb and anechoic chambers). Modal survey tests were used to test-validate the dynamic characteristics of FEMs used for acoustic test excitation. Modal survey testing and subsequent model correlation has validated the natural frequencies and mode shapes of the FEMs. The modal survey test results provide a basis for the analysis models used for acoustic loading response test and analysis comparisons

  15. Tobacco cessation and household spending on non-tobacco goods: results from the US Consumer Expenditure Surveys.

    PubMed

    Rogers, Erin S; Dave, Dhaval M; Pozen, Alexis; Fahs, Marianne; Gallo, William T

    2017-03-16

    To estimate the impact of tobacco cessation on household spending on non-tobacco goods in the USA. Using 2006-2015 Consumer Expenditure Survey data, 9130 tobacco-consuming households were followed for four quarters. Households were categorised during the fourth quarter as having: (1) recent tobacco cessation, (2) long-term cessation, (3) relapsed cessation or (4) no cessation. Generalised linear models were used to compare fourth quarter expenditures on alcohol, food at home, food away from home, housing, healthcare, transportation, entertainment and other goods between the no-cessation households and those with recent, long-term or relapsed cessation. The full sample was analysed, and then analysed by income quartile. In the full sample, households with long-term and recent cessation had lower spending on alcohol, food, entertainment and transportation (p<0.001). Recent cessation was further associated with reduced spending on food at home (p<0.001), whereas relapsed cessation was associated with higher spending on healthcare and food away from home (p<0.001). In the highest income quartile, long-term and recent cessations were associated with reduced alcohol spending only (p<0.001), whereas in the lowest income quartile, long-term and recent cessations were associated with lower spending on alcohol, food at home, transportation and entertainment (p<0.001). Households that quit tobacco spend less in areas that enable or complement their tobacco cessation, most of which may be motivated by financial strain. The most robust association between tobacco cessation and spending was the significantly lower spending on alcohol. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Collection of Resource and Expenditure Data on the Schools and Staffing Survey. Working Paper Series.

    ERIC Educational Resources Information Center

    Isaacs, Julia B.; Garet, Michael S.; Sherman, Joel D.; Cullen, Andrew; Phelps, Richard

    This report discusses the possibility of expanding the resource and finance data to be collected as part of the 1999-2000 Schools and Staffing Survey (SASS) of the National Center for Education Statistics (NCES). The proposal under consideration, which is being field tested in the fall of 1998 and winter of 1999, has two major components. The…

  17. Policy implications of using a household consumption and expenditures survey versus an observed-weighed food record survey to design a food fortification program.

    PubMed

    Lividini, Keith; Fiedler, John L; Bermudez, Odilia I

    2013-12-01

    Observed-Weighed Food Record Surveys (OWFR) are regarded as the most precise dietary assessment methodology, despite their recognized shortcomings, which include limited availability, high cost, small samples with uncertain external validity that rarely include all household members, Hawthorne effects, and using only 1 or 2 days to identify "usual intake." Although Household Consumption and Expenditures Surveys (HCES) also have significant limitations, they are increasingly being used to inform nutrition policy To investigate differences in fortification simulations based on OWFR and HCES from Bangladesh. The pre- and postfortification nutrient intake levels from the two surveys were compared. The total population-based rank orderings of oil, wheat flour, and sugar coverage were identical for the two surveys. OWFR found differences in women's and children's coverage rates and average quantities consumed for all three foods that were not detected by HCES. Guided by the Food Fortification Formulator, we found that these differences did not result in differences in recommended fortification levels. Differences were found, however, in estimated impacts: although both surveys found that oil would be effective in reducing the prevalence of inadequate vitamin A intake among both subpopulations, only OWFR also found that sugar and wheat flour fortification would significantly reduce inadequate vitamin A intake among children. Despite the less precise measure of food consumption from HCES, the two surveys provide similar guidance for designing a fortification program. The external validity of these findings is limited. With relatively minor modifications, the precision of HCES in dietary assessment and the use ofHCES in fortification programming could be strengthened.

  18. A National Study of Out-of-Pocket Expenditures for Mammography Screening

    PubMed Central

    Sambamoorthi, Usha

    2011-01-01

    Abstract Objectives To identify variations in screening mammography expenditures, primarily out-of-pocket and total expenditures, of women 40–64 years of age in the United States and factors associated with variations. Methods Retrospective analysis of data collected from the 2007 and 2008 Medical Expenditure Panel Survey (MEPS). The sample included 2020 women 40–64 years of age who received one mammogram in 2007 or 2008. Ordinary least squares regression was used to describe relationships among out-of-pocket mammography expenditures, total mammography expenditures, and out-of-pocket mammography expenditures as a percentage of total mammography expenditures and such independent variables as insurance status and type, income, region of the United States, and type of facility where a mammogram was received. Results The average out-of-pocket expenditure for a mammogram in 2007 or 2008 was $33, representing 14.1% of the total mammogram expenditure ($266). After controlling for demographic and health factors, women who were uninsured, were from the Midwest, and had a mammogram at an office-based facility had greater out-of-pocket mammography expenditures. Women who were uninsured, lived in the South, and received their mammogram at an office-based facility had out-of-pocket mammography expenditures that represented a greater proportion of the total mammography expenditures. Conclusions Large variations in out-of-pocket expenditures were observed among women with and without insurance and between insurance types, geographic regions of the United States, and types of facilities where mammograms were received. A higher financial burden of mammography screening among some subgroups of women may act as a barrier to future mammography screening. PMID:21848432

  19. Estimated annual health care expenditures in individuals with peripheral arterial disease.

    PubMed

    Scully, Rebecca E; Arnaoutakis, Dean J; DeBord Smith, Ann; Semel, Marcus; Nguyen, Louis L

    2017-08-25

    The clinical impact of peripheral arterial disease (PAD) is well characterized and is associated with significant morbidity and mortality. Health care-related expenditures among individuals with PAD, particularly for patients, are not well described. Health care-related expenditure data from the 2011 to 2014 Agency for Healthcare Research and Quality Medical Expenditure Panel Surveys were analyzed for individuals with a diagnosis of PAD compared with U.S. adults 40 years of age and older. Weighted average annual expenditures were estimated using a multivariable generalized linear model. Subanalyses were also performed for out-of-pocket (OOP) expenditures by insurance type. Adjusted for age, gender, and race, individuals with a diagnosis of PAD (weighted n = 640,098) had significantly higher average annual health care-related expenditures compared with the U.S. adult population as a whole (weighted n = 148,387,362). Average annual expenditures per individual for patients with PAD were $11,553 (95% confidence interval [CI], $8137-$14,968) compared with only $4219 (95% CI, $4064-$4375; P < .001) for those without. Expenditures were driven by increased prescription medication expenditures as well as by expenditures for inpatient care, outpatient hospital-based care, and outpatient office-based care. Individuals with PAD had significantly higher OOP prescription medication expenditures ($386 [95% CI, $258-$515] vs $192 [95% CI, $183-$202]; P = .003), which varied by insurance type, ranging from $179 (95% CI, $70-$288) for those with Medicare to $1196 (95% CI, $106-$2244) for those without insurance, although this difference did not reach significance. Individuals with a diagnosis of PAD have higher health care-related expenditures and OOP expenses compared with other US adults. These expenditures compound lost wages, care by family members, and lost opportunity costs, increasing the burden carried by patients with PAD. Copyright © 2017 Society for Vascular Surgery

  20. Hyperlipidemia and Medical Expenditures by Cardiovascular Disease Status in US Adults.

    PubMed

    Zhang, Donglan; Wang, Guijing; Fang, Jing; Mercado, Carla

    2017-01-01

    Hyperlipidemia is a major risk factor for cardiovascular disease (CVD), affecting 73.5 million American adults. Information about health care expenditures associated with hyperlipidemia by CVD status is needed to evaluate the economic benefit of primary and secondary prevention programs for CVD. The study sample includes 48,050 men and nonpregnant women ≥18 from 2010 to 2012 Medical Expenditure Panel Survey. A 2-part econometric model was used to estimate annual hyperlipidemia-associated medical expenditures by CVD status. The estimation results from the 2-part model were used to calculate per-capita and national medical expenditures associated with hyperlipidemia. We adjusted the medical expenditures into 2012 dollars. Among those with CVD, per person hyperlipidemia-associated expenditures were $1105 [95% confidence interval (CI), $877-$1661] per year, leading to an annual national expenditure of $15.47 billion (95% CI, $5.23-$27.75 billion). Among people without CVD, per person hyperlipidemia-associated expenditures were $856 (95% CI, $596-$1211) per year, resulting in an annual national expenditure of $23.11 billion (95% CI, $16.09-$32.71 billion). Hyperlipidemia-associated expenditures were attributable mostly to the costs of prescription medication (59%-90%). Among people without CVD, medication expenditures associated with hyperlipidemia were $13.72 billion (95% CI, $10.55-$15.74 billion), higher in men than in women. Hyperlipidemia significantly increased medical expenditures and the increase was higher in people with CVD than without. The information on estimated expenditures could be used to evaluate and develop effective programs for CVD prevention.

  1. Expenditures of medicine use in hypertensive/diabetic elderly and physical activity and engagement in walking: cross secctional analysis of SABE Survey.

    PubMed

    Bueno, Denise Rodrigues; de Fátima Nunes Marucci, Maria; Gobbo, Luis Alberto; de Almeida-Roediger, Manuela; de Oliveira Duarte, Yeda Aparecida; Lebrão, Maria Lucia

    2017-03-20

    The literature shows the inverse association between physical activity level (PAL) and chronic diseases that have a significant burden over health care costs. However, in upper-middle income countries and in elderly population this information are scarce. To describe the annual drug expenditures for the hypertensive and diabetic elderly population in Brazil and to analyze the association with PAL and engagement in walking. This cross sectional study is part of SABE Survey and comprised 806 hypertensive and/or diabetic elderly (≥60 years old). The annual expenditures of medicine use was estimated for all medications for hypertension and/or diabetes they were taking. The PAL was considered insufficient when moderate physical activity was <150 min/week or vigorous physical activity was < 75 min/week. Engagement in walking was considered by at least 1 day a week. All expenditures were presented through the descriptive values (in American Dollars US$) according PAL and engagement in walking. The association analysis between annual expenditures, PAL and engagement in walking were performed by multiple logistic regression models adjusted for gender, age and body mass index. The average annual cost was higher in diabetic and insufficient physically activity elderly. The 1-year estimated.cost was US$ 73386,09 and 295% higher in insufficiently physically active. Older people who reported not walking had a higher risk to higher annual expenditures of medicine use (OR = 1.57, 95% CI 1.03-2.40). The annual expenditures of medicine use for controlling hypertension and diabetes of Brazilian elderly were higher and inversely associated with physical activity level and engagement in walking.

  2. Validation of dietary applications of Household Consumption and Expenditures Surveys (HCES) against a 24-hour recall method in Uganda.

    PubMed

    Dary, Omar; Jariseta, Zo Rambeloson

    2012-09-01

    The benefits of food fortification depend on the proportion of the population that uses the fortified food (coverage), the amount of the food being consumed, and the additional content of micronutrients in the food. Coverage and amounts consumed can be determined by 24-hour recall or Food Frequency Questionnaires (FFQs). However, these methods are rarely applied. Secondary analysis of data from Household Consumption and Expenditures Surveys (HCES) can be used for these purposes; however, such data analysis has not been validated. To compare the results of HCES and 24-hour recall for estimating the consumption profile of potential fortification vehicles in Uganda. Food intake estimates for 24- to 59-month-old children and 15- to 49-year-old women derived from a one-day 24-hour recall carried out in Uganda (Kampala, North, and Southwest) were compared with data from two HCES (2006, nationwide, and 2008, coupled with the 24-hour recall). The analyzed foods were vegetable oil, sugar, wheat flour, maize flour, and rice. Food consumption estimates calculated from HCES may be less accurate than estimates derived by 24-hour recall. Nevertheless, the HCES results are sensitive enough to differentiate consumption patterns among population strata. In Uganda, HCES predicted proportion of the population that consumes the foods, and approximated intakes of main food vehicles by the "observed" consumers (those who reported using the foods), although estimates for the latter were lower for wheat flour and rice. HCES data offer the basic information needed to provide a rationale for, and help design, food fortification programs. Individual intake surveys are still needed, however, to assess intrahousehold use of foods.

  3. Health care utilisation and out-of-pocket expenditure associated with back pain: a nationally representative survey of Australian women.

    PubMed

    Kirby, Emma R; Broom, Alex F; Sibbritt, David W; Refshauge, Kathryn M; Adams, Jon

    2013-01-01

    Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. Survey of 1,310 women (response rate 80.9%) who reported seeking help for back pain from the '1946-51 cohort' of the Australian Longitudinal Study on Women's Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0) different health care practitioners, and had, on average, 12.2 (SD = 9.7) discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress) points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women's access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in excess of AU$1.4 billion, thus indicating the prominence of back pain as

  4. Health Care Utilisation and Out-of-Pocket Expenditure Associated with Back Pain: A Nationally Representative Survey of Australian Women

    PubMed Central

    Kirby, Emma R.; Broom, Alex F.; Sibbritt, David W.; Refshauge, Kathryn M.; Adams, Jon

    2013-01-01

    Background Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. Objective To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. Methods Survey of 1,310 women (response rate 80.9%) who reported seeking help for back pain from the ‘1946-51 cohort’ of the Australian Longitudinal Study on Women’s Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. Results In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0) different health care practitioners, and had, on average, 12.2 (SD = 9.7) discrete health care practitioner consultations for back pain. Average self-reported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. Conclusions Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress) points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women’s access to multiple providers. We extrapolate that for Australian working-age women, total out-of-pocket expenditure on back pain care per annum is in excess of AU$1

  5. Data collecting activities of the 'Outlook for Space' Panel. [information sources for technological forecasting survey

    NASA Technical Reports Server (NTRS)

    Stroud, W. G.

    1977-01-01

    The paper describes the work of the 'Outlook for Space' Panel, a NASA-wide study group concerned with the role space flight might play in American society during the years approaching 2000. The study considers the progression of projects from 'could do' (for which capability exists), to 'should do' (because of social benefits), to 'will do' (unknown at this time). Opinions as to objectives were solicited from NASA personnel, advisory committees, industrial organizations, and academic theoreticians. Poll data was examined. A large-scale survey of the attitudes of young people toward the future and space was also undertaken, and a complete matrix is presented of themes (such as production and management of food and forestry resources) and theme subcategory specific activities (for example, global crop production), versus the students' perceived areas of national interest or benefit (e.g., expansion of human knowledge).

  6. Data collecting activities of the 'Outlook for Space' Panel. [information sources for technological forecasting survey

    NASA Technical Reports Server (NTRS)

    Stroud, W. G.

    1977-01-01

    The paper describes the work of the 'Outlook for Space' Panel, a NASA-wide study group concerned with the role space flight might play in American society during the years approaching 2000. The study considers the progression of projects from 'could do' (for which capability exists), to 'should do' (because of social benefits), to 'will do' (unknown at this time). Opinions as to objectives were solicited from NASA personnel, advisory committees, industrial organizations, and academic theoreticians. Poll data was examined. A large-scale survey of the attitudes of young people toward the future and space was also undertaken, and a complete matrix is presented of themes (such as production and management of food and forestry resources) and theme subcategory specific activities (for example, global crop production), versus the students' perceived areas of national interest or benefit (e.g., expansion of human knowledge).

  7. Trends in health care expenditure in U.S. adults with diabetes: 2002-2011.

    PubMed

    Ozieh, Mukoso N; Bishu, Kinfe G; Dismuke, Clara E; Egede, Leonard E

    2015-10-01

    Direct medical cost of diabetes in the U.S. has been estimated to be 2.3 times higher relative to individuals without diabetes. This study examines trends in health care expenditures by expenditure category in U.S. adults with diabetes between 2002 and 2011. We analyzed 10 years of data representing a weighted population of 189,013,514 U.S. adults aged ≥18 years from the Medical Expenditure Panel Survey. We used a novel two-part model to estimate adjusted mean and incremental medical expenditures by diabetes status, while adjusting for demographics, comorbidities, and time. Relative to individuals without diabetes ($5,058 [95% CI 4,949-5,166]), individuals with diabetes ($12,180 [11,775-12,586]) had more than double the unadjusted mean direct expenditures over the 10-year period. After adjustment for confounders, individuals with diabetes had $2,558 (2,266-2,849) significantly higher direct incremental expenditures compared with those without diabetes. For individuals with diabetes, inpatient expenditures rose initially from $4,014 in 2002/2003 to $4,183 in 2004/2005 and then decreased continuously to $3,443 in 2010/2011, while rising steadily for individuals without diabetes. The estimated unadjusted total direct expenditures for individuals with diabetes were $218.6 billion/year and adjusted total incremental expenditures were approximately $46 billion/year. Our findings show that compared with individuals without diabetes, individuals with diabetes had significantly higher health expenditures from 2002 to 2011 and the bulk of the expenditures came from hospital inpatient and prescription expenditures. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  8. Nonresidential buildings energy consumption survey: 1979 consumption and expenditures. Part 2. Steam, fuel oil, LPG, and all fuels

    SciTech Connect

    Patinkin, L.

    1983-12-01

    This report presents data on square footage and on total energy consumption and expenditures for commercial buildings in the contiguous United States. Also included are detailed consumption and expenditures tables for fuel oil or kerosene, liquid petroleum gas (LPG), and purchased steam. Commercial buildings include all nonresidential buildings with the exception of those where industrial activities occupy more of the total square footage than any other type of activity. 7 figures, 23 tables.

  9. [Study on correction of data bias caused by different missing mechanisms in survey of medical expenditure among students enrolling in Urban Resident Basic Medical Insurance].

    PubMed

    Zhang, Haixia; Zhao, Junkang; Gu, Caijiao; Cui, Yan; Rong, Huiying; Meng, Fanlong; Wang, Tong

    2015-05-01

    The study of the medical expenditure and its influencing factors among the students enrolling in Urban Resident Basic Medical Insurance (URBMI) in Taiyuan indicated that non response bias and selection bias coexist in dependent variable of the survey data. Unlike previous studies only focused on one missing mechanism, a two-stage method to deal with two missing mechanisms simultaneously was suggested in this study, combining multiple imputation with sample selection model. A total of 1 190 questionnaires were returned by the students (or their parents) selected in child care settings, schools and universities in Taiyuan by stratified cluster random sampling in 2012. In the returned questionnaires, 2.52% existed not missing at random (NMAR) of dependent variable and 7.14% existed missing at random (MAR) of dependent variable. First, multiple imputation was conducted for MAR by using completed data, then sample selection model was used to correct NMAR in multiple imputation, and a multi influencing factor analysis model was established. Based on 1 000 times resampling, the best scheme of filling the random missing values is the predictive mean matching (PMM) method under the missing proportion. With this optimal scheme, a two stage survey was conducted. Finally, it was found that the influencing factors on annual medical expenditure among the students enrolling in URBMI in Taiyuan included population group, annual household gross income, affordability of medical insurance expenditure, chronic disease, seeking medical care in hospital, seeking medical care in community health center or private clinic, hospitalization, hospitalization canceled due to certain reason, self medication and acceptable proportion of self-paid medical expenditure. The two-stage method combining multiple imputation with sample selection model can deal with non response bias and selection bias effectively in dependent variable of the survey data.

  10. Health Expenditure and All-Cause Mortality in the 'Galaxy' of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis.

    PubMed

    Golinelli, Davide; Toscano, Fabrizio; Bucci, Andrea; Lenzi, Jacopo; Fantini, Maria Pia; Nante, Nicola; Messina, Gabriele

    2017-08-21

    The sustainability of healthcare systems is a topic of major interest. During periods of economic instability, policy makers typically reallocate resources and execute linear cuts in different areas of public spending, including healthcare. The aim of this paper was to examine whether and how per capita public healthcare expenditure (PHE) in the Italian regions was related to the all-cause mortality rate (MR) between 1999 and 2013 and to determine which expenditure item most affected mortality in the short and very short term. We conducted a pooled cross-sectional time series study. Secondary data were extracted from 'Health for All', a database released periodically by the Italian National Institute of Statistics. PHE is subdivided into directly provided services (DPS), pharmaceutical care, general practitioner care, specialist medical care, privately delivered hospital care, other privately delivered medical services, and psychiatric support and rehabilitation. We used a fixed-effects regression to assess the effects of PHE items on the MR after controlling for a number of socioeconomic and supply variables. Higher spending on DPS was associated with a lower MR. Other expenditure variables were not significantly associated with the MR. The results highlight the importance of medical services and goods provided directly by public services (i.e. hospital-based general and specialized wards and offices, emergency departments, etc.). DPS represents the driving force of the system and should be considered a determinant of the health of the Italian population. Our results suggest that the context and financing methods of a healthcare system should be carefully analysed before linear cuts are made or resources are reallocated.

  11. The role of general practitioners in medical school admission interview panels in the UK (2012-2014): a national survey.

    PubMed

    Rashid, Mohammed Ahmed; Benson, John

    2016-07-01

    Recent primary care workforce pressures in the UK have prompted national reviews. Recommendations to increase the proportion of medical students entering general practice have led to interest in the role of medical schools in career choices. This study sought to identify the career backgrounds of admissions leads at UK medical schools and the proportion of general practitioners on admission interview panels. A national survey using a proforma circulated to all UK medical school admission leads via the Medical Schools Council. UK medical schools. UK medical schools. Prevalence of assessment lead and panel members' professional groups. Responses were received from 18 (54.5%) of the 33 UK medical schools. General practitioners led the admissions process in 2 (11%) of these. Fifteen schools were able to furnish detailed data about interview panel composition, having held a combined total of 876 distinct interview panels during the 2012-2013 and 2013-2014 admission years; 683 panels (78%) included a secondary care physician, but only 261 panels (29.8%) included general practitioners. General practitioner representation ranged from 3.8% to 100% of individual schools' panels; however, eight schools (about half the respondents able to offer numbers of participants) omitted general practitioner representation in more than half of their interview panels. Despite the UK policy focus to increase the proportion of medical students becoming general practitioners, doctors from this clinical background are not proportionately represented as admissions leads or on admissions interview panels. Increasing general practitioner involvement in admissions processes may be one way in which medical schools can support general practice as a career aspiration.

  12. Patterns of Eye Care Use and Expenditures Among Children with Diagnosed Eye Conditions

    PubMed Central

    Ganz, Michael; Xuan, Ziming; Hunter, David G.

    2007-01-01

    Purpose: Little is known about the use and expenditure patterns of children's eye care services and about possible disparities in care for those children. This report describes the use and expenditure patterns of eye and non-eye care services for children < 18 years old in the United States. Methods: Use and expenditure levels were estimated using self-reported information from the nationally representative Medical Expenditure Panel Surveys for 48,304 members of randomly selected households in the United States that were < 18 years old from 1996 to 2001. Means presented for children with and without diagnosed eye conditions were adjusted for child and family characteristics using generalized linear models. Results: Children with diagnosed eye conditions had higher use and expenditure levels than children without such conditions. Families of children with diagnosed eye conditions incurred higher out-of-pocket expenditures. Black children and children living below 400% of the federal poverty level had lower use and expenditure levels indicating they received fewer and less intensive services. Conclusions: Children with diagnosed eye conditions experienced higher overall use of health care. Certain groups of children appear to be underserved. To plan for future delivery of children's eye and vision care services and to assess progress toward Healthy People 2010 goals, estimates of use and expenditure patterns stratified by socioeconomic factors will be needed. PMID:17434774

  13. Utilization and expenditures on chiropractic care in the United States from 1997 to 2006.

    PubMed

    Davis, Matthew A; Sirovich, Brenda E; Weeks, William B

    2010-06-01

    To investigate national utilization and expenditures on chiropractic care between 1997 and 2006. The nationally representative Medical Expenditure Panel Survey (MEPS). We performed descriptive analyses and generated national estimates from data obtained from U.S. adult (>or=18 years) MEPS respondents who reported having visited a chiropractor (annual sample size between 789 and 1,082). For each year, we examined the estimated total national expenditure, the total number of U.S. adults who received chiropractic care, the total number of ambulatory visits to U.S. chiropractors, and the inflation-adjusted charges and expenditures per U.S. adult chiropractic patient. The total number of U.S. adults who visited a chiropractor increased 57 percent from 7.7 million in 2000 to 12.1 million in 2003. From 1997 to 2006, the inflation-adjusted national expenditures on chiropractic care increased 56 percent from U.S.$3.8 billion to U.S.$5.9 billion. Inflation-adjusted total mean expenditures per patient and expenditures per office visit remained unchanged. The large increase in U.S. adult expenditures on chiropractic care between 1997 and 2006 was due to a 57 percent increase in the total number of U.S. adult chiropractic patients that occurred from 2000 to 2003. From 2003 to 2006, the total number of U.S. adult chiropractic patients has remained stable.

  14. Utilization and Expenditures on Chiropractic Care in the United States from 1997 to 2006

    PubMed Central

    Davis, Matthew A; Sirovich, Brenda E; Weeks, William B

    2010-01-01

    Objective To investigate national utilization and expenditures on chiropractic care between 1997 and 2006. Data Source The nationally representative Medical Expenditure Panel Survey (MEPS). Study Design We performed descriptive analyses and generated national estimates from data obtained from U.S. adult (≥18 years) MEPS respondents who reported having visited a chiropractor (annual sample size between 789 and 1,082). For each year, we examined the estimated total national expenditure, the total number of U.S. adults who received chiropractic care, the total number of ambulatory visits to U.S. chiropractors, and the inflation-adjusted charges and expenditures per U.S. adult chiropractic patient. Principal Findings The total number of U.S. adults who visited a chiropractor increased 57 percent from 7.7 million in 2000 to 12.1 million in 2003. From 1997 to 2006, the inflation-adjusted national expenditures on chiropractic care increased 56 percent from U.S.$3.8 billion to U.S.$5.9 billion. Inflation-adjusted total mean expenditures per patient and expenditures per office visit remained unchanged. Conclusion The large increase in U.S. adult expenditures on chiropractic care between 1997 and 2006 was due to a 57 percent increase in the total number of U.S. adult chiropractic patients that occurred from 2000 to 2003. From 2003 to 2006, the total number of U.S. adult chiropractic patients has remained stable. PMID:20002763

  15. Dynamics of Adult Participation in Part-Time Education and Training: Results from the British Household Panel Survey

    ERIC Educational Resources Information Center

    Macleod, Flora; Lambe, Paul

    2008-01-01

    In this paper we analyse the dynamics of adult participation in part-time education and training throughout the 90s and into the 2000s using data from 14 waves (1992-2005) of the British Household Panel Survey (BHPS). We study the volume (stocks) of participation and non-participation and the gross flows between states. This analysis provides a…

  16. Dynamics of Adult Participation in Part-Time Education and Training: Results from the British Household Panel Survey

    ERIC Educational Resources Information Center

    Macleod, Flora; Lambe, Paul

    2008-01-01

    In this paper we analyse the dynamics of adult participation in part-time education and training throughout the 90s and into the 2000s using data from 14 waves (1992-2005) of the British Household Panel Survey (BHPS). We study the volume (stocks) of participation and non-participation and the gross flows between states. This analysis provides a…

  17. Distinguishing the Influences of Father's and Mother's Involvement on Adolescent Academic Achievement: Analyses of Taiwan Education Panel Survey Data

    ERIC Educational Resources Information Center

    Hsu, Hsien-Yuan; Zhang, Dalun; Kwok, Oi-Man; Li, Yan; Ju, Song

    2011-01-01

    Using a sample drawn from Taiwan, this study evaluated the role of mother and father involvement in adolescent academic achievement. The participants were drawn from the Taiwan Education Panel Survey (TEPS) and consisted of 8,108 adolescents who studied seventh grade in 2001. Father and mother involvement related to academic achievement was…

  18. Radiation dose survey in a paediatric cardiac catheterisation laboratory equipped with flat-panel detectors.

    PubMed

    Dragusin, O; Gewillig, M; Desmet, W; Smans, K; Struelens, L; Bosmans, H

    2008-01-01

    Flat-panel X-ray detectors for fluoroscopy represent a modern imaging equipment that is being implemented in paediatric cardiac catheterisation laboratories. Infants and children represent a group of patients with a high radiosensitivity. A survey of 273 (126 diagnostic and 147 therapeutic) paediatric catheterisations was performed to investigate the radiation doses delivered by the new X-ray system. Statistical parameters (75th, 50th and 25th percentiles) of dose-area product (DAP) and fluoroscopy time are reported for patients divided into six age groups: 0-30 d, >1-12 m, >1-3, >3-5, >5-10 and >10-15 y. For accurate risk estimation, effective dose (E) has been determined for all patients using the PCXMC software. For diagnostic procedures, the third quartile of E ranges from 11.3 mSv for newborns to 7 mSv for children of 10-15 y. Therapeutic procedures are more complex than diagnostic. Consequently, the third quartile of E is 22.6 mSv (0-30 d), 18.6 (>1-12 m), 13.3 (>1-3 y), 21.5 (>3-5 y), 17.8 (>5-10 y) and 34.1 mSv (>10-15 y). Dose conversion factors, which relate the DAP and E, have been estimated for each age group. The results of this study may serve as a first step in the optimisation process, in order to make full use of the dose reduction potential of flat-panel systems.

  19. Patient-Centered Care Categorization of U.S. Health Care Expenditures

    PubMed Central

    Conway, Patrick; Goodrich, Kate; Machlin, Steven; Sasse, Benjamin; Cohen, Joel

    2011-01-01

    Objective To categorize national medical expenditures into patient-centered categories. Data Sources The 2007 Medical Expenditure Panel Survey (MEPS), a nationally representative annual survey of the civilian noninstitutionalized population. Study Design Descriptive statistics categorizing expenditures into seven patient-centered care categories: chronic conditions, acute illness, trauma/injury or poisoning, dental, pregnancy/birth-related, routine preventative health care, and other. Data Collection Methods MEPS cohort. Principal Findings Nearly half of expenditures were for chronic conditions. The remaining expenditures were as follows: acute illness (25 percent), trauma/poisoning (8 percent), dental (7 percent), routine preventative health care (6 percent), pregnancy/birth-related (4 percent), and other (3 percent). Hospital-based expenditures accounted for the majority for acute illness, trauma/injury, and pregnancy/birth and over a third for chronic conditions. Conclusions This patient-centered viewpoint may complement other methods to examine health care expenditures and may better represent how patients interact with the health care system and expend resources. PMID:21091472

  20. Health care expenditures associated with pediatric pain-related conditions in the United States.

    PubMed

    Groenewald, Cornelius B; Wright, Davene R; Palermo, Tonya M

    2015-05-01

    The primary objective of this study was to assess the impact of pediatric pain-related conditions on health care expenditures. We analyzed data from a nationally representative sample of 6- to 17-year-old children captured in the 2007 National Health Interview Survey and 2008 Medical Expenditure Panel Survey. Health care expenditures of children with pain-related conditions were compared with those of children without pain-related conditions. Pain-related conditions were associated with incremental health care expenditures of $1339 (95% confidence interval [CI], $248-$2447) per capita. Extrapolated to the nation, pediatric pain-related conditions were associated with $11.8 billion (95% CI, $2.18-$21.5 billion) in total incremental health care expenditures. The incremental health care expenditures associated with pediatric pain-related conditions were similar to those of attention deficit and hyperactivity disorder ($9.23 billion; 95% CI, $1.89-$18.1 billion), but more than those associated with asthma ($5.35 billion; 95% CI, $0-$12.3 billion) and obesity ($0.73 billion; 95% CI, $6.28-$8.81 billion). Health care expenditures for pediatric pain-related conditions exert a considerable economic burden on society. Efforts to prevent and treat pediatric pain-related conditions are urgently needed.

  1. Inadequate physical activity and health care expenditures in the United States.

    PubMed

    Carlson, Susan A; Fulton, Janet E; Pratt, Michael; Yang, Zhou; Adams, E Kathleen

    2015-01-01

    This study estimates the percentage of health care expenditures in the non-institutionalized United States (U.S.) adult population associated with levels of physical activity inadequate to meet current guidelines. Leisure-time physical activity data from the National Health Interview Survey (2004-2010) were merged with health care expenditure data from the Medical Expenditure Panel Survey (2006-2011). Health care expenditures for inactive (i.e., no physical activity) and insufficiently active adults (i.e., some physical activity but not enough to meet guidelines) were compared with active adults (i.e., ≥150minutes/week moderate-intensity equivalent activity) using an econometric model. Overall, 11.1% (95% CI: 7.3, 14.9) of aggregate health care expenditures were associated with inadequate physical activity (i.e., inactive and insufficiently active levels). When adults with any reported difficulty walking due to a health problem were excluded, 8.7% (95% CI: 5.2, 12.3) of aggregate health care expenditures were associated with inadequate physical activity. Increasing adults' physical activity to meet guidelines may reduce U.S. health care expenditures.

  2. Health care expenditures associated with pediatric pain-related conditions in the United States

    PubMed Central

    Groenewald, Cornelius B.; Wright, Davene R.; Palermo, Tonya M.

    2015-01-01

    The primary objective of this study was to assess the impact of pediatric pain-related conditions on health care expenditures. We analyzed data from a nationally representative sample of 6- to 17-year-old children captured in the 2007 National Health Interview Survey and 2008 Medical Expenditure Panel Survey. Health care expenditures of children with pain-related conditions were compared with those of children without pain-related conditions. Pain-related conditions were associated with incremental health care expenditures of $1339 (95% confidence interval [CI], $248-$2447) per capita. Extrapolated to the nation, pediatric pain-related conditions were associated with $11.8 billion (95% CI, $2.18-$21.5 billion) in total incremental health care expenditures. The incremental health care expenditures associated with pediatric pain-related conditions were similar to those of attention deficit and hyperactivity disorder ($9.23 billion; 95% CI, $1.89-$18.1 billion), but more than those associated with asthma ($5.35 billion; 95% CI, $0-$12.3 billion) and obesity ($0.73 billion; 95% CI, $6.28-$8.81 billion). Health care expenditures for pediatric pain-related conditions exert a considerable economic burden on society. Efforts to prevent and treat pediatric pain-related conditions are urgently needed. PMID:25734992

  3. A basket two-part model to analyze medical expenditure on interdependent multiple sectors.

    PubMed

    Sugawara, Shinya; Wu, Tianyi; Yamanishi, Kenji

    2016-09-01

    This study proposes a novel statistical methodology to analyze expenditure on multiple medical sectors using consumer data. Conventionally, medical expenditure has been analyzed by two-part models, which separately consider purchase decision and amount of expenditure. We extend the traditional two-part models by adding the step of basket analysis for dimension reduction. This new step enables us to analyze complicated interdependence between multiple sectors without an identification problem. As an empirical application for the proposed method, we analyze data of 13 medical sectors from the Medical Expenditure Panel Survey. In comparison with the results of previous studies that analyzed the multiple sector independently, our method provides more detailed implications of the impacts of individual socioeconomic status on the composition of joint purchases from multiple medical sectors; our method has a better prediction performance.

  4. Maternal Depressive Symptoms and Healthcare Expenditures for Publicly Insured Children with Chronic Health Conditions

    PubMed Central

    Beil, Heather; Beeber, Linda S.

    2017-01-01

    This study estimated the prevalence of maternal depressive symptoms and tested associations between maternal depressive symptoms and healthcare utilization and expenditures among United States publicly insured children with chronic health conditions (CCHC). A total of 6,060 publicly insured CCHC from the 2004–2009 Medical Expenditure Panel Surveys were analyzed using negative binomial models to compare healthcare utilization for CCHC of mothers with and without depressive symptoms. Annual healthcare expenditures for both groups were compared using a two-part model with a logistic regression and generalized linear model. The prevalence of depressive symptoms among mothers with CCHC was 19 %. There were no differences in annual healthcare utilization for CCHC of mothers with and without depressive symptoms. Maternal depressive symptoms were associated with greater odds of ED expenditures [odds ratio (OR) 1.26; 95 % CI 1.03–1.54] and lesser odds of dental expenditures (OR 0.81; 95 % CI 0.66–0.98) and total expenditures (OR 0.71; 95 % CI 0.51–0.98). Children of symptomatic mothers had lower predicted outpatient expenditures and higher predicted expenditures for total health, prescription medications, dental care; and office based, inpatient and ED visits. Mothers with CCHC were more likely to report depressive symptoms than were mothers with children without chronic health conditions. There were few differences in annual healthcare utilization and expenditures between CCHC of mothers with and without depressive symptoms. However, having a mother with depressive symptoms was associated with higher ED expenditures and higher predicted healthcare expenditures in a population of children who comprise over three-fourths of the top decile of Medicaid spending. PMID:25047785

  5. Healthcare expenditures for autism during times of school transition: some vulnerable families fall behind.

    PubMed

    Thomas, Kathleen C; Parish, Susan L; Williams, Christianna S

    2014-10-01

    This study explores the association between school transition age and healthcare expenditures for children with autism. The paper explores three questions: (1) What is the composition of services overall and paid out-of-pocket and does it differ at transition? (2) Do transition age children have higher total and out-of-pocket health care expenditures than other children with autism? (3) Does the effect of transition differ for vulnerable families who often experience problems accessing care? Pooled data from the Medical Expenditure Panel Survey 2000-2009 on children under 21 years of age with autism (n = 337) were used to describe expenditures for services by source of payment and estimate two-part models of total and out-of-pocket expenditures as a function of child transition age (5, 6, 11, 14) and other child and family characteristics. Median total annual expenditures for health care among children with autism are $2,400; median out-of-pocket expenditures are $390. The majority of total expenditures are devoted to outpatient medical services; nearly half of family out-of-pocket spending is devoted to prescription medications. When children are transition age, a larger proportion of both overall and out-of-pocket expenditures go toward ambulatory therapy, while a smaller proportion of out-of-pocket expenditures are devoted to prescription medications compared to children of other ages. Transition age children from vulnerable families experience a drop in expenditures that families with more resources fill through out-of-pocket spending. Findings raise questions about the dimensions of care for children with autism. Schools may be better positioned than health insurance to foster continuity of care.

  6. Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study

    PubMed Central

    Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

    2015-01-01

    Background Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. Objective The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Methods Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. Results The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. Conclusions We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties. PMID:27227131

  7. Estimating population food and nutrient exposure: a comparison of store survey data with household panel food purchases.

    PubMed

    Eyles, Helen; Neal, Bruce; Jiang, Yannan; Ni Mhurchu, Cliona

    2016-05-28

    Population exposure to food and nutrients can be estimated from household food purchases, but store surveys of foods and their composition are more available, less costly and might provide similar information. Our aim was to compare estimates of nutrient exposure from a store survey of packaged food with those from household panel food purchases. A cross-sectional store survey of all packaged foods for sale in two major supermarkets was undertaken in Auckland, New Zealand, between February and May 2012. Longitudinal household food purchase data (November 2011 to October 2012) were obtained from the nationally representative, population-weighted New Zealand Nielsen HomeScan® panel. Data on 8440 packaged food and non-alcoholic beverage products were collected in the store survey. Food purchase data were available for 1229 households and 16 812 products. Store survey data alone produced higher estimates of exposure to Na and sugar compared with estimates from household panel food purchases. The estimated mean difference in exposure to Na was 94 (95 % CI 72, 115) mg/100 g (20 % relative difference; P<0·01), to sugar 1·6 (95 % CI 0·8, 2·5) g/100 g (11 %; P<0·01), to SFA -0·3 (95 % CI -0·8, 0·3) g/100 g (6 %; P=0·3) and to energy -18 (-71, 35) kJ/100 g (2 %; P=0·51). Compared with household panel food purchases, store survey data provided a reasonable estimate of average population exposure to key nutrients from packaged foods. However, caution should be exercised in using such data to estimate population exposure to Na and sugar and in generalising these findings to other countries, as well as over time.

  8. Trade as a structural driver of dietary risk factors for noncommunicable diseases in the Pacific: an analysis of household income and expenditure survey data

    PubMed Central

    2014-01-01

    Background Noncommunicable diseases are a health and development challenge. Pacific Island countries are heavily affected by NCDs, with diabetes and obesity rates among the highest in the world. Trade is one of multiple structural drivers of NCDs in the Pacific, but country-level data linking trade, diets and NCD risk factors are scarce. We attempted to illustrate these links in five countries. The study had three objectives: generate cross-country profiles of food consumption and expenditure patterns; highlight the main ‘unhealthy’ food imports in each country to inform targeted policymaking; and demonstrate the potential of HCES data to analyze links between trade, diets and NCD risk factors, such as obesity. Methods We used two types of data: obesity rates as reported by WHO and aggregated household-level food expenditure and consumption from Household Income and Expenditure Survey reports. We classified foods in HIES data into four categories: imported/local, ‘unhealthy’/’healthy’, nontraditional/traditional, processed/unprocessed. We generated cross-country profiles and cross-country regressions to examine the relationships between imported foods and unhealthy foods, and between imported foods and obesity. Results Expenditure on imported foods was considerable in all countries but varied across countries, with highest values in Kiribati (53%) and Tonga (52%) and lowest values in Solomon Islands and Vanuatu (30%). Rice and sugar accounted for significant amounts of imported foods in terms of expenditure and calories, ranking among the top 3 foods in most countries. We found significant or near-significant associations in expenditure and caloric intake between ‘unhealthy’ and imported foods as well as between imported foods and obesity, though inferences based on these associations should be made carefully due to data constraints. Conclusions While additional research is needed, this study supports previous findings on trade as a structural

  9. Widows' land security in the era of HIV/AIDS: panel survey evidence from Zambia.

    PubMed

    Chapoto, Antony; Jayne, T S; Mason, Nicole M

    2011-01-01

    In areas of Africa hard hit by HIV/AIDS, there are growing concerns that many women lose access to land after the death of their husbands. However, there remains a dearth of quantitative evidence on the proportion of widows who lose access to their deceased husband's land, whether they lose all or part of that land, and whether there are factors specific to the widow, her family, or the broader community that influence her ability to maintain rights to land. This study examines these issues using average treatment effects models with propensity score matching applied to a nationally representative panel data of 5,342 rural households surveyed in 2001 and 2004. Results are highly variable, with roughly a third of households incurring the death of a male household head controlling less than 50% of the land they had prior to their husband's death, while over a quarter actually controlled as much or even more land than while their husbands were alive. Widows who were in relatively wealthy households prior to their husband's death lose proportionately more land than widows in households that were relatively poor. Older widows and widows related to the local headman enjoy greater land security. Women in matrilineal inheritance areas were no less likely to lose land than women in patrilineal areas.

  10. Employment transitions and mental health: an analysis from the British household panel survey

    PubMed Central

    Thomas, C.; Benzeval, M.; Stansfeld, S.

    2005-01-01

    Study objective: To describe the impact of changes between employment and various forms of non-employment, and vice versa, on the psychological wellbeing of men and of women. Design: Separate multivariate models for men and for women were constructed to study the association between employment transitions and episodes of psychological distress (general health questionnaire). Participants: 13 359 employment transitions from 5092 people aged 16–74 years in the British household panel survey from 1991 to 1998. Main results: Transitions from paid employment to either unemployment or long term sick leave were associated with increased psychological distress for both men and women. Starting maternity leave or staying home to look after the family were also associated with psychological distress for women. Transitions from these roles to formal employment resulted in an improvement in mental health. There was some evidence that the effects were felt most strongly within six months of the transition. Conclusions: This paper provides further evidence that movements between paid employment and various forms of non-employment, in addition to unemployment, have an impact on mental health. The emphasis on transitions between a full range of employment states for both men and women from a large population based longitudinal study and a comparison of the relative magnitude of effects are unique features of this analysis. Interventions are suggested to minimise the psychological distress associated with transitions. PMID:15709086

  11. The relationship between gambling expenditure, socio-demographics, health-related correlates and gambling behaviour-a cross-sectional population-based survey in Finland.

    PubMed

    Castrén, Sari; Kontto, Jukka; Alho, Hannu; Salonen, Anne H

    2017-07-01

    To investigate gambling expenditure and its relationship with socio-demographics, health-related correlates and past-year gambling behaviour. Cross-sectional population survey. Population-based survey in Finland. Finnish people aged 15-74 years drawn randomly from the Population Information System. The participants in this study were past-year gamblers with gambling expenditure data available (n = 3251, 1418 women and 1833 men). Expenditure shares, means of weekly gambling expenditure (WGE, €) and monthly gambling expenditure as a percentage of net income (MGE/NI, %) were calculated. The correlates used were perceived health, smoking, mental health [Mental Health Inventory (MHI)-5], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)-C], game types, gambling frequency, gambling mode and gambling severity [South Oaks Gambling Screen (SOGS)]. Gender (men versus women) was found to be associated significantly with gambling expenditure, with exp(β) = 1.40, 95% confidence interval (CI) = 1.29, 1.52 and P < 0.005 for WGE, and exp(β) = 1.39, 95% CI = 1.27, 1.51 and P < 0.005 for MGE/NI. All gambling behaviour correlates were associated significantly with WGE and MGE/NI: gambling frequency (several times a week versus once a month/less than monthly, exp(β) = 30.75, 95% CI = 26.89, 35.17 and P < 0.005 for WGE, and exp(β) = 31.43, 95% CI = 27.41, 36.03 and P < 0.005 for MGE/NI), gambling severity (probable pathological gamblers versus non-problem gamblers, exp(β) = 2.83, 95% CI = 2.12, 3.77 and P < 0.005 for WGE, and exp(β) = 2.67, 95% CI = 2.00, 3.57 and P < 0.005 for MGE/NI) and on-line gambling (on-line and land-based versus land-based only, exp(β) = 1.35, 95% CI = 1.24, 1.47 and P < 0.005 for WGE, and exp(β) = 1.35, 95% CI = 1.24, 1.47 and P < 0.005 for MGE/NI). In Finland, male gender is associated significantly with both weekly gambling expenditure and monthly gambling expenditure related to net income. People in Finland with lower

  12. Financial burden of household out-of-pocket expenditures for prescription drugs: cross-sectional analysis based on national survey data.

    PubMed

    McLeod, Logan; Bereza, Basil G; Shim, Minsup; Grootendorst, Paul

    2011-01-01

    Commentaries on the adequacy of insurance coverage for prescription drugs available to Canadians have emphasized differences in the coverage provided by different provincial governments. Less is known about the actual financial burden of prescription drug spending and how this burden varies by province of residence, affluence and source of primary drug coverage. We used data from a nationally representative household expenditure survey to analyze the financial burden of prescription drugs. We focused on the drug budget share (defined as the share of the household budget spent on prescription drugs), considering how it varied by province, total household budget and likely primary source of drug insurance coverage (i.e., provincial government plan for senior citizens, social assistance plan or private coverage). We examined both "typical" households (at the median of the distribution of the drug budget share) and households with relatively large shares (in the top 5%). Finally, we estimated the percentage of households with catastrophic drug expenditures (defined as a drug budget share of 10% or more) and the average catastrophic drug expenditures. Senior, social assistance and general population households accounted for 21.1%, 8.9% and 69.9% of the sample of 14,430 respondents to the 2006 Survey of Household Spending, respectively. The median drug budget share in Canada was 1.1% for senior households (range 0.4% [Ontario] to 3.6% [Saskatchewan]) and 0.1% for both social assistance households and general population households, with little appreciable variation across provinces for these latter 2 categories. The 95th percentile drug budget share in Canada was 7.4% for senior households (range 3.5% [Ontario] to 12.7% [Saskatchewan]), 5.4% for social assistance households (range 2.3% [British Columbia] to 13.0% [Prince Edward Island]) and 2.6% for general population households (range 2.1% [Ontario] to 5.4% [Prince Edward Island]). The interprovincial range of the 95th

  13. Cross-Sectional and Panel Data Analyses of an Incompletely Observed Variable Derived from the Nonrandomized Method for Surveying Sensitive Questions

    ERIC Educational Resources Information Center

    Yamaguchi, Kazuo

    2016-01-01

    This article describes (1) the survey methodological and statistical characteristics of the nonrandomized method for surveying sensitive questions for both cross-sectional and panel survey data and (2) the way to use the incompletely observed variable obtained from this survey method in logistic regression and in loglinear and log-multiplicative…

  14. The Impact of Health Insurance Programs on Out-of-Pocket Expenditures in Indonesia: An Increase or a Decrease?

    PubMed Central

    Aji, Budi; De Allegri, Manuela; Souares, Aurelia; Sauerborn, Rainer

    2013-01-01

    We used panel data from the Indonesian Family Life Survey to investigate the impact of health insurance programs on reducing out-of-pocket expenditures. We employed three linear panel data models, two of which accounted for endogeneity: pooled ordinary least squares (OLS), pooled two-stage least squares (2SLS) for instrumental variable (IV), and fixed effects (FE). The study revealed that two health insurance programs had a significantly negative impact on out-of-pocket expenditures by using IV estimates. In the IV model, Askeskin decreased out-of-pocket expenditures by 34% and Askes by 55% compared with non-Askeskin and non-Askes, respectively, while Jamsostek was found to bear a nonsignificant effect on out-of-pocket expenditures. In the FE model, only Askeskin had a significant negative effect with an 11% reduction on out-of-pocket expenditures. This study showed that two large existing health insurance programs in Indonesia, Askeskin and Askes, effectively reduced household out-of-pocket expenditures. The ability of programs to offer financial protection by reducing out-of-pocket expenditures is likely to be a direct function of their benefits package and co-payment policies. PMID:23873263

  15. The impact of health insurance programs on out-of-pocket expenditures in Indonesia: an increase or a decrease?

    PubMed

    Aji, Budi; De Allegri, Manuela; Souares, Aurelia; Sauerborn, Rainer

    2013-07-18

    We used panel data from the Indonesian Family Life Survey to investigate the impact of health insurance programs on reducing out-of-pocket expenditures. We employed three linear panel data models, two of which accounted for endogeneity: pooled ordinary least squares (OLS), pooled two-stage least squares (2SLS) for instrumental variable (IV), and fixed effects (FE). The study revealed that two health insurance programs had a significantly negative impact on out-of-pocket expenditures by using IV estimates. In the IV model, Askeskin decreased out-of-pocket expenditures by 34% and Askes by 55% compared with non-Askeskin and non-Askes, respectively, while Jamsostek was found to bear a nonsignificant effect on out-of-pocket expenditures. In the FE model, only Askeskin had a significant negative effect with an 11% reduction on out-of-pocket expenditures. This study showed that two large existing health insurance programs in Indonesia, Askeskin and Askes, effectively reduced household out-of-pocket expenditures. The ability of programs to offer financial protection by reducing out-of-pocket expenditures is likely to be a direct function of their benefits package and co-payment policies.

  16. [Socioeconomic differentials in health and health related behaviors: findings from the Korea Youth Panel Survey].

    PubMed

    Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song

    2005-11-01

    This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health

  17. Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea.

    PubMed

    Kim, Younhee; Yang, Bongmin

    2011-05-01

    The compositions of health expenditures by households in South Korea with and without catastrophic health expenditures were compared. Also, relationships between catastrophic health expenditures and household incomes, and between such health expenditures and expenditure patterns were explored. Data from the 2006 South Korean Household Income & Expenditure Survey, a representative survey of 90,696 households were analyzed. We used a double-hurdle model to assess each income source and expenditure category. The independent variable was the presence of catastrophic health expenditure. After adjusting for household characteristics, the results showed that earned, business, and property incomes were significantly lower, but transfer and loan incomes were significantly higher in households with catastrophic health expenditures than in those without such health expenditures. All consumption categories, other than health expenditure, were significantly lower in households with catastrophic health expenditures than in those without catastrophic health expenditures. This suggests that households with catastrophic health expenditures faced challenges in offset by the potentially excessive health expenditure and may have been obliged to reduce consumption of other items. The expansion of insurance coverage and lowering of out-of-pocket rates in the South Korean Health Insurance benefits could be a necessary first step in protecting households from the occurrence of health related economic catastrophes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  18. Health expenditure estimation and functional form: applications of the generalized gamma and extended estimating equations models.

    PubMed

    Hill, Steven C; Miller, G Edward

    2010-05-01

    Health-care expenditure regressions are used in a wide variety of economic analyses including risk adjustment and program and treatment evaluations. Recent articles demonstrated that generalized gamma models (GGMs) and extended estimating equations (EEE) models provide flexible approaches to deal with a variety of data problems encountered in expenditure estimation. To date there have been few empirical applications of these models to expenditures. We use data from the US Medical Expenditure Panel Survey to compare the bias, predictive accuracy, and marginal effects of GGM and EEE models with other commonly used regression models in a cross-validation study design. Health-care expenditure distributions vary in the degree of heteroskedasticity, skewness, and kurtosis by type of service and population. To examine the ability of estimators to address a range of data problems, we estimate models of total health expenditures and prescription drug expenditures for two populations, the elderly and privately insured adults. Our findings illustrate the need for researchers to examine their assumptions about link functions: the appropriate link function varies across our four distributions. The EEE model, which has a flexible link function, is a robust estimator that performs as well, or better, than the other models in each distribution.

  19. Dental care utilization and expenditures in children with special health care needs.

    PubMed

    Beil, Heather; Mayer, Michelle; Rozier, R Gary

    2009-09-01

    The authors compared children with special health care needs (CSHCN) and children without special health care needs (SHCN) with respect to the odds, amount and determinants of having any dental care and dental care expenditures. The authors assessed data from the 2004 Medical Expenditures Panel Survey, Agency for Healthcare Research and Quality, to identify a sample of 8,518 children aged 2 to 17 years. The authors used logistic regression to determine the effect of having SHCN on the probability of having any dental care expenditure, for total dental care expenditures and procedure-specific expenditures. They tested the modifying effect between CSHCN and other variables on the probability of having any dental care expenditure. Compared with children without SHCN, CSHCN did not differ in the probability (odds ratio = 0.91, 95 percent confidence interval [CI] = 0.76 to 1.09) or amount (beta = 30.17, 95 percent CI = -162.93 to 223.27) of total dental care expenditures. Likewise, CSHCN did not differ in their likelihood of having undergone a preventive, restorative, diagnostic or other procedure. Known determinants of dental care utilization did not modify the relationships between having SCHN and any dental care expenditure. Despite the reported difficulty in CSHCN's accessing dental care, the authors found that CSHCN had dental care utilization and expenditures that were comparable with those of children without SHCN. Furthermore, the association of CSHCN status and any dental care expenditure was not modified by known determinants of dental care utilization. Future research should focus on characterizing risk for dental disease among CSHCN more accurately and identifying factors that affect dental care utilization in CSHCN, including provider and parent characteristics. The study results highlight low rates of dental care utilization among all young children, including CSHCN. Efforts to increase dental care utilization among children are warranted and need to

  20. The Association Between Self-Rated Mental Health Status and Total Health Care Expenditure

    PubMed Central

    Nguyen, Muoi T.; Chan, Winnie Y.; Keeler, Courtney

    2015-01-01

    Abstract Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data. This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6). Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ2 tests and a 2-part model (logistics regression and generalized linear model regression for the first and second stages, respectively). Although predictive of any health expenditure, SRMH alone was not highly predictive of the dollar value of that health expenditure conditional on any spending. By comparison, the K6 measure was significantly and positively associated with the probability of any health expenditure as well as the dollar value of that spending. Taken together, both the K6 and SRMH measures suggest a positive relationship between poor mental health and the probability of any health expenditure and total expenditure conditional on any spending, even when adjusting for other confounding factors such as race/ethnicity, sex, age, educational attainment, insurance status, and some regional characteristics. Our results suggest that psychological distress and SRMH may represent potential pathways linking poor mental health to increased health care expenditure. Further research exploring the nuances of these relationships may aid researchers, practitioners, and policy makers in addressing issues of inflated health care expenditure in populations at risk for poor mental health. PMID:26334899

  1. Family Formation Processes: Assessing the Need for a New Nationally Representative Household Panel Survey in the United States

    PubMed Central

    Manning, Wendy D.

    2015-01-01

    The American family has undergone rapid transformation. Careful measurement attention to family formation is important because families are at the heart of numerous decisions, roles, and responsibilities with implications for understanding the well-being of families, adults and children. This paper considers whether there is a need for a new household panel study that addresses family formation. This paper consists of a review of the recent body of population-based, American surveys and finds a considerable gap in the ability to study the implications of families for the health and well-being of Americans. Earlier panel surveys used to assess family life anchored questions around marital events, but changes in family patterns require attention to a more diverse set of family forms. The paper concludes with recommendations for a multi-purpose panel study. The key challenge is to keep to pace with complexity and changes in American family life while at the same time maintaining a parsimonious set of survey questions. PMID:26612969

  2. Incremental and comparative health care expenditures for head and neck cancer in the United States.

    PubMed

    Dwojak, Sunshine M; Bhattacharyya, Neil

    2014-10-01

    Determine the incremental costs associated with head and neck cancer (HNCa) and compare the costs with other common cancers. Cross-sectional analysis of a healthcare expenditure database. The Medical Expenditure Panel Survey is a national survey of US households. All cases of HNCa were extracted for 2006, 2008, and 2010. The incremental expenditures associated with HNCa were determined by comparing the healthcare expenditures of individuals with HNCa to the population without cancer, controlling for age, sex, education, insurance status, marital status, geographic region, and comorbidities. Healthcare expenditures for HNCa were then compared to individuals with lung cancer and colon cancer to determine relative healthcare expenditures. An estimated 264,713 patients (annualized) with HNCa were identified. The mean annual healthcare expenditures per individual for HNCa were $23,408 ± $3,397 versus $3,860 ± $52 for those without cancer. The mean adjusted incremental cost associated with HNCa was $15,852 ± $3,297 per individual (P < .001). Within this incremental cost, there was an increased incremental outpatient services cost of $3,495 ± $1,044 (P = .001) and an increased incremental hospital inpatient cost of $6,783 ± $2,894 (P = .020) associated with HNCa. The annual healthcare expenditures per individual fell in between those for lung cancer ($25,267 ± $2,375, P = .607) and colon cancer ($16,975 ± $1,291, P = .055). Despite its lower relative incidence, HNCa is associated with a significant incremental increase in annual healthcare expenditures per individual, which is comparable to or higher than other common cancers. In aggregate, the estimated annual costs associated with HNCa are $4.20 billion. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Healthcare Expenditures Associated with Depression Among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach.

    PubMed

    Agarwal, Parul; Sambamoorthi, Usha

    2015-12-01

    Depression is common among individuals with osteoarthritis and leads to increased healthcare burden. The objective of this study was to examine excess total healthcare expenditures associated with depression among individuals with osteoarthritis in the US. Adults with self-reported osteoarthritis (n = 1881) were identified using data from the 2010 Medical Expenditure Panel Survey (MEPS). Among those with osteoarthritis, chi-square tests and ordinary least square regressions (OLS) were used to examine differences in healthcare expenditures between those with and without depression. Post-regression linear decomposition technique was used to estimate the relative contribution of different constructs of the Anderson's behavioral model, i.e., predisposing, enabling, need, personal healthcare practices, and external environment factors, to the excess expenditures associated with depression among individuals with osteoarthritis. All analysis accounted for the complex survey design of MEPS. Depression coexisted among 20.6 % of adults with osteoarthritis. The average total healthcare expenditures were $13,684 among adults with depression compared to $9284 among those without depression. Multivariable OLS regression revealed that adults with depression had 38.8 % higher healthcare expenditures (p < 0.001) compared to those without depression. Post-regression linear decomposition analysis indicated that 50 % of differences in expenditures among adults with and without depression can be explained by differences in need factors. Among individuals with coexisting osteoarthritis and depression, excess healthcare expenditures associated with depression were mainly due to comorbid anxiety, chronic conditions and poor health status. These expenditures may potentially be reduced by providing timely intervention for need factors or by providing care under a collaborative care model.

  4. Estimating and preventing hospital internal turnover of newly licensed nurses: A panel survey.

    PubMed

    Kovner, Christine T; Djukic, Maja; Fatehi, Faridaben K; Fletcher, Jason; Jun, Jin; Brewer, Carol; Chacko, Thomas

    2016-08-01

    Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses' unit-level turnover rates in hospitals. The purpose of this study is to: (1) identify factors that predict new nurses staying in the same units, positions, and job titles to inform unit-level retention strategies, and (2) examine the changes in work environment perceptions over time between nurses who remain in the same unit, position, and title to those who changed unit, position and/or title. A panel survey design was used to analyze changes over time. Participants were newly licensed registered nurses who were licensed for the first time between August 1st, 2004 and July 31st, 2005. The nurses came from metropolitan statistical areas or rural areas that were nested to reflect a nationally representative USA sample (58% response rate). The analytic sample for this study was 1335. Data were collected in January 2006 and 2007 following the Dillman total design approach. All potential respondents received paper surveys and non-responders received repeated mailings. Using multinomial regression the five variables with the largest effects on unit retention were (1) variety (positive), (2) having another job for pay (negative), (3) first basic degree (having a bachelors or higher degree increased the probability of staying), (4) negative affectivity (positive), and (5) job satisfaction (positive). Nurses who changed unit, and/or position, and/or title reported more positive change scores on a variety of work attitudes. Almost 30% of new nurses working in hospitals leave their unit, and/or position, and/or title during

  5. [Healthcare expenditure].

    PubMed

    Huguier, Michel

    2012-10-01

    Healthcare expenditure is divided between medical infrastructure and individual patient management. Total healthcare costs in France amount to roughly 175 billion euros, financed through public health insurance (77%), private insurance (14%), and individual expenditure (9%). The principal expenditures are for hospitalization (44%), community medical, dental and paramedical care (28%), drugs (20%) and miscellaneous resources (8%). The main factors of rising costs are medical progress and aging. More controllable costs include healthcare provision, the level of reimbursement, public education and information, and physician training. France devotes 9.2% of its gross national product to healthcare, compared to 7-8% in Sweden, Germany and the United Kingdom, representing a diference of about 18 billion euros. In France there is a chronic imbalance between resources and expenditure, creating a cumulative budget deficit of about 100 billlion euros. Major efforts must be made to improve efficiency, and it will be necessary to choose between preserving our healthcare system or our financial system. If the latter is prioritized, healthcare will inevitably deteriorate.

  6. Library Research and Statistics. Research on Libraries and Librarianship in 2001; Number of Libraries in the United States and Canada; Highlights of NCES Surveys; Library Acquisition Expenditures, 2000-2001: U.S. Public, Academic, Special, and Government Libraries; LJ Budget Report: The New Wariness; Price Indexes for Public and Academic Libraries; Library Buildings 2001: Keep on Constructin'; Expenditures for Resources in School Library Media Centers, 1999-2000: New Money, Old Books.

    ERIC Educational Resources Information Center

    Lynch, Mary Jo; Oder, Norman; Halstead, Kent; Fox, Bette-Lee; Miller, Marilyn L.; Schontz, Marilyn L.

    2002-01-01

    Presents eight articles that discuss research on libraries and librarianship; number of libraries in the U.S. and Canada; highlights of NCES (National Center for Education Statistics) surveys; library acquisition expenditures; budgets; price indexes; library buildings construction; and expenditures for school library media center resources. (LRW)

  7. A Feasibility Study on Using an Internet-Panel Survey to Measure Perceptions of E-cigarettes in 3 Metropolitan Areas, 2015.

    PubMed

    Miller, Eric A; Berman, Lewis; Atienza, Audie; Middleton, Deirdre; Iachan, Ronaldo; Tortora, Robert; Boyle, John

    Internet-panel surveys are emerging as a means to quickly and cost-effectively collect health data, and because of their large memberships, they could be used for community-level surveys. To determine the feasibility of using an internet-panel survey to quickly provide community-level data, we conducted a pilot test of a health survey in 3 US metropolitan areas. We conducted internet-panel surveys in Cleveland, Ohio; New York, New York; and Seattle, Washington, in 2015. Slightly more than 500 people responded to the survey in each city. We compared weighted unadjusted prevalence estimates from the internet-panel data with estimates from the 2014 Health Information National Trends Survey (HINTS) for the following question in each survey: "Compared to smoking cigarettes, would you say that electronic cigarettes are…much less harmful, less harmful, just as harmful, more harmful, much more harmful, or I've never heard of electronic cigarettes." We used multivariable logistic regression to compare associations of respondents' demographic and health characteristics with perceived harm from e-cigarettes. The prevalence of the perception that e-cigarettes are less harmful than smoking cigarettes ranged from 35.9% to 39.9% in the internet-panel sites and was 43.0% in HINTS. Most patterns of beliefs and respondent characteristics in the internet-panel data were consistent with patterns in HINTS. We found inconsistent patterns between internet-panel sites and HINTS by race/ethnicity and education. This feasibility study found that internet-panel surveys could quickly produce community-level data for targeted public health interventions and evaluation, but they may be limited in producing estimates among subgroups.

  8. Regional inequality in China's health care expenditures.

    PubMed

    Chou, Win Lin; Wang, Zijun

    2009-07-01

    This paper has two parts. The first part examines the regional health expenditure inequality in China by testing two hypotheses on health expenditure convergence. Cross-section regressions and cluster analysis are used to study the health expenditure convergence and to identify convergence clusters. We find no single nationwide convergence, only convergence by cluster. In the second part of the paper, we investigate the long-run relationship between health expenditure inequality, income inequality, and provincial government budget deficits (BD) by using new panel co-integration tests with health expenditure data in China's urban and rural areas. We find that the income inequality and real provincial government BD are useful in explaining the disparity in health expenditure prevailing between urban and rural areas. In order to reduce health-spending inequality, one long-run policy suggestion from our findings is for the government to implement more rapid economic development and stronger financing schemes in poorer rural areas.

  9. Integrating food poverty and minimum cost diet methods into a single framework: a case study using a Nepalese household expenditure survey.

    PubMed

    Geniez, Perrine; Mathiassen, Astrid; de Pee, Saskia; Grede, Nils; Rose, Donald

    2014-06-01

    Current tools assessing affordability of nutritious diets are incomplete. "Food poverty" uses expenditure data to identify households unable to acquire a diet adequate in energy but does not consider other nutrients. The "minimum cost of a nutritious diet" method provides a threshold for purchasing a nutritious diet but must rely on other data to identify "nutrient-poor" households. Integrating both methods into a single framework using a common data source, we sought to jointly estimate the proportions of a population that are food and nutrient poor. Household expenditure data from the 2010/11 Nepal Living Standards Survey were used, focusing on representative samples of households from the mountain region (n = 401) and Kathmandu (n = 857). Food poverty thresholds were set at the cost for a low-income household to purchase a basket of foods providing adequate energy following the Cost of Basic Need method. Linear optimization was used to calculate a "nutrient poverty" threshold. Household expenditures were used to determine food and nutrient poverty rates. The food and nutrient poverty thresholds were 13,294 and 18,628 rupees/person/year, respectively, in the mountain region and 14,610 and 22,945 rupees/ person/year, respectively, in Kathmandu. In the mountain region, 34% of households were both food and nutrient poor and 24% were just nutrient poor. In Kathmandu the percentages were 7% and 14%, respectively. This approach, integrating two commonly used tools, provides a more nuanced interpretation of economic access to a nutritious diet and an opportunity to improve the design and targeting of nutrition and food security interventions.

  10. EVA 2 activity on Flight Day 5 to survey the HST solar array panels

    NASA Image and Video Library

    1997-02-15

    STS082-719-002 (14 Feb. 1997) --- Astronaut Joseph R. Tanner (right) stands on the end of Discovery's Remote Manipulator System (RMS) arm and aims a camera at the solar array panels on the Hubble Space Telescope (HST) as astronaut Gregory J. Harbaugh assists. The second Extravehicular Activity (EVA) photograph was taken with a 70mm camera from inside Discovery's cabin.

  11. Is income relevant for health expenditure and economic growth nexus?

    PubMed

    Halıcı-Tülüce, Nadide Sevil; Doğan, İbrahim; Dumrul, Cüneyt

    2016-03-01

    This paper examines the relationship between health expenditure and economic growth using panel data consisting low and high-income countries. Using dynamic panel data methodology, we analyze twenty five high-income and nineteen low-income economies for the periods of 1995-2012 and 1997-2009, respectively. We find reciprocal relationship between health expenditure and economic growth in the short run and one-way causality from economic growth to public health expenditure in the long-run. In high-income countries, there is a two-way causality for both private and public health expenditures in the short-run, while in the long-run there is a one-way causality between economic growth and private health expenditures. The crucial finding of this study is that private health expenditures have negative influence on economic growth while public health expenditures have both negative and statistically significant effect.

  12. Long-running German panel survey shows that personal and economic choices, not just genes, matter for happiness

    PubMed Central

    Headey, Bruce; Muffels, Ruud; Wagner, Gert G.

    2010-01-01

    Psychologists and economists take contradictory approaches to research on what psychologists call happiness or subjective well-being, and economists call subjective utility. A direct test of the most widely accepted psychological theory, set-point theory, shows it to be flawed. Results are then given, using the economists’ newer “choice approach”—an approach also favored by positive psychologists—which yields substantial payoffs in explaining long-term changes in happiness. Data come from the German Socio-Economic Panel (1984–2008), a unique 25-y prospective longitudinal survey. This dataset enables direct tests of theories explaining long-term happiness. PMID:20921399

  13. Long-running German panel survey shows that personal and economic choices, not just genes, matter for happiness.

    PubMed

    Headey, Bruce; Muffels, Ruud; Wagner, Gert G

    2010-10-19

    Psychologists and economists take contradictory approaches to research on what psychologists call happiness or subjective well-being, and economists call subjective utility. A direct test of the most widely accepted psychological theory, set-point theory, shows it to be flawed. Results are then given, using the economists' newer "choice approach"--an approach also favored by positive psychologists--which yields substantial payoffs in explaining long-term changes in happiness. Data come from the German Socio-Economic Panel (1984-2008), a unique 25-y prospective longitudinal survey. This dataset enables direct tests of theories explaining long-term happiness.

  14. Effects of comorbid health conditions on healthcare expenditures among people with severe mental illness.

    PubMed

    Lee, Sungkyu; Rothbard, Aileen; Choi, Sunha

    2016-08-01

    Little is known about the incremental cost burden associated with treating comorbid health conditions among people with severe mental illness (SMI). This study compares the extent to which each individual medical condition increases healthcare expenditures between people with SMI and people without mental illness. Data were obtained from the 2011 Medical Expenditure Panel Survey (MEPS; N = 17 764). Mental illness and physical health conditions were identified through ICD-9 codes. Guided by the Andersen's behavioral model of health services utilization, generalized linear models were conducted. Total healthcare expenditures among individuals with SMI were approximately 3.3 times greater than expenditures by individuals without mental illness ($11 399 vs. $3449, respectively). Each additional physical health condition increased the total healthcare expenditure by 17.4% for individuals with SMI compared to the 44.8% increase for individuals without mental illness. The cost effect of having additional health conditions on the total healthcare expenditures among individuals with SMI is smaller than those individuals without mental illness. Whether this is due to limited access to healthcare for the medical problems or better coordination between medical and mental health providers, which reduces duplicated medical procedures or visits, requires future investigation.

  15. Using Quantile Regression to Examine Health Care Expenditures during the Great Recession

    PubMed Central

    Chen, Jie; Vargas-Bustamante, Arturo; Mortensen, Karoline; Thomas, Stephen B

    2014-01-01

    Objective To examine the association between the Great Recession of 2007–2009 and health care expenditures along the health care spending distribution, with a focus on racial/ethnic disparities. Data Sources/Study Setting Secondary data analyses of the Medical Expenditure Panel Survey (2005–2006 and 2008–2009). Study Design Quantile multivariate regressions are employed to measure the different associations between the economic recession of 2007–2009 and health care spending. Race/ethnicity and interaction terms between race/ethnicity and a recession indicator are controlled to examine whether minorities encountered disproportionately lower health spending during the economic recession. Principal Findings The Great Recession was significantly associated with reductions in health care expenditures at the 10th–50th percentiles of the distribution, but not at the 75th–90th percentiles. Racial and ethnic disparities were more substantial at the lower end of the health expenditure distribution; however, on average the reduction in expenditures was similar for all race/ethnic groups. The Great Recession was also positively associated with spending on emergency department visits. Conclusion This study shows that the relationship between the Great Recession and health care spending varied along the health expenditure distribution. More variability was observed in the lower end of the health spending distribution compared to the higher end. PMID:24134797

  16. Occupational Choice, Socio-Economic Status and Educational Attainment: A Study of the Occupational Choices and Destinations of Young People in the British Household Panel Survey

    ERIC Educational Resources Information Center

    Croll, Paul

    2008-01-01

    The article considers young people's occupational choices at the age of 15 in relation to their educational attainment, the occupations of their parents and their actual occupations when they are in their early 20s. It uses data from the British Household Panel Survey over periods of between five and ten years. The young people in the survey are…

  17. Health Insurance Coverage and Medical Expenditures of Immigrants and Native-Born Citizens in the United States

    PubMed Central

    2009-01-01

    Objectives. I examined insurance coverage and medical expenditures of both immigrant and US-born adults to determine the extent to which immigrants contribute to US medical expenditures. Methods. I used data from the 2003 Medical Expenditure Panel Survey to perform 2-part multivariate analyses of medical expenditures, controlling for health status, insurance coverage, race/ethnicity, and other sociodemographic factors. Results. Approximately 44% of recent immigrants and 63% of established immigrants were fully insured over the 12-month period analyzed. Immigrants' per-person unadjusted medical expenditures were approximately one half to two thirds as high as expenditures for the US born, even when immigrants were fully insured. Recent immigrants were responsible for only about 1% of public medical expenditures even though they constituted 5% of the population. After controlling for other factors, I found that immigrants' medical costs averaged about 14% to 20% less than those who were US born. Conclusions. Insured immigrants had much lower medical expenses than insured US-born citizens, even after the effects of insurance coverage were controlled. This suggests that immigrants' insurance premiums may be cross-subsidizing care for the US-born. If so, health care resources could be redirected back to immigrants to improve their care. PMID:19443829

  18. Attrition Bias in Panel Data: A Sheep in Wolf's Clothing? A Case Study Based on the Mabel Survey.

    PubMed

    Cheng, Terence C; Trivedi, Pravin K

    2015-09-01

    This paper investigates the nature and consequences of sample attrition in a unique longitudinal survey of medical doctors. We describe the patterns of non-response and examine if attrition affects the econometric analysis of medical labour market outcomes using the estimation of physician earnings equations as a case study. We compare the econometric gestimates obtained from a number of different modelling strategies, which are as follows: balanced versus unbalanced samples; an attrition model for panel data based on the classic sample selection model; and a recently developed copula-based selection model. Descriptive evidence shows that doctors who work longer hours, have lower years of experience, are overseas trained and have changed their work location are more likely to drop out. Our analysis suggests that the impact of attrition on inference about the earnings of general practitioners is small. For specialists, there appears to be some evidence for an economically significant bias. Finally, we discuss how the top-up samples in the Medicine in Australia: Balancing Employment and Life survey can be used to address the problem of panel attrition.

  19. Health status, emotional/behavioral problems, health care use, and expenditures in overweight/obese US children/adolescents.

    PubMed

    Turer, Christy Boling; Lin, Hua; Flores, Glenn

    2013-01-01

    To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents. Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures. Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures. Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  20. A novel nonparametric item response theory approach to measuring socioeconomic position: a comparison using household expenditure data from a Vietnam health survey, 2003.

    PubMed

    Reidpath, Daniel D; Ahmadi, Keivan

    2014-01-01

    Measures of household socio-economic position (SEP) are widely used in health research. There exist a number of approaches to their measurement, with Principal Components Analysis (PCA) applied to a basket of household assets being one of the most common. PCA, however, carries a number of assumptions about the distribution of the data which may be untenable, and alternative, non-parametric, approaches may be preferred. Mokken scale analysis is a non-parametric, item response theory approach to scale development which appears never to have been applied to household asset data. A Mokken scale can be used to rank order items (measures of wealth) as well as households. Using data on household asset ownership from a national sample of 4,154 consenting households in the World Health Survey from Vietnam, 2003, we construct two measures of household SEP. Seventeen items asking about assets, and utility and infrastructure use were used. Mokken Scaling and PCA were applied to the data. A single item measure of total household expenditure is used as a point of contrast. An 11 item scale, out of the 17 items, was identified that conformed to the assumptions of a Mokken Scale. All the items in the scale were identified as strong items (Hi > .5). Two PCA measures of SEP were developed as a point of contrast. One PCA measure was developed using all 17 available asset items, the other used the reduced set of 11 items identified in the Mokken scale analaysis. The Mokken Scale measure of SEP and the 17 item PCA measure had a very high correlation (r = .98), and they both correlated moderately with total household expenditure: r = .59 and r = .57 respectively. In contrast the 11 item PCA measure correlated moderately with the Mokken scale (r = .68), and weakly with the total household expenditure (r = .18). The Mokken scale measure of household SEP performed at least as well as PCA, and outperformed the PCA measure developed with the 11 items used in the

  1. Health Expenditure Dynamics and Years of U.S. Residence: Analyzing Spending Disparities among Latinos by Citizenship/Nativity Status

    PubMed Central

    Bustamante, Arturo Vargas; Chen, Jie

    2012-01-01

    Objective We investigate health expenditure disparities between Latinos and non-Latino whites by years of United States residence and citizenship/nativity status. Data Sources We link the Medical Expenditure Panel Survey and the National Health Interview Survey from 2000 to 2007. The sample consists of 31,514 Latinos and 76,021 white adults (18–64 years). Study Design The likelihood of any health spending, total health expenditure, and the out-of-pocket (OOP) share of health expenditure are our main dependent variables. We use two-part multivariate models to adjust for confounding factors. A stratified analysis by insurance status checks for the results' robustness. The decomposition technique is implemented to estimate the share of disparities that can be explained by observed and unobserved variables. Principal Findings Latinos are much less likely to have any health spending (68 percent), total health expenditure (57 percent), and more likely to pay OOP (6 percent) compared with the white population. Overall, disparities narrow or disappear for naturalized Latinos the longer they stay in the country. Among noncitizen Latinos, disparities remain constant or decline slightly, but they remain large over time. Conclusions Low-health spending by foreign-born Latinos contributes to health expenditure disparities between Latinos and whites. Our findings provide preliminary evidence on health-spending convergence over time between foreign-born Latinos and that of whites. PMID:21644969

  2. The comparison of road safety survey answers between web-panel and face-to-face; Dutch results of SARTRE-4 survey.

    PubMed

    Goldenbeld, C; de Craen, S

    2013-09-01

    In the Netherlands, a comparison of an online and a face-to-face sample of car drivers was made to study differences on a number of selected questions from the SARTRE-4 road safety survey. Contrary to expectations, there was no indication that online respondents were more likely to come from higher educated or more privileged social groups. Confirming earlier research, the results indicated that online respondents were less inclined to give socially desirable answers and were less inclined to use more extreme ratings in their opinions about measures. Contrary to expectations, face-to-face respondents did not tend to give more positive answers in judgment of road safety measures. Weighting to make samples comparable on gender, age, and education had almost no effect on outcomes. The implications for a transition from face-to-face survey to online panel method are discussed. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

  3. Food crop production, nutrient availability, and nutrient intakes in Bangladesh: exploring the agriculture-nutrition nexus with the 2010 Household Income and Expenditure Survey.

    PubMed

    Fiedler, John L

    2014-12-01

    Systematic collection of national agricultural data has been neglected in many low- and middle-income countries for the past 20 years. Commonly conducted nationally representative household surveys collect substantial quantities of highly underutilized food crop production data. To demonstrate the potential usefulness of commonly available household survey databases for analyzing the agriculture-nutrition nexus. Using household data from the 2010 Bangladesh Household Income and Expenditure Survey, the role and significance of crop selection, area planted, yield, nutrient production, and the disposition of 34 food crops in affecting the adequacy of farming households' nutrient availability and nutrient intake status are explored. The adequacy of each farming household's available energy, vitamin A, calcium, iron, and zinc and households' apparent intakes and intake adequacies are estimated. Each household's total apparent nutrient intake adequacies are estimated, taking into account the amount of each crop that households consume from their own production, together with food purchased or obtained from other sources. Even though rice contains relatively small amounts of micronutrients, has relatively low nutrient density, and is a relatively poor source of nutrients compared with what other crops can produce on a given tract of land, because so much rice is produced in Bangladesh, it is the source of 90% of the total available energy, 85% of the zinc, 67% of the calcium, and 55% of the iron produced by the agricultural sector. The domination of agriculture and diet by rice is a major constraint to improving nutrition in Bangladesh. Simple examples of how minor changes in the five most common cropping patterns could improve farming households' nutritional status are provided. Household surveys' agricultural modules can provide a useful tool for better understanding national nutrient production realities and possibilities.

  4. Out-of-pocket expenditure and its determinants in the context of private healthcare sector expansion in sub-Saharan Africa urban cities: evidence from household survey in Ouagadougou, Burkina Faso.

    PubMed

    Beogo, Idrissa; Huang, Nicole; Gagnon, Marie-Pierre; Amendah, Djesika D

    2016-01-21

    Conventional wisdom suggests that out-of-pocket (OOP) expenditure reduces healthcare utilization. However, little is known about the expenditure borne in urban settings with the current development of the private health sector in sub-Saharan Africa. In an effort to update knowledge on medical expenditure, this study investigated the level and determinants of OOP among individuals reporting illness or injury in Ouagadougou, Burkina Faso and who either self-treated or received healthcare in either a private or public facility. A cross-sectional study was conducted with a representative sample of 1017 households (5638 individuals) between August and November 2011. Descriptive statistics and multivariate techniques including generalized estimating equations were used to analyze the data. Among the surveyed sample, 29.6% (n = 1666) persons reported a sickness or injury. Public providers were the single most important providers of care (36.3%), whereas private and informal providers (i.e.: self-treatment, traditional healers) accounted for 29.8 and 34.0%, respectively. Almost universally (96%), households paid directly for care OOP. The average expenditure per episode of illness was 8404XOF (17.4USD) (median 3750XOF (7.8USD). The total expenditure was higher for those receiving care in private facilities compared to public ones [14,613.3XOF (30.3USD) vs. 8544.1XOF (17.7USD); p < 0.001], and the insured patients' bill almost tripled uninsured (p < 0.001). Finally, medication was the most expensive component of expenditure in both public and private facilities with a mean of 8022.1XOF (16.7USD) and 12,270.5 (25.5USD), respectively. OOP was the principal payment mechanism of households. A significant difference in OOP was found between public and private provider users. Considering the importance of private healthcare in Burkina Faso, regulatory oversight is necessary. Furthermore, an extensive protection policy to shield households from catastrophic health expenditure is

  5. Parent-Reported Health Consequences and Relationship to Expenditures in Children with ADHD.

    PubMed

    deJong, Neal A; Williams, Christianna S; Thomas, Kathleen C

    2016-04-01

    (1) To describe parents' report of special needs for children with ADHD on the Children with Special Health Care Needs (CSHCN) Screener; and (2) to assess the association between responses to Screener items and annual mental health and total health expenditures per child. In pooled 2002-2011 Medical Expenditure Panel Survey (MEPS) data, we identify children ages 4-17 years with ADHD. We use OLS and two-part regressions to model the relationship between CSHCN Screener items and mental health and total health expenditures. Based on these models we estimate adjusted, average total health expenditures for children with ADHD-both with and without a co-morbid mental health condition-and different combinations of endorsed Screener items. This research was conducted in accordance with prevailing ethical principles. There were 3883 observations on 2591 children with ADHD. Without a co-morbid mental health condition, average total expenditures per year from adjusted, model-based estimates were $865 for those meeting no Screener items, $2664 for those meeting only the medication item, $3595 for those meeting the medication and counseling items, and $4203 for those meeting the medication, counseling, and use of more health services items. Children with a co-morbid mental health condition had greater total health expenditures for each combination of Screener items. The associations between Screener items and mental health expenditures were similar, but with a slightly lower marginal effect of the medication item (p < 0.001 for all comparisons). Parents' responses on the CSHCN Screener are associated with meaningful variation in expenditures for children with ADHD. Though cross-sectional, this study suggests that the CSHCN Screener can be a useful categorization scheme for children with ADHD. It may be an efficient, standardized tool at the point of care for identifying children who need more resources and for targeting intensive interventions in the context of population health

  6. Energy expenditure in caving

    PubMed Central

    Antoni, Giorgia; Marini, Elisabetta; Curreli, Nicoletta; Tuveri, Valerio; Comandini, Ornella; Cabras, Stefano; Gabba, Silvia; Madeddu, Clelia; Crisafulli, Antonio

    2017-01-01

    The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE) was in the range 225–287 kcal/h for women-men (MET = 4.1), respectively; subjects had an energy intake from food in the range 1000–1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis) showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue. PMID:28158208

  7. Comparison of response patterns in different survey designs: a longitudinal panel with mixed-mode and online-only design.

    PubMed

    Rübsamen, Nicole; Akmatov, Manas K; Castell, Stefanie; Karch, André; Mikolajczyk, Rafael T

    2017-01-01

    Increasing availability of the Internet allows using only online data collection for more epidemiological studies. We compare response patterns in a population-based health survey using two survey designs: mixed-mode (choice between paper-and-pencil and online questionnaires) and online-only design (without choice). We used data from a longitudinal panel, the Hygiene and Behaviour Infectious Diseases Study (HaBIDS), conducted in 2014/2015 in four regions in Lower Saxony, Germany. Individuals were recruited using address-based probability sampling. In two regions, individuals could choose between paper-and-pencil and online questionnaires. In the other two regions, individuals were offered online-only participation. We compared sociodemographic characteristics of respondents who filled in all panel questionnaires between the mixed-mode group (n = 1110) and the online-only group (n = 482). Using 134 items, we performed multinomial logistic regression to compare responses between survey designs in terms of type (missing, "do not know" or valid response) and ordinal regression to compare responses in terms of content. We applied the false discovery rates (FDR) to control for multiple testing and investigated effects of adjusting for sociodemographic characteristic. For validation of the differential response patterns between mixed-mode and online-only, we compared the response patterns between paper and online mode among the respondents in the mixed-mode group in one region (n = 786). Respondents in the online-only group were older than those in the mixed-mode group, but both groups did not differ regarding sex or education. Type of response did not differ between the online-only and the mixed-mode group. Survey design was associated with different content of response in 18 of the 134 investigated items; which decreased to 11 after adjusting for sociodemographic variables. In the validation within the mixed-mode, only two of those were among the 11 significantly

  8. Weight loss and lifetime medical expenditures: a case study with TRICARE prime beneficiaries.

    PubMed

    Dall, Timothy M; Zhang, Yiduo; Zhang, Shiping; Arday, David R; Sahai, Navita; Dorn, Patricia; Jain, Anjali

    2011-03-01

    TRICARE's Prime (managed care) plan spends more than $1 billion annually in medical expenditures attributed to overweight and obesity. This study estimates change in lifetime disease prevalence and medical expenditures associated with weight loss for beneficiaries in TRICARE's Prime plan. This 2010 analysis uses Markov Chain Monte Carlo simulation with demographics, biometrics, health behavior, and disease presence for 857,200 overweight and 521,800 obese beneficiaries aged 18-64 years in 2008 to model future onset of diseases linked to excess weight. Prediction equations in the simulation come from multiple sources: (1) regression analysis with longitudinal (2007-2008) TRICARE medical claims and electronic health records for 2.1 million beneficiaries; (2) regression analysis with Medical Expenditure Panel Survey (2002-2007) and National Health and Nutrition Examination Survey (1999-2008) data; (3) cancer and mortality risk from Surveillance, Epidemiology, and End Results data; and (4) published findings from clinical trials. Among overweight and obese beneficiaries, lifetime medical expenditures declined $440 (3% discount rate) for each permanent 1% reduction in body weight. This includes $590 in savings from improved health, offset by $150 in additional expenditures from prolonged life. Estimates range from $660 reduction for grossly obese adults aged <45 years to $40 gain from grossly obese adults aged 55-64 years (where expenditures from increased longevity exceed savings from improved health). If weight loss is temporary and regained after 24 months, lifetime expenditures decline by $40 per 1% reduction in body weight. Long-term benefits from weight loss are substantially greater than short-term benefits, underscoring the need for a societal perspective to combat obesity. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

  9. Malaria Incidence Rates from Time Series of 2-Wave Panel Surveys

    PubMed Central

    Maheu-Giroux, Mathieu; Chiyaka, Christinah; Singer, Burton H.

    2016-01-01

    Methodology to estimate malaria incidence rates from a commonly occurring form of interval-censored longitudinal parasitological data—specifically, 2-wave panel data—was first proposed 40 years ago based on the theory of continuous-time homogeneous Markov Chains. Assumptions of the methodology were suitable for settings with high malaria transmission in the absence of control measures, but are violated in areas experiencing fast decline or that have achieved very low transmission. No further developments that can accommodate such violations have been put forth since then. We extend previous work and propose a new methodology to estimate malaria incidence rates from 2-wave panel data, utilizing the class of 2-component mixtures of continuous-time Markov chains, representing two sub-populations with distinct behavior/attitude towards malaria prevention and treatment. Model identification, or even partial identification, requires context-specific a priori constraints on parameters. The method can be applied to scenarios of any transmission intensity. We provide an application utilizing data from Dar es Salaam, an area that experienced steady decline in malaria over almost five years after a larviciding intervention. We conducted sensitivity analysis to account for possible sampling variation in input data and model assumptions/parameters, and we considered differences in estimates due to submicroscopic infections. Results showed that, assuming defensible a priori constraints on model parameters, most of the uncertainty in the estimated incidence rates was due to sampling variation, not to partial identifiability of the mixture model for the case at hand. Differences between microscopy- and PCR-based rates depend on the transmission intensity. Leveraging on a method to estimate incidence rates from 2-wave panel data under any transmission intensity, and from the increasing availability of such data, there is an opportunity to foster further methodological

  10. Racial/Ethnic Disparity Trends in Children's Mental Health Care Access and Expenditures from 2002 to 2007

    PubMed Central

    Cook, Benjamin Lê; Barry, Colleen L; Busch, Susan H

    2013-01-01

    Objective To examine trends in disparities in children's mental health care. Data 2002–2007 Medical Expenditure Panel Survey. Study Design We used the Institute of Medicine (IOM) definition of health care disparities and estimated two-part expenditure models to examine disparity trends in any mental health care use, any outpatient care, and psychotropic drug use, as well as expenditures in these three categories, conditional on use. We used 2-year longitudinal panel data to determine disparities in care initiation among children with unmet need. Principal Findings Assessing trends over time between 2002 and 2007, we identified that disparities persist for blacks and Latinos in receipt of any mental health care, any outpatient care, and any psychotropic drug use. Among those with positive mental health care expenditures, Latino–white disparities in overall mental health care expenditures increased over time. Among children with unmet need, significant disparities in initiation of an episode of mental health care were found, with whites approximately twice as likely as blacks and Latinos to initiate care. Conclusions Disparities in children's mental health care use are persistent and driven by disparities in initiation, suggesting policies to improve detection or increase initial access to care may be critical to reducing disparities. PMID:22716901

  11. Using Household Consumption and Expenditures Survey (HCES) data to assess dietary intake in relation to the nutrition transition: a case study from Cape Verde.

    PubMed

    Dop, Marie Claude; Pereira, Clodomir; Mistura, Lorenza; Martinez, Claudio; Cardoso, Edith

    2012-09-01

    Few surveys of food and nutrient intakes are conducted at the individual level in low- and middle-income countries, whereas Household Consumption and Expenditures Surveys (HCES) are regularly carried out to monitor economic conditions. Because of the paucity of individual-level data, there is interest in using HCES to aid in the design of food and nutrition policies. Data from the 2001/02 HCES from Cape Verde were used to assess household dietary intakes in the context of the country's nutrition transition. The survey included weighed measurements of household food intake and measurements of the weight and height of all household members. Households were classified as "underweight" if they had at least one underweight member, "overweight" if they had at least one overweight member, and "dual burden" if they had at least one underweight and one overweight member. The proportion of households classified as underweight, overweight, and dual burden was 18%, 41%, and 14%, respectively. Household food and nutrient intakes were higher in the overweight households (particularly protein, vitamin A, and calcium) and lower in the underweight households, while there was no clear pattern of intakes in the dual burden group. Overweight households consumed more animal food groups than other households. Intakes of fruits and vegetables were low in all groups. The HCES data for Cape Verde were useful for assessing the extent of the nutrition transition and characterizing dietary intakes by anthropometric classification. Analysis of nutrient and food intakes showed that ensuring sufficient energy availability is no longer the most important issue for Cape Verde, but that ensuring dietary quality is equally crucial, in particular increasing access to fruits and vegetables.

  12. School Expenditures and Student Achievement: Evidence for the United States

    ERIC Educational Resources Information Center

    Ram, Rati

    2004-01-01

    Using state-level panel data, this study estimates a simple achievement function in the fixed-effects format to explore further the nexus between school expenditure and student achievement in the United States. Five main points are noted. First, the effect of per-pupil expenditure is positive and carries high statistical significance in some…

  13. Faculty Employment and R&D Expenditures at Research Universities

    ERIC Educational Resources Information Center

    Zhang, Liang; Ehrenberg, Ronald G.

    2010-01-01

    This study uses panel data to examine the relationship between faculty employment and external R&D expenditures at Research and Doctoral institutions over a 15-year period of time. On average, a 1% increase in the number of full-time faculty is associated with about 0.2% increase in total R&D expenditure. Further, a one percentage point increase…

  14. Faculty Employment and R&D Expenditures at Research Universities

    ERIC Educational Resources Information Center

    Zhang, Liang; Ehrenberg, Ronald G.

    2010-01-01

    This study uses panel data to examine the relationship between faculty employment and external R&D expenditures at Research and Doctoral institutions over a 15-year period of time. On average, a 1% increase in the number of full-time faculty is associated with about 0.2% increase in total R&D expenditure. Further, a one percentage point increase…

  15. School Expenditures and Student Achievement: Evidence for the United States

    ERIC Educational Resources Information Center

    Ram, Rati

    2004-01-01

    Using state-level panel data, this study estimates a simple achievement function in the fixed-effects format to explore further the nexus between school expenditure and student achievement in the United States. Five main points are noted. First, the effect of per-pupil expenditure is positive and carries high statistical significance in some…

  16. Selection of population controls for a Salmonella case-control study in the UK using a market research panel and web-survey provides time and resource savings.

    PubMed

    Mook, P; Kanagarajah, S; Maguire, H; Adak, G K; Dabrera, G; Waldram, A; Freeman, R; Charlett, A; Oliver, I

    2016-04-01

    Timely recruitment of population controls in infectious disease outbreak investigations is challenging. We evaluated the timeliness and cost of using a market research panel as a sampling frame for recruiting controls in a case-control study during an outbreak of Salmonella Mikawasima in the UK in 2013. We deployed a web-survey by email to targeted members of a market research panel (panel controls) in parallel to the outbreak control team interviewing randomly selected public health staff by telephone and completing paper-based questionnaires (staff controls). Recruitment and completion of exposure history web-surveys for panel controls (n = 123) took 14 h compared to 15 days for staff controls (n = 82). The average staff-time cost per questionnaire for staff controls was £13·13 compared to an invoiced cost of £3·60 per panel control. Differences in the distribution of some exposures existed between these control groups but case-control studies using each group found that illness was associated with consumption of chicken outside of the home and chicken from local butchers. Recruiting market research panel controls offers time and resource savings. More rapid investigations would enable more prompt implementation of control measures. We recommend that this method of recruiting controls is considered in future investigations and assessed further to better understand strengths and limitations.

  17. Gender, Marital Status, and Commercially Prepared Food Expenditure

    ERIC Educational Resources Information Center

    Kroshus, Emily

    2008-01-01

    Objective: Assess how per capita expenditure on commercially prepared food as a proportion of total food expenditure varies by the sex and marital status of the head of the household. Design: Prospective cohort study, data collected by the United States Bureau of Labor Statistics 2004 Consumer Expenditure Survey. Setting: United States.…

  18. Household Expenditures on Private Tutoring: Emerging Evidence from Malaysia

    ERIC Educational Resources Information Center

    Kenayathulla, Husaina Banu

    2013-01-01

    Private tutoring has been a burgeoning phenomenon in Malaysia for decades. This study examines the determinants of private tutoring expenditures in Malaysia using the 2004/2005 Household Expenditures Survey and applies hurdle regression models to the data. The results indicate that total household expenditures, household head's level of education,…

  19. Household Expenditures on Private Tutoring: Emerging Evidence from Malaysia

    ERIC Educational Resources Information Center

    Kenayathulla, Husaina Banu

    2013-01-01

    Private tutoring has been a burgeoning phenomenon in Malaysia for decades. This study examines the determinants of private tutoring expenditures in Malaysia using the 2004/2005 Household Expenditures Survey and applies hurdle regression models to the data. The results indicate that total household expenditures, household head's level of education,…

  20. Hypertension-associated expenditures for medication among US adults.

    PubMed

    Wang, Guijing; Yan, Lili; Ayala, Carma; George, Mary G; Fang, Jing

    2013-11-01

    We sought to estimate how much the presence of hypertension adds to annual per capita and total expenditures for medication among US adults. The sample included 21,782 civilian noninstitutionalized adults aged ≥ 18 years who participated in the 2007 Medical Expenditure Panel Survey. Hypertension was defined as having a diagnosis of high blood pressure (except during pregnancy) or taking a blood pressure medication. We used a 2-part model to examine all-cause medication expenditure associated with hypertension. The prevalence of hypertension was 32.2%. Overall, 66.7% of adults purchased prescribed medications, with this proportion higher among hypertensive (93.0%) than normotensive (54.4%) adults (P < 0.001). Hypertensive adults were more likely to have medication expenditures than were normotensive adults (odds ratio (OR) = 6.42; P < 0.001). Among hypertensive adults, those aged ≥ 45 years were more likely to incur medication expenditure than those aged 18-44 years (OR = 3.00, P < 0.001 for those aged 45-64 years; OR = 5.95, P < 0.001 for those aged ≥ 65 years), whereas women were 2.91 times as likely as men to have medication spending (P < 0.001). Hispanics were less likely than non-Hispanic whites to have such spending (OR = 0.51; P < 0.001). Among those purchasing medications, the average cost was $1,510 higher among hypertensive persons ($2,337) than normotensive persons ($827). Hypertension-associated expenditures for medication were estimated at $68 billion in the US civilian non-institutionalized population in 2007. The presence of hypertension among US adults is associated with an increase of all-cause expenditures for medication, with this increase varying across groups by age and sex. © Published by Oxford University Press on behalf of American Journal of Hypertension Ltd 2013. This work is written by (a) US Government employees(s) and is in the public domain in the US.

  1. Health Literacy Impact on National Healthcare Utilization and Expenditure.

    PubMed

    Rasu, Rafia S; Bawa, Walter Agbor; Suminski, Richard; Snella, Kathleen; Warady, Bradley

    2015-08-17

    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. 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. The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. 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

  2. National Trends in Direct Health Care Expenditures Among US Adults With Migraine: 2004 to 2013.

    PubMed

    Raval, Amit D; Shah, Anal

    2017-01-01

    Migraine is a common neurological disorder with significant economic burden in the United States. However, changes in the economic burden of migraine in the past decade have not been examined considering therapeutic advances at the national level. Therefore, we estimated cross-sectional trends in the incremental total and types of direct health care expenditures among individuals with migraine using nationally representative data, the Medical Expenditures Panel Survey. The analytic sample was comprised of an annually weighted population of 228,010,000 adults aged 18 years and older from 2004 to 2013. Two-part models were used to estimate the incremental total and types of annual direct health care expenditures (adjusted to 2013 US dollars) among individuals with migraine after adjusting for predisposing, enabling, need, personal health practice, and external environment factors selected on the basis of the Anderson Healthcare Behavior Model. The unadjusted average annual total health care expenditure for individuals with migraine was $8,033 (standard error [SE] = $292) which comprised major proportions of outpatient ($2,952, SE = $128), prescription drugs ($2,207, SE = $91), and inpatient ($1,784, SE = $178) expenditures. Individuals with migraine had $866 (SE = $298) and $1,519 (SE = $400) greater adjusted annual total direct health care expenditures in 2004/2005 and 2012/2013 compared with those without migraine. However, those with migraine in 2012/2013 did not have significant changes in the total direct health care expenditures compared with those having migraine in 2004/2005 (changes: -$330, SE = $480). The estimated adjusted incremental total direct health care expenditures for individuals with migraine was approximately $9.20 billion per year compared with those without migraine. Although annual incremental total direct health care expenditures among individuals with migraine did not change significantly from 2004 to 2013, expenditures

  3. How do social activities mitigate informal caregivers' psychological distress? Evidence from a nine-year panel survey in Japan.

    PubMed

    Oshio, Takashi; Kan, Mari

    2016-08-22

    It is well known that informal caregiving negatively affects caregivers' mental health, while social activities improve mental health outcomes among middle-aged and elderly individuals. The goal of the present study was to examine how participation in social activities affected the trajectory of an informal caregiver's psychological distress. We used the data from a nationwide nine-wave panel survey of the middle-aged individuals (aged 50-59 years at baseline) in Japan conducted in 2005-13 (N = 24,193 individuals;12,352 women and 11,841 men), mainly focusing on the respondents beginning to provide informal caregiving during the survey period. We employed linear mixed-effects models to explain how the trajectory of psychological distress, measured by Kessler 6 (K6) scores, was associated with caregiving commencement and duration, as well as social activity participation. Participation in social activities was associated with mitigated K6 scores at caregiving commencement by 66.2 and 58.2 % for women and men, respectively. After caregiving started, participation in social activities reduced the average rise in K6 scores, per year, by 65.6 and 89.6 % for women and men, respectively. We observed similar results when focusing on participation before caregiving commencement to avoid endogeneity problems. Results suggest that participation in social activities can alleviate caregivers' psychological distress. Policy measures to support social activities are recommended for the health and well-being of current and potential caregivers.

  4. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes.

    PubMed

    Egede, Leonard E; Zheng, Deyi; Simpson, Kit

    2002-03-01

    This study ascertained the odds of diagnosed depression in individuals with diabetes and the relation between depression and health care use and expenditures. First, we compared data from 825 adults with diabetes with that from 20,688 adults without diabetes using the 1996 Medical Expenditure Panel Survey (MEPS). Second, in patients with diabetes, we compared depressed and nondepressed individuals to identify differences in health care use and expenditures. Third, we adjusted use and expenditure estimates for differences in age, sex, race/ethnicity, health insurance, and comorbidity with analysis of covariance. Finally, we used the Consumer Price Index to adjust expenditures for inflation and used SAS and SUDAAN software for statistical analyses. Individuals with diabetes were twice as likely as a comparable sample from the general U.S. population to have diagnosed depression (odds ratio 1.9, 95% CI 1.5-2.5). Younger adults (<65 years), women, and unmarried individuals with diabetes were more likely to have depression. Patients with diabetes and depression had higher ambulatory care use (12 vs. 7, P < 0.0001) and filled more prescriptions (43 vs. 21, P < 0.0001) than their counterparts without depression. Finally, among individuals with diabetes, total health care expenditures for individuals with depression was 4.5 times higher than that for individuals without depression ($247,000,000 vs. $55,000,000, P < 0.0001). The odds of depression are higher in individuals with diabetes than in those without diabetes. Depression in individuals with diabetes is associated with increased health care use and expenditures, even after adjusting for differences in age, sex, race/ethnicity, health insurance, and comorbidity.

  5. The impact of poverty, chronic illnesses, and health insurance status on out-of-pocket health care expenditures in later life.

    PubMed

    Kim, Jinhyun; Richardson, Virginia

    2014-10-01

    This study aims to examine poverty, chronic illnesses, health insurance, and health care expenditures, within the context of a political economy of aging perspective. Subsamples of 1,773 older adults from the Medical Expenditure Panel Survey were selected for analyses. The results showed that chronic illnesses influenced out-of-pocket health care costs. Older persons with more than one health insurance spent less on out-of-pocket health care costs. The results have implications for health care social workers concerned with the growing costs of chronic illnesses, implementing integrated care, and advocating for extending public health insurance coverage especially for our most impoverished older adults.

  6. Comparing Medical Ecology, Utilization, and Expenditures Between 1996-1997 and 2011-2012.

    PubMed

    Johansen, Michael E

    2017-07-01

    This study compared ecology (number of individuals using a service), utilization (number of services used), and expenditures (dollars spent) for various categories of medical services between primarily 1996-1997 and 2011-2012. A repeated cross-sectional study was performed using nationally representative data mainly from the 1996, 1997, 2011, and 2012 Medical Expenditure Panel Survey (MEPS). These data were augmented with the 2002-2003 MEPS as well as the 1999-2000 and 2011-2012 National Heath and Nutrition Examination Survey. Individuals (number per 1,000 people), utilization, and expenditures during an average month in 1996-1997 and 2011-2012 were determined for 15 categories of services. The number of individuals who used various medical services was unchanged for many categories of services (total, outpatient, outpatient physician, users of prescribed medications, primary care and specialty physicians, inpatient hospitalization, and emergency department). It was, however, increased for others (optometry/podiatry, therapy, and alternative/complementary medicine) and decreased for a few (dental and home health). The number of services used (utilization) largely mirrored the findings for individual use, with the exception of an increase in the number of prescribed medications and a decrease in number of primary care physician visits. There were large increases in dollars spent (expenditures) in every category with the exception of primary care physician and home health; the largest absolute increases were in prescribed medications, specialty physicians, emergency department visits, and likely inpatient hospitalizations. Although the number of individuals with visits during an average month and the total utilization of medical services were largely unchanged between the 2 time periods, total expenditures increased markedly. The increases in expenditure varied dramatically by category. © 2017 Annals of Family Medicine, Inc.

  7. Hospice shared-care saved medical expenditure and reduced the likelihood of intensive medical utilization among advanced cancer patients in Taiwan--a nationwide survey.

    PubMed

    Lin, Wen-Yuan; Chiu, Tai-Yuan; Ho, Chih-Te; Davidson, Lance E; Hsu, Hua-Shui; Liu, Chiu-Shong; Chiu, Chang-Fang; Peng, Ching-Tien; Chen, Chih-Yi; Hu, Wen-Yu; Hsu, Ling-Nu; Li, Chia-Ing; Li, Tsai-Chung; Lin, Chin-Yu; Chen, Ching-Yu; Lin, Cheng-Chieh

    2014-07-01

    Hospice shared care (HSC) is a new care model that has been adopted to treat inpatient advanced cancer patients in Taiwan since 2005. Our aim was to assess the effect of HSC on medical expenditure and the likelihood of intensive medical utilization by advanced cancer patients. This is a nationwide retrospective study. HSC was defined as using "Hospice palliative care (HPC) teams to provide consultation and service to advanced cancer patients admitted in the nonhospice care ward." There were 120,481 deaths due to cancer between 2006 and 2008 in Taiwan. Patients receiving HSC were matched by propensity score to patients receiving usual care. Of the 120,481 cancer deaths, 12,137 paired subjects were matched. Medical expenditures for 1 year before death were assessed between groups using a database from the Bureau of National Health Insurance. Paired t and McNemar's tests were applied for comparing the medical expenditure and intensive medical utilization before death between paired groups. Compared to the non-HSC group, subjects receiving HSC had a lower average medical expenditure per person (US$3,939 vs. US$4,664; p<0.001). The HSC group had an adjusted net savings of US$557 (13.3%; p<0.001) in inpatient medical expenditure per person compared with the non-HSC group. Subjects that received different types of HPC had 15.4-44.9% less average medical expenditure per person and significantly lower likelihood of intensive medical utilization than those that did not receive HPC. HSC is associated with significant medical expenditure savings and reduced likelihood of intensive medical utilization. All types of HPC are associated with medical expenditure savings.

  8. The Association Between Self-Rated Mental Health Status and Total Health Care Expenditure: A Cross-Sectional Analysis of a Nationally Representative Sample.

    PubMed

    Nguyen, Muoi T; Chan, Winnie Y; Keeler, Courtney

    2015-09-01

    Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ tests and a 2-part model (logistics regression and generalized linear model regression for the first and second stages, respectively).Although predictive of any health expenditure, SRMH alone was not highly predictive of the dollar value of that health expenditure conditional on any spending. By comparison, the K6 measure was significantly and positively associated with the probability of any health expenditure as well as the dollar value of that spending. Taken together, both the K6 and SRMH measures suggest a positive relationship between poor mental health and the probability of any health expenditure and total expenditure conditional on any spending, even when adjusting for other confounding factors such as race/ethnicity, sex, age, educational attainment, insurance status, and some regional characteristics.Our results suggest that psychological distress and SRMH may represent potential pathways linking poor mental health to increased health care expenditure. Further research exploring the nuances of these relationships may aid researchers, practitioners, and policy makers in addressing issues of inflated health care expenditure in populations at risk for poor mental health.

  9. Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.

    PubMed

    Manski, Richard J; Moeller, John F; Chen, Haiyan; Schimmel, Jody; Pepper, John V; St Clair, Patricia A

    2015-02-01

    To determine if providing dental insurance to older Americans would close the current gaps in dental use and expenditure between insured and uninsured older Americans. We used data from the 2008 Health and Retirement Survey (HRS) supplemented by data from the 2006 Medical Expenditure Panel Survey (MEPS). We compared the simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured. The HRS is a nationally representative survey administered by the Institute for Social Research (ISR). The MEPS is a nationally representative household survey sponsored by the Agency for Healthcare Research and Quality (AHRQ). We found that expanding dental coverage to older uninsured Americans would close previous gaps in dental use and expense between uninsured and insured noninstitutionalized Americans 55 years and older. Providing dental coverage to previously uninsured older adults would produce estimated monthly costs net of markups for administrative costs that comport closely to current market rates. Estimates also suggest that the total cost of providing dental coverage targeted specifically to nonusers of dental care may be less than similar costs for prior users. © Health Research and Educational Trust.

  10. Dental Use and Expenditures for Older Uninsured Americans: The Simulated Impact of Expanded Coverage

    PubMed Central

    Manski, Richard J; Moeller, John F; Chen, Haiyan; Schimmel, Jody; Pepper, John V; St Clair, Patricia A

    2015-01-01

    Objective To determine if providing dental insurance to older Americans would close the current gaps in dental use and expenditure between insured and uninsured older Americans. Data Sources/Study Setting We used data from the 2008 Health and Retirement Survey (HRS) supplemented by data from the 2006 Medical Expenditure Panel Survey (MEPS). Study Design We compared the simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured. Data Collection/Extraction Methods The HRS is a nationally representative survey administered by the Institute for Social Research (ISR). The MEPS is a nationally representative household survey sponsored by the Agency for Healthcare Research and Quality (AHRQ). Principal Findings We found that expanding dental coverage to older uninsured Americans would close previous gaps in dental use and expense between uninsured and insured noninstitutionalized Americans 55 years and older. Conclusions Providing dental coverage to previously uninsured older adults would produce estimated monthly costs net of markups for administrative costs that comport closely to current market rates. Estimates also suggest that the total cost of providing dental coverage targeted specifically to nonusers of dental care may be less than similar costs for prior users. PMID:25040355

  11. Social class related inequalities in household health expenditure and economic burden: evidence from Kerala, south India.

    PubMed

    Mukherjee, Subrata; Haddad, Slim; Narayana, Delampady

    2011-01-07

    In the Indian context, a household's caste characteristics are most relevant for identifying its poverty and vulnerability status. Inadequate provision of public health care, the near-absence of health insurance and increasing dependence on the private health sector have impoverished the poor and the marginalised, especially the scheduled tribe population. This study examines caste-based inequalities in households' out-of-pocket health expenditure in the south Indian state of Kerala and provides evidence on the consequent financial burden inflicted upon households in different caste groups. Using data from a 2003-2004 panel survey in Kottathara Panchayat that collected detailed information on health care consumption from 543 households, we analysed inequality in per capita out-of-pocket health expenditure across castes by considering households' health care needs and types of care utilised. We used multivariate regression to measure the caste-based inequality in health expenditure. To assess health expenditure burden, we analysed households incurring high health expenses and their sources of finance for meeting health expenses. The per capita health expenditures reported by four caste groups accord with their status in the caste hierarchy. This was confirmed by multivariate analysis after controlling for health care needs and influential confounders. Households with high health care needs are more disadvantaged in terms of spending on health care. Households with high health care needs are generally at higher risk of spending heavily on health care. Hospitalisation expenditure was found to have the most impoverishing impacts, especially on backward caste households. Caste-based inequality in household health expenditure reflects unequal access to quality health care by different caste groups. Households with high health care needs and chronic health care needs are most affected by this inequality. Households in the most marginalised castes and with high health care

  12. School context, friendship ties and adolescent mental health: A multilevel analysis of the Korean Youth Panel Survey (KYPS).

    PubMed

    Kim, Harris Hyun-Soo

    2015-11-01

    Research on the social determinants of health suggests that interpersonal networks play a critical role in facilitating individual mental and physical well-being. Prior studies also indicate that ecological or contextual factors contribute to positive health outcomes. This study extends prior research by examining the factors associated with adolescent health in an Asian context. Based on the multilevel analysis of the Korean Youth Panel Survey (2006 & 2007), a longitudinal project funded by the Korean government, it investigates some of the key variables related to the mental health of Korean students. Much of previous research focuses on the functions of social capital. This study contributes to the social epidemiology literature by investigating the possible downside of network ties. Specifically, it asks whether having delinquent friends is associated with negative mental health experiences. In addition, little research has been conducted concerning the associations between adolescent health outcomes and school characteristics. This study moves in that direction by examining the relationship between mental well-being of students and a variety of school related variables (e.g., subjective attitude toward school and quality of relationship with peers and teachers). Hierarchical linear modeling shows that, among the social capital control variables, being properly integrated into the family and frequent peer interaction significantly add to mental health. At the individual (student) level only, ties to delinquent friends are negatively associated with mental health, while at both individual and contextual levels, school characteristics are positively related to adolescent subjective well-being. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Beverage caffeine intake in US consumers and subpopulations of interest: estimates from the Share of Intake Panel survey.

    PubMed

    Knight, C A; Knight, I; Mitchell, D C; Zepp, J E

    2004-12-01

    Concerns exist about the potential adverse health effects of high consumption of dietary caffeine, especially in children and pregnant women. Recommended caffeine intakes corresponding to no adverse health effects have been suggested recently for healthy adults (400-450 mg/day), for women contemplating pregnancy (300 mg/day), and for young children age 4-6 years (45 mg/day). To determine whether current caffeine intake approaches these levels, intake from major dietary sources (coffee, tea and carbonated soft drinks) were measured in 10,712 caffeinated beverage consumers in the 1999 US Share of Intake Panel, a targeted beverage survey. Mean caffeine intakes in adult caffeinated beverage consumers ranged from 106 to 170 mg/day (90th percentile intake was 227-382 mg/day). In children 1-5 and 6-9 years, mean caffeine intakes were 14 and 22 mg/day, respectively; corresponding 90th percentile intakes were 37 and 45 mg/day. Pregnant women consumed an average of 58 mg/day (157 mg/day at the 90th percentile), and women of reproductive age ingested 91-109 mg/day (229-247 mg/day at the 90th percentile). These data show that while mean caffeine intakes are within recommended safe levels, heavy consumers of certain subpopulations, including young children and women contemplating pregnancy, might benefit from dietary advice.

  14. The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample

    PubMed Central

    Kessler, Ronald C.; Borges, Guilherme; Sampson, Nancy; Miller, Matthew; Nock, Matthew K.

    2009-01-01

    Controversy exists about whether the repeatedly-documented associations between smoking and subsequent suicide-related outcomes (SROs; ideation, plans, gestures, and attempts) are due to unmeasured common causes or to causal effects of smoking on SROs. We address this issue by examining associations of smoking with subsequent SROs with and without controls for potential explanatory variables in the National Comorbidity Survey (NCS) panel. The latter consists of 5001 people who participated in both the 199002 NCS and the 2001–03 NCS Follow-up Survey. Explanatory variables include socio-demographics, potential common causes (parental history of mental-substance disorders; other respondent childhood adversities) and potential mediators (respondent history of DSM-III-R mental-substance disorders). Small gross (i.e., without controls) prospective associations are found between history of early-onset nicotine dependence and both subsequent suicide ideation and, among ideators, subsequent suicide plans. None of the baseline smoking measures, though, predicts subsequent suicide gestures or attempts among ideators. The smoking-ideation association largely disappear, but the association of early-onset nicotine dependence with subsequent suicide plans persists (Odds-ratio = 3.0), after adjustment for control variables. However, the latter association is as strong with remitted as active nicotine dependence, arguing against a direct causal effect of nicotine dependence on suicide plans. Decomposition of the control variable effects, furthermore, suggests that these effects are due to common causes more than to mediators. These results refine our understanding of the ways in which smoking is associated with later SROs and for the most part argue against the view that these associations are due to causal effects of smoking. PMID:18645572

  15. Antimicrobial Prescribing in Dogs and Cats in Australia: Results of the Australasian Infectious Disease Advisory Panel Survey.

    PubMed

    Hardefeldt, L Y; Holloway, S; Trott, D J; Shipstone, M; Barrs, V R; Malik, R; Burrows, M; Armstrong, S; Browning, G F; Stevenson, M

    2017-07-01

    Investigations of antimicrobial use in companion animals are limited. With the growing recognition of the need for improved antimicrobial stewardship, there is urgent need for more detailed understanding of the patterns of antimicrobial use in this sector. To investigate antimicrobial use for medical and surgical conditions in dogs and cats by Australian veterinarians. A cross-sectional study was performed over 4 months in 2011. Respondents were asked about their choices of antimicrobials for empirical therapy of diseases in dogs and cats, duration of therapy, and selection based on culture and susceptibility testing, for common conditions framed as case scenarios: 11 medical, 2 surgical, and 8 dermatological. A total of 892 of the 1,029 members of the Australian veterinary profession that completed the survey satisfied the selection criteria. Empirical antimicrobial therapy was more common for acute conditions (76%) than chronic conditions (24%). Overall, the most common antimicrobial classes were potentiated aminopenicillins (36%), fluoroquinolones (15%), first- and second-generation cephalosporins (14%), and tetracyclines (11%). Third-generation cephalosporins were more frequently used in cats (16%) compared to dogs (2%). Agreement with Australasian Infectious Disease Advisory Panel (AIDAP) guidelines (generated subsequently) was variable ranging from 0 to 69% between conditions. Choice of antimicrobials by Australian veterinary practitioners was generally appropriate, with relatively low use of drugs of high importance, except for the empirical use of fluoroquinolones in dogs, particularly for otitis externa and 3rd-generation cephalosporins in cats. Future surveys will determine whether introduction of the 2013 AIDAP therapeutic guidelines has influenced prescribing habits. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  16. What Should Dental Services for People with Disabilities Be Like? Results of an Irish Delphi Panel Survey

    PubMed Central

    Mac Giolla Phadraig, Caoimhin; Nunn, June; Dougall, Alison; O'Neill, Eunan; McLoughlin, Jacinta; Guerin, Suzanne

    2014-01-01

    Background This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland. Methods The study used a three round modified e-Delphi method, involving dental service professionals and people with disabilities or their representatives, in Ireland. Three rounds were completed online using SurveyMonkey. Round 1 asked: “List what you think dental services for people with disabilities in Ireland should be like.” Items for subsequent rounds were generated from responses to Round 1. Round 2 and Round 3 used 5 point Likert scales to rank these items by priority: from No Priority (1) to Top Priority (5). Consensus was achieved on each item where at least 80% of respondents considered an item either High or Top Priority. A consensus meeting concluded the process. Results Sixty-one panelists started and 48 completed the survey. The Delphi panel agreed on level of priority for 69 items and generated 16 consensus statements. These statements covered a range of topics such as access to care, availability of information and training, quality of care, dental treatment and cost. A recurrent theme relating to the appropriateness of care to individual need arose across topics suggesting a need to match service delivery according to the individual's needs, wants and expectations rather than the disability type/diagnosis based service which predominates today. Conclusions This process produced a list of prioritised goals for dental services for people with disabilities. This creates a foundation for building evidence-based service models for people with disabilities in Ireland. PMID:25420015

  17. The association between smoking and subsequent suicide-related outcomes in the National Comorbidity Survey panel sample.

    PubMed

    Kessler, R C; Borges, G; Sampson, N; Miller, M; Nock, M K

    2009-12-01

    Controversy exists about whether the repeatedly documented associations between smoking and subsequent suicide-related outcomes (SROs; ideation, plans, gestures and attempts) are due to unmeasured common causes or to causal effects of smoking on SROs. We address this issue by examining associations of smoking with subsequent SROs with and without controls for potential explanatory variables in the National Comorbidity Survey (NCS) panel. The latter consists of 5001 people who participated in both the 1990-2002 NCS and the 2001-2003 NCS follow-up survey. Explanatory variables include sociodemographics, potential common causes (parental history of mental-substance disorders; other respondent childhood adversities) and potential mediators (respondent history of Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, revised mental-substance disorders). Small gross (that is, without controls) prospective associations are found between history of early-onset nicotine dependence and both subsequent suicide ideation and, among ideators, subsequent suicide plans. None of the baseline smoking measures, though, predicts subsequent suicide gestures or attempts among ideators. The smoking-ideation association largely disappear, but the association of early-onset nicotine dependence with subsequent suicide plans persists (odds ratio=3.0), after adjustment for control variables. However, the latter association is as strong with remitted as active nicotine dependence, arguing against a direct causal effect of nicotine dependence on suicide plans. Decomposition of the control variable effects, furthermore, suggests that these effects are due to common causes more than to mediators. These results refine our understanding of the ways in which smoking is associated with later SROs and for the most part argue against the view that these associations are due to causal effects of smoking.

  18. Changes in economic status of households associated with catastrophic health expenditures for cancer in South Korea.

    PubMed

    Choi, Jae-Woo; Cho, Kyoung-Hee; Choi, Young; Han, Kyu-Tae; Kwon, Jeoung-A; Park, Eun-Cheol

    2014-01-01

    Cancer imposes significant economic challenges for individuals, families, and society. Households of cancer patients often experience income loss due to change in job status and/or excessive medical expenses. Thus, we examined whether changes in economic status for such households is affected by catastrophic health expenditures. We used the Korea Health Panel Survey (KHPS) Panel 1st-4th (2008- 2011 subjects) data and extracted records from 211 out of 5,332 households in the database for this study. To identify factors associated with catastrophic health expenditures and, in particular, to examine the relationship between change in economic status and catastrophic health expenditures, we conducted a generalized linear model analysis. Among 211 households with cancer patients, 84 (39.8%) experienced catastrophic health expenditures, while 127 (40.2%) did not show evidence of catastrophic medical costs. If a change in economic status results from a change in job status for head of household (job loss), these households are more likely to incur catastrophic health expenditure than households who have not experienced a change in job status (odds ratios (ORs)=2.17, 2.63, respectively). A comparison between households with a newly-diagnosed patient versus households with patients having lived with cancer for one or two years, showed the longer patients had cancer, the more likely their households incurred catastrophic medical costs (OR=1.78, 1.36, respectively). Change in economic status of households in which the cancer patient was the head of household was associated with a greater likelihood that the household would incur catastrophic health costs. It is imperative that the Korean government connect health and labor policies in order to develop economic programs to assist households with cancer patients.

  19. Supplemental Nutrition Assistance Program (SNAP) Participation and Health Care Expenditures Among Low-Income Adults.

    PubMed

    Berkowitz, Seth A; Seligman, Hilary K; Rigdon, Joseph; Meigs, James B; Basu, Sanjay

    2017-09-25

    Food insecurity is associated with high health care expenditures, but the effectiveness of food insecurity interventions on health care costs is unknown. To determine whether the Supplemental Nutrition Assistance Program (SNAP), which addresses food insecurity, can reduce health care expenditures. This is a retrospective cohort study of 4447 noninstitutionalized adults with income below 200% of the federal poverty threshold who participated in the 2011 National Health Interview Survey (NHIS) and the 2012-2013 Medical Expenditure Panel Survey (MEPS). Self-reported SNAP participation in 2011. Total health care expenditures (all paid claims and out-of-pocket costs) in the 2012-2013 period. To test whether SNAP participation was associated with lower subsequent health care expenditures, we used generalized linear modeling (gamma distribution, log link, with survey design information), adjusting for demographics (age, gender, race/ethnicity), socioeconomic factors (income, education, Social Security Disability Insurance disability, urban/rural), census region, health insurance, and self-reported medical conditions. We also conducted sensitivity analyses as a robustness check for these modeling assumptions. A total of 4447 participants (2567 women and 1880 men) were enrolled in the study, mean (SE) age, 42.7 (0.5) years; 1889 were SNAP participants, and 2558 were not. Compared with other low-income adults, SNAP participants were younger (mean [SE] age, 40.3 [0.6] vs 44.1 [0.7] years), more likely to have public insurance or be uninsured (84.9% vs 67.7%), and more likely to be disabled (24.2% vs 10.6%) (P < .001 for all). In age- and gender-adjusted models, health care expenditures between those who did and did not participate in SNAP were similar (difference, $34; 95% CI, -$1097 to $1165). In fully adjusted models, SNAP was associated with lower estimated annual health care expenditures (-$1409; 95% CI, -$2694 to -$125). Sensitivity analyses were consistent with

  20. 76 FR 52955 - Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... HUMAN SERVICES Medicare Program; Meeting of the Technical Advisory Panel on Medicare Trustee Reports.... SUMMARY: This notice announces public meetings of the Technical Advisory Panel on Medicare Trustee Reports... Health Expenditures and Medicare expenditures. The Panel's discussion is expected to be very technical...

  1. Analysis of four studies in a comparative framework reveals: health linkage consent rates on British cohort studies higher than on UK household panel surveys.

    PubMed

    Knies, Gundi; Burton, Jonathan

    2014-11-27

    A number of cohort studies and longitudinal household panel studies in Great Britain have asked for consent to link survey data to administrative health data. We explore commonalities and differences in the process of collecting consent, achieved consent rates and biases in consent with respect to socio-demographic, socio-economic and health characteristics. We hypothesise that British cohort studies which are rooted within the health sciences achieve higher consent rates than the UK household longitudinal studies which are rooted within the social sciences. By contrast, the lack of a specific health focus in household panel studies means there may be less selectivity in consent, in particular, with respect to health characteristics. Survey designs and protocols for collecting informed consent to health record linkage on two British cohort studies and two UK household panel studies are systematically compared. Multivariate statistical analysis is then performed on information from one cohort and two household panel studies that share a great deal of the data linkage protocol but vary according to study branding, survey design and study population. We find that consent is higher in the British cohort studies than in the UK household panel studies, and is higher the more health-focused the study is. There are no systematic patterns of consent bias across the studies and where effects exist within a study or study type they tend to be small. Minority ethnic groups will be underrepresented in record linkage studies on the basis of all three studies. Systematic analysis of three studies in a comparative framework suggests that the factors associated with consent are idiosyncratic to the study. Analysis of linked health data is needed to establish whether selectivity in consent means the resulting research databases suffer from any biases that ought to be considered.

  2. Causal Inference in Panel Data with Application to Estimating Race-of-Interviewer Effects in the General Social Survey

    ERIC Educational Resources Information Center

    An, Weihua; Winship, Christopher

    2017-01-01

    In this article, we review popular parametric models for analyzing panel data and introduce the latest advances in matching methods for panel data analysis. To the extent that the parametric models and the matching methods offer distinct advantages for drawing causal inference, we suggest using both to cross-validate the evidence. We demonstrate…

  3. Young adults' health care utilization and expenditures prior to the Affordable Care Act.

    PubMed

    Lau, Josephine S; Adams, Sally H; Boscardin, W John; Irwin, Charles E

    2014-06-01

    To examine young adults' health care utilization and expenditures prior to the Affordable Care Act. We used 2009 Medical Expenditure Panel Survey to (1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and (2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other sociodemographic factors, including race/ethnicity and income. Young adults had (1) significantly lower rates of overall utilization (72%) than other age groups (83%-88%, p < .001), (2) the lowest rate of office-based utilization (55% vs. 67%-77%, p < .001) and (3) higher rate of emergency room visits compared with adolescents (15% vs. 12%, p < .01). Uninsured young adults had high out-of-pocket expenses. Compared with the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/person, p < .001) but essentially the same out-of-pocket expenses ($403 vs. $380/person, p = .57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language, and sex. Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of emergency room visits. The Affordable Care Act provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address noninsurance barriers and ensure equal access to health services. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. Health expenditure comparison of extended-release metoprolol succinate and immediate-release metoprolol tartarate

    PubMed Central

    Vaidya, Varun; Patel, Pranav

    2012-01-01

    Background Metoprolol, a selective beta-1 blocker, is available in two different salt forms in the market – metoprolol succinate (MS) and metoprolol tartarate (MT). Both the formulations are Food and Drug Administration approved for the treatment of hypertension. Several studies have shown similar efficacies between the two salts; however, they differ in their pharmacokinetic properties and are therefore priced differently. The primary objective of this study was to compare the overall health care expenditures of hypertensive patients on MT and MS to see if the price difference in the two preparations is offset by savings in overall expenditure. Methods Two cohorts of patients using MT and MS were selected from the 2008 Medical Expenditure Panel Survey. Propensity score matching technique was used to balance the cohorts on various parameters such as demographic information, insurance status, and comorbidity score. Patients using MT were matched to patients using MS on the logit of propensity score using calipers of width equal to 0.2 of the standard deviation of the logit of the propensity score. Multiple regression analysis was carried out to examine the association between health expenditure and type of metoprolol salt, adjusting for other covariates. Results A total of 742 patients were found to use metoprolol (MT-388, MS-354). After propensity score matching, a total of 582 patients were left in the sample for final analysis (291 patients in each cohort). The average annual health care expenditure was slightly higher in the MT cohort; however, after adjusting for covariates in a multivariate analysis, the difference was found to be statistically insignificant (P = 0.23). Conclusion Both the products of metoprolol were found to have similar average annual total health care expenditure; however, MS once a day has higher out-of-pocket cost. PMID:22359463

  5. Shared Decision-Making and Health Care Expenditures Among Children With Special Health Care Needs

    PubMed Central

    Mayne, Stephanie; Localio, A. Russell; Alessandrini, Evaline A.; Guevara, James P.

    2012-01-01

    Background And Objectives To understand the association between shared decision-making (SDM) and health care expenditures and use among children with special health care needs (CSHCN). Methods We identified CSHCN <18 years in the 2002–2006 Medical Expenditure Panel Survey by using the CSHCN Screener. Outcomes included health care expenditures (total, out-of-pocket, office-based, inpatient, emergency department [ED], and prescription) and utilization (hospitalization, ED and office visit, and prescription rates). The main exposure was the pattern of SDM over the 2 study years (increasing, decreasing, or unchanged high or low). We assessed the impact of these patterns on the change in expenditures and utilization over the 2 study years. Results Among 2858 subjects representing 12 million CSHCN, 15.9% had increasing, 15.2% decreasing, 51.9% unchanged high, and 17.0% unchanged low SDM. At baseline, mean per child total expenditures were $2131. Over the 2 study years, increasing SDM was associated with a decrease of $339 (95% confidence interval: $21, $660) in total health care costs. Rates of hospitalization and ED visits declined by 4.0 (0.1, 7.9) and 11.3 (4.3, 18.3) per 100 CSHCN, and office visits by 1.2 (0.3, 2.0) per child with increasing SDM. Relative to decreasing SDM, increasing SDM was associated with significantly lower total and out-of-pocket costs, and fewer office visits. Conclusions We found that increasing SDM was associated with decreased utilization and expenditures for CSHCN. Prospective study is warranted to confirm if fostering SDM reduces the costs of caring for CSHCN for the health system and families. PMID:22184653

  6. Young Adults' Health Care Utilization and Expenditures Prior to the Affordable Care Act

    PubMed Central

    Lau, Josephine S.; Adams, Sally H.; Boscardin, W. John; Irwin, Charles E.

    2014-01-01

    Purpose Examine young adults' health care utilization and expenditures prior to the ACA. Methods We used 2009 Medical Expenditure Panel Survey (MEPS) to 1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and 2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other socio-demographic factors, including race/ethnicity and income. Results Young adults had: 1) significantly lower rates of overall utilization (72%) than other age groups (83-88%, P<.001) and 2), the lowest rate of office-based utilization (55% vs. 67-77%, P<.001) and higher rate of ER visits compared to adolescents (15% v. 12%, P<.01). Uninsured young adults had high out-of-pocket expenses. Compared to the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/ person, P<.001), but essentially the same out-of-pocket expenses ($403 vs. $380/person, p =.57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language and sex. Conclusions Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of ER visits. The ACA provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address non-insurance barriers and ensure equal access to health services. PMID:24702839

  7. Widow(er) poverty and out-of-pocket medical expenditures near the end of life.

    PubMed

    McGarry, Kathleen; Schoeni, Robert F

    2005-05-01

    Elderly widows are three times as likely to live in poverty as older married people. This study investigates the gap in poverty, income, and wealth between these groups. Focus is placed on the role played by out-of-pocket medical expenditures spent on dying spouses. A national panel survey of people age 70 and older in 1993 was used. Income, poverty, wealth, and out-of-pocket expenditures were examined before and after widowhood, with comparisons made with couples not experiencing a death. Forty-four percent of the difference in economic status between widow(er)s and married elderly persons was due to disparities in economic status that existed prior to widowhood. The remaining 56% was due to factors more directly related to the death of a spouse, including the loss of income and expenses associated with dying. On average, out-of-pocket medical expenditures in the final 2 years of life were equal to 30% of the couple's annual income. For couples in the bottom quarter of the income distribution, these expenditures were 70% of their income. As policy makers continue to debate expansions and reforms of Medicare, the potential effects of these reforms on economic well-being, particularly among widows, should be considered.

  8. Is changing status through housing tenure associated with changes in mental health? Results from the British Household Panel Survey

    PubMed Central

    Popham, Frank; Williamson, Lee; Whitley, Elise

    2015-01-01

    Background Actual or perceived status, such as housing tenure, may impact on health through stress-inducing social comparisons. Studies of how status change impacts mental health change are rare but important because they are less prone to confounding. Methods We used data from the British Household Panel Survey to compare psychological distress in local authority renters who opted to buy their home under the UK's Right to Buy (RTB) policy versus those who continued to rent the same (social non-mover (SNM)) or a different (social mover (SM)) local authority property or who bought privately (owner mover (OM)). General Health Questionnaire (GHQ-12) scores before and after any change in tenure and/or address were compared across groups using a difference-in-difference approach. Results Individuals who moved house (bought or rented) were younger while those who bought (the same or different house) were better off, more likely to be employed, and had higher educational qualifications. Individuals who bought their home (under RTB or privately) had lower distress scores from the outset. Individuals who moved house (bought or rented) experienced a rise in distress prior to moving that was no longer evident 1 year after the move. There was no evidence that changing tenure reduced psychological distress comparing (difference (95% CI)) average GHQ score 2 years preaddress and 1 year postaddress/tenure change in RTB vs SNM, SM, OM: −0.08 (−0.68 to 0.51), 0.16 (−0.70 to 1.01) and −0.17 (−1.28 to 0.94), respectively). Conclusions Changing tenure under RTB did not, on average, impact psychological distress, suggesting that this status change did not change mental health. PMID:25294896

  9. Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey.

    PubMed

    Martin, Adam; Goryakin, Yevgeniy; Suhrcke, Marc

    2014-12-01

    The aim of this study is to explore the relationship between active travel and psychological wellbeing. This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2-2008/9). Fixed effects regression models were used to investigate how (i.) travel mode choice, (ii.) commuting time, and (iii.) switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire. After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between overall psychological wellbeing (on a 36-point Likert scale) and (i.) active travel (0.185, 95% CI: 0.048 to 0.321) and public transport (0.195, 95% CI: 0.035 to 0.355) when compared to car travel, (ii.) time spent (per 10minute change) walking (0.083, 95% CI: 0.003 to 0.163) and driving (-0.033, 95% CI: -0.064 to -0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199 to 0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel. The positive psychological wellbeing effects identified in this study should be considered in cost-benefit assessments of interventions seeking to promote active travel. Copyright © 2014. Published by Elsevier Inc.

  10. Physicians' Characteristics Associated with Exploring Suicide Risk among Patients with Depression: A French Panel Survey of General Practitioners

    PubMed Central

    Bocquier, Aurélie; Pambrun, Elodie; Dumesnil, Hélène; Villani, Patrick; Verdoux, Hélène; Verger, Pierre

    2013-01-01

    Background General practitioners (GPs) have a key role to play in suicide prevention, but the rates at which they question patients with depression about suicidal thoughts and plans are rather low. Little is known about GPs' characteristics associated with such inquiries. Our objectives were to describe GPs' attitudes, perceived barriers, and self-reported practices in this questioning of these patients and to analyze factors associated with these practices. Methodology This cross-sectional survey was conducted among participants in a panel of randomly selected French GPs (1249/1431 participated: 87.3%). GPs were interviewed with a standardized questionnaire covering their professional and personal characteristics, attitudes, and practices in exploring the suicide risk of their patients with depression. We built a suicide inquiry score by summing the responses to 5 items and used a multiple linear regression analysis to explore the characteristics associated with this score. Principal Findings Most GPs reported inquiring about the presence of suicidal ideation often or very often; less than 30% reported that they frequently explored signs of a specific suicide plan. The mean suicide inquiry score was 12.4 (SD, 2.9; range, 5–20). False ideas, such as thinking that patients who report suicidal ideas do not often commit suicide, were frequent (42.3%). Previous continuing medical education on suicide, participation in a formal mental health network, and patients who committed suicide in the past 5 years were associated with a higher score. Reluctance to question patients about suicide and perception of insufficient skill were associated with a lower score. Conclusions/Significance This study showed great variability in French GPs' practices in exploring suicide risk in patients with depression. Interventions aiming at improving GPs' initial training and continuing medical education in suicide and/or depression, and their collaboration with mental health specialists

  11. Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey

    PubMed Central

    Martin, Adam; Goryakin, Yevgeniy; Suhrcke, Marc

    2014-01-01

    Objective The aim of this study is to explore the relationship between active travel and psychological wellbeing. Method This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2–2008/9). Fixed effects regression models were used to investigate how (i.) travel mode choice, (ii.) commuting time, and (iii.) switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire. Results After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between overall psychological wellbeing (on a 36-point Likert scale) and (i.) active travel (0.185, 95% CI: 0.048 to 0.321) and public transport (0.195, 95% CI: 0.035 to 0.355) when compared to car travel, (ii.) time spent (per 10 minute change) walking (0.083, 95% CI: 0.003 to 0.163) and driving (− 0.033, 95% CI: − 0.064 to − 0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199 to 0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel. Conclusion The positive psychological wellbeing effects identified in this study should be considered in cost–benefit assessments of interventions seeking to promote active travel. PMID:25152507

  12. Catastrophic expenditure on medicines in Brazil

    PubMed Central

    Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Oliveira, Maria Auxiliadora; Arrais, Paulo Sergio Dourado; Ramos, Luiz Roberto; Pizzol, Tatiane da Silva Dal; Mengue, Sotero Serrate; Farias, Mareni Rocha; Bertoldi, Andréa Dâmaso

    2016-01-01

    ABSTRACT OBJECTIVE To describe the magnitude of the expenditure on medicines in Brazil according to region, household size and composition in terms of residents in a situation of dependency. METHODS Population-based data from the national household survey were used, with probabilistic sample, applied between September 2013 and February 2014 in urban households. The expenditure on medicines was the main outcome of interest. The prevalence and confidence intervals (95%CI) of the outcomes were stratified according to socioeconomic classification and calculated according to the region, the number of residents dependent on income, the presence of children under five years and residents in a situation of dependency by age. RESULTS In about one of every 17 households (5.3%) catastrophic health expenditure was reported and, in 3.2%, the medicines were reported as one of the items responsible for this situation. The presence of three or more residents (3.6%) and resident in a situation of dependency (3.6%) were the ones that most reported expenditure on medicines. Southeast was the region with the lowest prevalence of expenditure on medicines. The prevalence of households with catastrophic health expenditure and on medicines in relation to the total of households showed a regressive tendency for economic classes. CONCLUSIONS Catastrophic health expenditure was present in 5.3%, and catastrophic expenditure on medicines in 3.2% of the households. Multi-person households, presence of residents in a situation of economic dependency and belonging to the class D or E had the highest proportion of catastrophic expenditure on medicines. Although the problem is important, permeated by aspects of iniquity, Brazilian policies seem to be protecting families from catastrophic expenditure on health and on medicine. PMID:27982383

  13. AAPM/RSNA physics tutorial for residents: physics of flat-panel fluoroscopy systems: Survey of modern fluoroscopy imaging: flat-panel detectors versus image intensifiers and more.

    PubMed

    Nickoloff, Edward Lee

    2011-01-01

    This article reviews the design and operation of both flat-panel detector (FPD) and image intensifier fluoroscopy systems. The different components of each imaging chain and their functions are explained and compared. FPD systems have multiple advantages such as a smaller size, extended dynamic range, no spatial distortion, and greater stability. However, FPD systems typically have the same spatial resolution for all fields of view (FOVs) and are prone to ghosting. Image intensifier systems have better spatial resolution with the use of smaller FOVs (magnification modes) and tend to be less expensive. However, the spatial resolution of image intensifier systems is limited by the television system to which they are coupled. Moreover, image intensifier systems are degraded by glare, vignetting, spatial distortions, and defocusing effects. FPD systems do not have these problems. Some recent innovations to fluoroscopy systems include automated filtration, pulsed fluoroscopy, automatic positioning, dose-area product meters, and improved automatic dose rate control programs. Operator-selectable features may affect both the patient radiation dose and image quality; these selectable features include dose level setting, the FOV employed, fluoroscopic pulse rates, geometric factors, display software settings, and methods to reduce the imaging time.

  14. National health expenditures, 1993.

    PubMed

    Levit, K R; Sensenig, A L; Cowan, C A; Lazenby, H C; McDonnell, P A; Won, D K; Sivarajan, L; Stiller, J M; Donham, C S; Stewart, M S

    1994-01-01

    This article presents data on health care spending for the United States, covering expenditures for various types of medical services and products and their sources of funding from 1960 to 1993. Although these statistics show a slowing in the growth of health care expenditures over the past few years, spending continues to increase faster than the overall economy. The share of the Nation's health care bill funded by the Federal Government through the Medicaid and Medicare programs steadily increased from 1991 to 1993. This significant change in the share of health expenditures funded by the public sector has caused Federal health expenditures as a share of all Federal spending to increase dramatically.

  15. Household income and health care expenditures in Mexico.

    PubMed

    Parker, S W; Wong, R

    1997-06-01

    The purpose of this paper is to examine the determinants of household health expenditures in Mexico. Our analysis involves the estimation of household monetary health care expenditures, using the economic and demographic characteristics of the household as covariates. We pay particular attention to the impact of household income on health expenditures, estimating the elasticity of health care expenditures with respect to income for different income groups and according to health insurance status. For the empirical analysis, we use the Mexican National Survey of Income and Expenditures of 1989. Our principle findings show that monetary health expenditures by Mexican households are sensitive to changes in household income levels and that the group which is most responsive to changes in income levels in the lower-income uninsured group. This suggests that in times of economic crisis, these households reduce cash expenditures on health care by proportionately more than higher-income and insured households.

  16. Determinants of Obesity and Associated Population Attributability, South Africa: Empirical Evidence from a National Panel Survey, 2008-2012

    PubMed Central

    Sartorius, Benn; Veerman, Lennert J.; Manyema, Mercy; Chola, Lumbwe; Hofman, Karen

    2015-01-01

    Background Obesity is a major risk factor for emerging non-communicable diseases (NCDS) in middle income countries including South Africa (SA). Understanding the multiple and complex determinants of obesity and their true population attributable impact is critical for informing and developing effective prevention efforts using scientific based evidence. This study identified contextualised high impact factors associated with obesity in South Africa. Methods Analysis of three national cross sectional (repeated panel) surveys, using a multilevel logistic regression and population attributable fraction estimation allowed for identification of contextualised high impact factors associated with obesity (BMI>30 kg/m2) among adults (15years+). Results Obesity prevalence increased significantly from 23.5% in 2008 to 27.2% in 2012, with a significantly (p-value<0.001) higher prevalence among females (37.9% in 2012) compared to males (13.3% in 2012). Living in formal urban areas, white ethnicity, being married, not exercising and/or in higher socio-economic category were significantly associated with male obesity. Females living in formal or informal urban areas, higher crime areas, African/White ethnicity, married, not exercising, in a higher socio-economic category and/or living in households with proportionate higher spending on food (and unhealthy food options) were significantly more likely to be obese. The identified determinants appeared to account for 75% and 43% of male and female obesity respectively. White males had the highest relative gain in obesity from 2008 to 2012. Conclusions The rising prevalence of obesity in South Africa is significant and over the past 5 years the rising prevalence of Type-2 diabetes has mirrored this pattern, especially among females. Targeting young adolescent girls should be a priority. Addressing determinants of obesity will involve a multifaceted strategy and requires at individual and population levels. With rising costs in the

  17. Gender differences in the mental health of single parents: New Zealand evidence from a household panel survey.

    PubMed

    Collings, Sunny; Jenkin, Gabrielle; Carter, Kristie; Signal, Louise

    2014-05-01

    In many countries single parents report poorer mental health than partnered parents. This study investigates whether there are gender differences in the mental health of single parents in New Zealand (and whether any gender difference varies with that among partnered parents), and examines key social and demographic mediators that may account for this difference. We used data on 905 single parents and 4,860 partnered parents from a New Zealand household panel survey that included the Kessler-10 measure of psychological distress. Linear regression analyses were used to investigate both interactions of gender and parental status, and confounding or mediation by other covariates. High/very high levels of psychological distress were reported by 15.7 % of single mothers and 9.1 % of single fathers, and 6.1 % of partnered mothers and 4.1 % of partnered fathers. In an Ordinary Least Squares regression of continuous K10 scores on gender, parental status and the interaction of both (plus adjustment for ethnicity, number of children and age), female single parents had a 1.46 higher K10 score than male single parents (95 % CI 0.48-2.44; 1.46). This difference was 0.98 (95 % CI -0.04 to 1.99) points greater than the gender difference among partnered parents. After controlling for further confounding or mediating covariates (educational level, labour force status and socioeconomic deprivation) both the gender difference among single parents (0.38, -0.56 to 1.31) and the interaction of gender and parental status (0.28 greater gender difference among single parents, -0.69 to 1.65) greatly reduced in magnitude and became non-significant, mainly due to adjustment for individual socioeconomic deprivation. The poorer mental health of single parents remains an important epidemiological phenomenon. Although research has produced mixed findings of the nature of gender differences in the mental health of single parents, our research adds to the increasing evidence that it is single

  18. Recent revisions to and recommendations for national health expenditures accounting

    PubMed Central

    Haber, Susan G.; Newhouse, Joseph P.

    1991-01-01

    The Health Care Financing Administration (HCFA) has importantly revised the methodology for estimating annual national health expenditures. Among other changes, the revisions estimated out-of-pocket spending directly, disaggregated expenditures to a greater degree, and reduced undercounting and double counting. Estimates of total spending and out-of-pocket spending changed. This article summarizes a meeting of a technical advisory panel, convened by HCFA, that reviewed the modifications adopted and made recommendations for future revisions. PMID:10114932

  19. 43 CFR 3861.2-3 - Mineral surveyor's report of expenditures and improvements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-3 Mineral surveyor's report of expenditures and... provision requiring an expenditure of $500 as a basis for patent as to all of the claims of the...

  20. Trends in Educational Expenditure.

    ERIC Educational Resources Information Center

    Burke, Gerald

    This study provides an overview of expenditures for education and training by educational institutions in Australia, 1991-2001. The study used newly available data from the Australian Bureau of Statistics (ABS) and administrative data from the main sectors' reports on the size and trends in public and private education expenditures. It analyzed…

  1. Household energy consumption and expenditures 1993

    SciTech Connect

    1995-10-05

    This presents information about household end-use consumption of energy and expenditures for that energy. These data were collected in the 1993 Residential Energy Consumption Survey; more than 7,000 households were surveyed for information on their housing units, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information represents all households nationwide (97 million). Key findings: National residential energy consumption was 10.0 quadrillion Btu in 1993, a 9% increase over 1990. Weather has a significant effect on energy consumption. Consumption of electricity for appliances is increasing. Houses that use electricity for space heating have lower overall energy expenditures than households that heat with other fuels. RECS collected data for the 4 most populous states: CA, FL, NY, TX.

  2. International Developments of Educational Expenditure, 1950-1965.

    ERIC Educational Resources Information Center

    Edding, Friedrich; Berstecher, Dieter

    This document describes, analyzes, and interprets international developments reflected in public educational expenditures. The report includes (1) a survey of educational expenditures of 35 UNESCO member countries between 1950 and 1965 in relation to other aggregate data, (2) a description and interpretation of shifts in the composition of total…

  3. Expenditures on Children by Families: 2002 Annual Report.

    ERIC Educational Resources Information Center

    Lino, Mark

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 2002 dollars using the Consumer Price Index. Data and…

  4. Expenditures on Children by Families: 2001 Annual Report.

    ERIC Educational Resources Information Center

    Lino, Mark

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 2001 dollars using the Consumer Price Index. Data and…

  5. Expenditures on Children by Families: 2000 Annual Report.

    ERIC Educational Resources Information Center

    Lino, Mark

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 2000 dollars using the Consumer Price Index. Data and…

  6. Expenditures on Children by Families: 1997 Annual Report.

    ERIC Educational Resources Information Center

    Lino, Mark

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 1997 dollars using the Consumer Price Index. Data and…

  7. Expenditures on Children by Families: 1999 Annual Report.

    ERIC Educational Resources Information Center

    Lino, Mark

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 1999 dollars using the Consumer Price Index. Data and…

  8. Expenditures on Children by Families: 1998 Annual Report.

    ERIC Educational Resources Information Center

    Lino, Mark

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families, using data from the 1990-92 Consumer Expenditure Survey, updated to 1998 dollars using the Consumer Price Index. Data and…

  9. Examination of Generational Differences in Household Apparel Expenditures.

    ERIC Educational Resources Information Center

    Norum, Pamela S.

    2003-01-01

    Data from the 1998 Consumer Expenditures Survey were used to estimate expenditure equations for apparel by age category: 1901-32, 1933-45, 1956-64, 1965-76, 1977-present). Significant differences were found between the 1956-64 cohort and others; they spent less on women's and more and children's clothing. The youngest group spent the highest…

  10. Using Comparative Expenditure Data for Institutional Planning. SAIR Conference Paper.

    ERIC Educational Resources Information Center

    Sanford, Timothy R.; Sadler, James C.

    The use of Higher Education General Information Survey (HEGIS) data and a software program to compare public university expenditures is discussed. Financial expenditures at the University of North Carolina, Chapel Hill, (UNC) and other public universities were compared using 1981-1982 and 1982-1983 HEGIS data for public university members of the…

  11. Examination of Generational Differences in Household Apparel Expenditures.

    ERIC Educational Resources Information Center

    Norum, Pamela S.

    2003-01-01

    Data from the 1998 Consumer Expenditures Survey were used to estimate expenditure equations for apparel by age category: 1901-32, 1933-45, 1956-64, 1965-76, 1977-present). Significant differences were found between the 1956-64 cohort and others; they spent less on women's and more and children's clothing. The youngest group spent the highest…

  12. The Effects of Survey Administration on Disclosure Rates to Sensitive Items Among Men: A Comparison of an Internet Panel Sample with a RDD Telephone Sample

    PubMed Central

    Hines, Denise A.; Douglas, Emily M.; Mahmood, Sehar

    2010-01-01

    Research using Internet surveys is an emerging field, yet research on the legitimacy of using Internet studies, particularly those targeting sensitive topics, remains under-investigated. The current study builds on the existing literature by exploring the demographic differences between Internet panel and RDD telephone survey samples, as well as differences in responses with regard to experiences of intimate partner violence perpetration and victimization, alcohol and substance use/abuse, PTSD symptomatology, and social support. Analyses indicated that after controlling for demographic differences, there were few differences between the samples in their disclosure of sensitive information, and that the online sample was more socially isolated than the phone sample. Results are discussed in terms of their implications for using Internet samples in research on sensitive topics. PMID:20948972

  13. The Effects of Survey Administration on Disclosure Rates to Sensitive Items Among Men: A Comparison of an Internet Panel Sample with a RDD Telephone Sample.

    PubMed

    Hines, Denise A; Douglas, Emily M; Mahmood, Sehar

    2010-11-01

    Research using Internet surveys is an emerging field, yet research on the legitimacy of using Internet studies, particularly those targeting sensitive topics, remains under-investigated. The current study builds on the existing literature by exploring the demographic differences between Internet panel and RDD telephone survey samples, as well as differences in responses with regard to experiences of intimate partner violence perpetration and victimization, alcohol and substance use/abuse, PTSD symptomatology, and social support. Analyses indicated that after controlling for demographic differences, there were few differences between the samples in their disclosure of sensitive information, and that the online sample was more socially isolated than the phone sample. Results are discussed in terms of their implications for using Internet samples in research on sensitive topics.

  14. Null association between workplace social capital and body mass index. Results from a four-wave panel survey among employees in Japan (J-HOPE study).

    PubMed

    Tsuboya, Toru; Tsutsumi, Akizumi; Kawachi, Ichiro

    2016-02-01

    Research on the longitudinal association of workplace social capital and obesity is limited. We sought to investigate the prospective association of social capital in the workplace with body mass index (BMI) among employees in Japan. We used repeat panel surveys from 12 private companies in Japan. In the present study, four annual surveys waves were used, including 8811, 10,608, 9766, and 6249 participants, respectively. The first survey was conducted between October 2010 and December 2011 (response rate = 77.4%), and the following three surveys were conducted at approximately annual intervals. Questionnaires inquiring about workplace social capital, and other characteristics were administered at each survey. Height and weight were objectively measured in 11 companies, and self-reported in one company. Cross-sectional as well as fixed effects analysis of change in social capital and change in BMI were conducted. Analyses were stratified by age, sex, BMI at baseline, and companies. The analysis was conducted in 2015. Over 3 years, approximately 32% of the participants changed their BMI by more than 1 unit, while workplace social capital changed for approximately 78% of the sample. We found no associations between change in workplace social capital and change in BMI. The null association was preserved across analyses stratified by sex, age, overweight/obesity status at baseline, and company. Workplace social capital is not associated with changes in employee BMI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. National Health Expenditures, 1993

    PubMed Central

    Levit, Katharine R.; Sensenig, Arthur L.; Cowan, Cathy A.; Lazenby, Helen C.; McDonnell, Patricia A.; Won, Darleen K.; Sivarajan, Lekha; Stiller, Jean M.; Donham, Carolyn S.; Stewart, Madie S.

    1994-01-01

    This article presents data on health care spending for the United States, covering expenditures for various types of medical services and products and their sources of funding from 1960 to 1993. Although these statistics show a slowing in the growth of health care expenditures over the past few years, spending continues to increase faster than the overall economy. The share of the Nation's health care bill funded by the Federal Government through the Medicaid and Medicare programs steadily increased from 1991 to 1993. This significant change in the share of health expenditures funded by the public sector has caused Federal health expenditures as a share of all Federal spending to increase dramatically. PMID:10140156

  16. Expenditures for Scientific Research Equipment at Ph.D. Granting Institutions, FY 1978.

    ERIC Educational Resources Information Center

    Gomberg, Irene L.; Atelsek, Frank J.

    At the request of the National Science Foundation (NSF), the Higher Education Panel (a stratified sample of 760 colleges and universities) collected information on the level of institutional expenditures for research equipment, the federal contribution to those expenditures, and the share of funds expended for high-cost items. The data were…

  17. Does Personality Moderate Reaction and Adaptation to Major Life Events? Evidence from the British Household Panel Survey

    PubMed Central

    Yap, Stevie C. Y.; Anusic, Ivana; Lucas, Richard E.

    2012-01-01

    A nationally representative panel study of British households was used to examine the extent to which Big Five personality traits interact with the experience of major life events (marriage, childbirth, unemployment, and widowhood) to predict increases and decreases in life satisfaction following the event. Results show that major life events are associated with changes in life satisfaction, and some of these changes are very long lasting. Personality traits did not have consistent moderating effects on the association between stressful life events and life satisfaction over time. PMID:23049147

  18. Effects of Energy Needs and Expenditures on U.S. Public Schools. Statistical Analysis Report.

    ERIC Educational Resources Information Center

    Smith, Timothy; Porch, Rebecca; Farris, Elizabeth; Fowler, William

    This report provides national estimates on energy needs and expenditures of U.S. public school districts. The survey provides estimates of Fiscal Year (FY) 2000 energy expenditures, FY 2001 energy budgets and expenditures, and FY 2002 energy budgets; methods used to cover energy budget shortfalls in FY 2001; and possible reasons for those…

  19. Small Change: Expenditures for Resources in School Library Media Centers, FY 1995-1996.

    ERIC Educational Resources Information Center

    Miller, Marilyn L.; Shontz, Marilyn L.

    1997-01-01

    Comparing 1994 and 1996, the eighth biennial survey of school libraries found median expenditures for books unchanged; audiovisuals, periodicals, microforms, and CD-ROM expenditures down; and software, local area network, and Internet expenditures up. The report also examines the extent of collaboration between library media specialists and…

  20. Obesity and health expenditures: evidence from Australia.

    PubMed

    Buchmueller, Thomas C; Johar, Meliyanni

    2015-04-01

    Rising rates of obesity are a public health concern in every industrialized country. This study investigates the relationship between obesity and health care expenditure in Australia, where the rate of obesity has tripled in the last three decades. Now one in four Australians is considered obese, defined as having a body mass index (BMI, kg/m(2)) of 30 or over. The analysis is based on a random sample survey of over 240,000 adults aged 45 and over that is linked at the individual-level to comprehensive administrative health care claims for the period 2006-2009. This sub-population group has an obesity rate that is nearly 30% and is a major consumer of health services. Relative to the average annual health expenditures of those with normal weight, we find that the health expenditures of those with a BMI between 30 and 35 (obese type I) are 19% higher and expenditures of those with BMI greater than 35 (obese type II/III) are 51% higher. We find large and significant differences in all types of care: inpatient, emergency department, outpatient and prescription drugs. The obesity-related health expenditures are higher for obese type I women than men, but in the obese type II/III state, obesity-related expenditures are higher for men. When we stratify further by age groups, we find that obesity has the largest impact among men over age 75 and women aged 60-74 years old. In addition, we find that obesity impacts health expenditures not only through its link to chronic diseases, but also because it increases the cost of recovery from acute health shocks. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Panel Discussion

    NASA Astrophysics Data System (ADS)

    Langer, James

    1997-03-01

    Panelists: Arthur Bienenstock, Stanford University Cherry Ann Murray, Lucent Technologies Venkatesh Narayanamurti, University of California-Santa Barbara Paul Peercy, SEMI-SEMATECH Robert Richardson, Cornell University James Roberto, Oak Ridge National Laboratory The Board on Physics and Astronomy is undertaking a series of reassessments of all branches of physics as the foundation of a new physics survey. As part of this project, a Committee on Condensed Matter and Materials Physics has been established under the leadership of Venkatesh Narayanamurti of the University of California-Santa Barbara. The committee has been working since June on a study that will include an illustrative recounting of major recent achievements; identification of new opportunities and challenges facing the field; and articulation-for leaders in government, industry, universities, and the public at large-of the important roles played by the field in modern society. An especially urgent issue is how to maintain the intellectual vitality of condensed matter and materials physics, and its contributions to the well-being of the United States, in an era of limited resources. The forum will feature a panel of materials researchers who are members of the Committee on Condensed Matter and Materials Physics. They will give a brief report on the status of the study and engage in a dialogue with the audience about issues facing the condensed matter and materials physics community. Broad community input is vital to the success of the study. Please come and make your voice heard!

  2. Income elasticity of health expenditures in Iran.

    PubMed

    Zare, Hossein; Trujillo, Antonio J; Leidman, Eva; Buttorff, Christine

    2013-09-01

    Because of its policy implications, the income elasticity of health care expenditures is a subject of much debate. Governments may have an interest in subsidizing the care of those with low income. Using more than two decades of data from the Iran Household Expenditure and Income Survey, this article investigates the relationship between income and health care expenditure in urban and rural areas in Iran, a resource rich, upper-middle-income country. We implemented spline and quantile regression techniques to obtain a more robust description of the relationship of interest. This study finds non-uniform effects of income on health expenditures. Although the results show that health care is a necessity for all income brackets, spline regression estimates indicate that the income elasticity is lowest for the poorest Iranians in urban and rural areas. This suggests that they will show low flexibility in medical expenses as income fluctuates. Further, a quantile regression model assessing the effect of income at different level of medical expenditure suggests that households with lower medical expenses are less elastic.

  3. Panel flutter

    NASA Technical Reports Server (NTRS)

    Dowell, E. H.

    1972-01-01

    Criteria are presented for the prediction of panel flutter, determination of its occurrence, design for its prevention, and evaluation of its severity. Theoretical analyses recommended for the prediction of flutter stability boundaries, vibration amplitudes, and frequencies for several types of panels are described. Vibration tests and wind tunnel tests are recommended for certain panels and environmental flow conditions to provide information for design of verification analysis. Appropriate design margins on flutter stability boundaries are given and general criteria are presented for evaluating the severity of possible short-duration, limited-amplitude panel flutter on nonreusable vehicles.

  4. Probability of solar panel clearing events at the Insight landing sites (Mars) from a dust devil track survey

    NASA Astrophysics Data System (ADS)

    Reiss, D.; Lorenz, R. D.

    2015-10-01

    The InSight robotic lander is scheduled to land on Mars in September 2016. InSight was designed to perform the first comprehensive surface-based geophysical investigation of Mars [1]. Passage of vortices may have a number of influences on the geophysical measurements to be made by InSight. Seismic data could be influenced by dust devils and vortices via several mechanisms such as loading of the elastic ground by a surface pressure field which causes a local tilt [e.g. 2]. In addition, the power supply of the InSight instruments is provided by solar arrays. Solar-powered missions on Mars like the Sojourner rover in 1997 were affected by a decline in electrical power output by 0.2-0.3 %per day caused by steadily dust deposition on its horizontal solar panel [3]. The solar-powered Mars Exploration Rovers (MERs) Spirit and Opportunity experienced similar dust deposition rates [4] which led to steady power decrease over time endangering longer rover operation times. The much longer operation times of the rovers were made possible by unanticipated 'dust clearing events' of the solar arrays by wind gust or dust devils [5]. Recent studies imply that dust devils are primarily responsible for those recurrent 'dust clearing events' [6]. In this study we investigate the potential frequency of intense dust devil occurrences at the InSight landing site regions, which are able to remove dust from its solar panels. We analyzed newly formed dust devil tracks within a given time span using multi-temporal HiRISE image data covering the same surface area. Based on these measurements we will give encounter rate predictions of intense (high tangential speed and high pressure drop) dust devils with the InSight lander.

  5. National health expenditures, 1988

    PubMed Central

    1990-01-01

    Every year, analysts in the Health Care Financing Administration present figures on what our Nation spends for health. As the result of a comprehensive re-examination of the definitions, concepts, methods, and data sources used to prepare those figures, this year's report contains new estimates of national health expenditures for calendar years 1960 through 1988. Significant changes have been made to estimates of spending for professional services and to estimates of what consumers pay out of pocket for health care. In the first article, trends in use of and expenditure for various types of goods and services are discussed, as well as trends in the sources of funds used to finance health care. In a companion article, the benchmark process is described in more detail, as are the data sources and methods used to prepare annual estimates of health expenditures. PMID:10113395

  6. National health expenditures, 1990

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Cowan, Cathy A.; Letsch, Suzanne W.

    1991-01-01

    During 1990, health expenditures as a share of gross national product rose to 12.2 percent, up from 11.6 percent in 1989. This dramatic increase is the second largest increase in the past three decades. The national health expenditure estimates presented in this article document rapidly rising health care costs and provide a context for understanding the health care financing crisis facing the Nation today. The 1990 national health expenditures incorporate the most recently available data. They differ from historical estimates presented in the preceding article. The length of time and complicated process of producing projections required use of 1989 national health expenditures—data available prior to the completion of the 1990 estimates presented here. PMID:10114934

  7. Examination of Parent Insurance Ratings, Child Expenditures, and Financial Burden Among Children With Autism: A Mismatch Suggests New Hypotheses to Test.

    PubMed

    Thomas, Kathleen C; Williams, Christianna S; deJong, Neal; Morrissey, Joseph P

    2016-02-01

    Families raising children with autism contribute significant amounts to the cost of care. In this era of health care reform, families have more insurance choices, but people are unfamiliar with health insurance terms. This study uses 2 national data sets to examine health insurance ratings from parents raising children with autism and child expenditures to explore how these measures align. Children with autism who met criteria for special health care needs and were continuously insured were examined. Data from the National Survey of Children With Special Health Care Needs 2009-2010 were used to examine parent report of adequate insurance (n = 3702). Pooled data from the Medical Expenditure Panel Survey 2002-2011 were used to examine expenditures (n = 346). Types of health insurance included private alone, Medicaid alone, and combined private and wrap-around Medicaid. Having Medicaid doubled the odds of reporting adequate insurance compared with private insurance alone (P < .0001), and children on Medicaid had the lowest out-of-pocket costs ($150, P < .0001). Children covered by combined private and wrap-around Medicaid had the highest total expenditures ($11 596, P < .05) and the highest expenditures paid by their insurance ($10 638, P < .05). These findings highlight a mismatch between parent ratings of insurance adequacy, child expenditures, and relative financial burden. Findings generate a number of questions to address within single sources of data. By elaborating the frameworks families use to judge the adequacy of their insurance, future research can develop policy strategies to improve both their satisfaction with their insurance coverage and the service use of children with autism. Copyright © 2016 by the American Academy of Pediatrics.

  8. Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey

    PubMed Central

    2017-01-01

    Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011–2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality. PMID:28581275

  9. Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey.

    PubMed

    Lee, Joo Eun; Jang, Sung In; Ju, Yeong Jun; Kim, Woorim; Lee, Hyo Jung; Park, Eun Cheol

    2017-07-01

    Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011-2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality. © 2017 The Korean Academy of Medical Sciences.

  10. National health expenditures, 1984

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.; Davidoff, Lawrence M.

    1985-01-01

    Growth in health care expenditures slowed to 9.1 percent in 1984, the smallest increase in expenditures in 19 years. Economic forces and emerging structural changes within the health sector played a role in slowing growth. Of the $1,580 per person spent for health care in 1984, 41 percent was financed by public programs; 31 percent by private health insurance; and the remainder by other private sources. Together, Medicare and Medicaid accounted for 27 percent of all health spending. PMID:10311395

  11. Comparison between the C-leg microprocessor-controlled prosthetic knee and non-microprocessor control prosthetic knees: a preliminary study of energy expenditure, obstacle course performance, and quality of life survey.

    PubMed

    Seymour, Ron; Engbretson, Brenda; Kott, Karen; Ordway, Nathaniel; Brooks, Gary; Crannell, Jessica; Hickernell, Elise; Wheeler, Katie

    2007-03-01

    This study investigated energy expenditure and obstacle course negotiation between the C-leg and various non-microprocessor control (NMC) prosthetic knees and compared a quality of life survey (SF-36v2) of use of the C-leg to national norms. Thirteen subjects with unilateral limb loss (12 with trans-femoral and one with a knee disarticulation amputation) participated in the study. The mean age was 46 years, range 30-75. Energy expenditure using both the NMC and C-leg prostheses was measured at self-selected typical and fast walking paces on a motorized treadmill. Subjects were also asked to walk through a standardized walking obstacle course carrying a 4.5 kg (10 lb) basket and with hands free. Finally, the SF-36v2 was completed for subjects while using the C-leg. Statistically significant differences were found in oxygen consumption between prostheses at both typical and fast paces with the C-leg showing decreased values. Use of the C-leg resulted in a statistically significant decrease in the number of steps and time to complete the obstacle course. Scores on a quality of life index for subjects using the C-leg were above the mean for norms for limitation in the use of an arm or leg, equal to the mean for the general United States population for the physical component score and were above this mean for the mental component score. Based on oxygen consumption and obstacle course findings, the C-leg when compared to the NMC prostheses may provide increased functional mobility and ease of performance in the home and community environment. Questionnaire results suggest a minimal quality of life impairment when using a C-leg for this cohort of individuals with amputation.

  12. Differences in healthcare expenditures for inflammatory bowel disease by insurance status, income, and clinical care setting.

    PubMed

    Park, Michelle D; Bhattacharya, Jay; Park, Kt

    2014-01-01

    Background. Socioeconomic factors and insurance status have not been correlated with differential use of healthcare services in inflammatory bowel disease (IBD). Aim. To describe IBD-related expenditures based on insurance and household income with the use of inpatient, outpatient, emergency, and office-based services, and prescribed medications in the United States (US). Methods. We evaluated the Medical Expenditure Panel Survey from 1996 to 2011 of individuals with Crohn's disease (CD) or ulcerative colitis (UC). Nationally weighted means, proportions, and multivariate regression models examined the relationships between income and insurance status with expenditures. Results. Annual per capita mean expenditures for CD, UC, and all IBD were $10,364 (N = 238), $7,827 (N = 95), and $9,528, respectively, significantly higher than non-IBD ($4,314, N = 276, 372, p < 0.05). Publicly insured patients incurred the highest costs ($18,067) over privately insured ($8,014, p < 0.05) or uninsured patients ($5,129, p < 0.05). Among all IBD patients, inpatient care composed the highest proportion of costs ($3,392, p < 0.05). Inpatient costs were disproportionately higher for publicly insured patients. Public insurance had higher odds of total costs than private (OR 2.13, CI [1.08-4.19]) or no insurance (OR 4.94, CI [1.26-19.47]), with increased odds for inpatient and emergency care. Private insurance had higher costs associated with outpatient care, office-based care, and prescribed medicines. Low-income patients had lower costs associated with outpatient (OR 0.38, CI [0.15-0.95]) and office-based care (OR 0.21, CI [0.07-0.62]). Conclusions. In the US, high inpatient utilization among publicly insured patients is a previously unrecognized driver of high IBD costs. Bridging this health services gap between SES strata for acute care services may curtail direct IBD-related costs.

  13. Panel methods

    NASA Astrophysics Data System (ADS)

    Srivastava, Ashok

    1993-10-01

    A comprehensive description of panel methods has been given to enable an understanding of the underlying theory and the basic structure of the panel codes for aerodynamic applications. Panel methods have seen peak activity in the industry and remain as yet the sole technique for efficient and practical computations on complex-aircraft configurations. The method of the linearized approach of solving flow problems is well proven and till the turn of the century panel methods will continue to remain as the workhorse for computing aerodynamic characteristics of aircraft shapes in the industry. The alternative Euler and Navier-Stokes solvers have yet to mature for applications to complex shapes, hence panel methods will be in the light for at least another decade.

  14. Medical Care Expenditures and Earnings Losses Among Persons With Arthritis and Other Rheumatic Conditions in 2003, and Comparisons With 1997

    PubMed Central

    Yelin, Edward; Murphy, Louise; Cisternas, Miriam G.; Foreman, Aimee J.; Pasta, David J.; Helmick, Charles G.

    2010-01-01

    Objective To obtain estimates of medical care expenditures and earnings losses associated with arthritis and other rheumatic conditions and the increment in such costs attributable to arthritis and other rheumatic conditions in the US in 2003, and to compare these estimates with those from 1997. Methods Estimates for 2003 were derived from the Medical Expenditures Panel Survey (MEPS), a national probability sample of households. We tabulated medical care expenditures of adult MEPS respondents, stratified by arthritis and comorbidity status, and used regression techniques to estimate the increment of medical care expenditures attributable to arthritis and other rheumatic conditions. We also estimated the earnings losses sustained by working-age adults with arthritis and other rheumatic conditions. Estimates for 2003 were compared with those from 1997, inflated to 2003 terms. Results In 2003, there were 46.1 million adults with arthritis and other rheumatic conditions (versus 36.8 million in 1997). Adults with arthritis and other rheumatic conditions incurred mean medical care expenditures of $6,978 in 2003 (versus $6,346 in 1997), of which $1,635 was for prescriptions ($899 in 1997). Expenditures for adults with arthritis and other rheumatic conditions totaled $321.8 billion in 2003 ($233.5 billion in 1997). In 2003, the mean increment in medical care expenditures attributable to arthritis and other rheumatic conditions was $1,752 ($1,762 in 1997), for a total of $80.8 billion ($64.8 billion in 1997). Persons with arthritis and other rheumatic conditions ages 18–64 years earned $3,613 less than other persons (versus $4,551 in 1997), for a total of $108.0 billion (versus $99.0 billion). Of this amount, $1,590 was attributable to arthritis and other rheumatic conditions (versus $1,946 in 1997), for a total of $47.0 billion ($43.3 billion in 1997). Conclusion Our findings indicate that the increase in medical care expenditures and earnings losses between 1997 and

  15. Understanding Expenditure Data.

    ERIC Educational Resources Information Center

    Dyke, Frances L.

    2000-01-01

    Stresses the importance of common understandings of cost definitions and data collection in order to create reliable databases with optimal utility for inter-institutional analysis. Examines definitions of common expenditure categories, discusses cost-accumulation rules governing financial reporting, and explains differences between direct costs…

  16. Student Service Expenditures Matter

    ERIC Educational Resources Information Center

    Ehrenberg, Ronald G.; Webber, Douglas A.

    2010-01-01

    The "Great Recession" has caused a fiscal crisis in both public and private higher education that is unmatched in recent memory. Institutions' attention is focused on what they can cut out of their budgets. Student-service expenditures are often seen as discretionary in institutional budgets; they are viewed by some critics as…

  17. Reciprocal relations between effort-reward imbalance at work and adverse health: a three-wave panel survey.

    PubMed

    Shimazu, Akihito; de Jonge, Jan

    2009-01-01

    Siegrist's [1996. Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1, 27-41.] Effort-Reward Imbalance (ERI) Model assumes that ERI at one point in time influences health at a later point in time. Empirical cross-sectional and longitudinal findings have supported the influence of ERI on adverse health. However, the ERI model does not explicitly take into account that the relation between ERI and adverse health may be also explained by reversed causal relations, or even reciprocal (bi-directional) relations in which ERI and health mutually influence each other. The present 3-wave panel study among 211 Japanese male blue-collar workers in one construction machinery company examined reciprocal relations between ERI and adverse health (i.e., psychological distress and physical complaints) with a 1-year time-lag per wave. Hypotheses were tested using structural equation modeling (Amos 7.0J). Results showed cross-lagged and causally dominant effects of ERI on both psychological distress and physical complaints after 1 year for both Time 1-Time 2 and Time 2-Time 3. In addition, cross-lagged effects of psychological distress on ERI were found after 1 year for both Time 1-Time 2 and Time 2-Time 3. These findings suggest that (perceived) ERI and employee health influence each other reciprocally rather than uni-directionally, and underline the importance of studying reversed causal effects in the relation between ERI and employee health.

  18. The performance of administrative and self-reported measures for risk adjustment of Veterans Affairs expenditures.

    PubMed

    Maciejewski, Matthew L; Liu, Chuan-Fen; Derleth, Ann; McDonell, Mary; Anderson, Steve; Fihn, Stephan D

    2005-06-01

    To evaluate the performance of different prospective risk adjustment models of outpatient, inpatient, and total expenditures of veterans who regularly use Veterans Affairs (VA) primary care. We utilized administrative, survey and expenditure data on 14,449 VA patients enrolled in a randomized trial that gave providers regular patient health assessments. This cohort study compared five administrative data-based, two self-report risk adjusters, and base year expenditures in prospective models. VA outpatient care and nonacute inpatient care expenditures were based on unit expenditures and utilization, while VA expenditures for acute inpatient care were calculated from a Medicare-based inpatient cost function. Risk adjusters for this sample were constructed from diagnosis, medication and self-report data collected during a clinical trial. Model performance was compared using adjusted R2 and predictive ratios. In all expenditure models, administrative-based measures performed better than self-reported measures, which performed better than age and gender. The Diagnosis Cost Groups (DCG) model explained total expenditure variation (R2=7.2 percent) better than other models. Prior outpatient expenditures predicted outpatient expenditures best by far (R2=42 percent). Models with multiple measures improved overall prediction, reduced over-prediction of low expenditure quintiles, and reduced under-prediction in the highest quintile of expenditures. Prediction of VA total expenditures was poor because expenditure variation reflected utilization variation, but not patient severity. Base year expenditures were the best predictor of outpatient expenditures and nearly the best for total expenditures. Models that combined two or more risk adjusters predicted expenditures better than single-measure models, but are more difficult and expensive to apply.

  19. Annual direct health care expenditures and employee absenteeism costs in high-risk, low-income mothers with major depression.

    PubMed

    Ammerman, Robert T; Chen, Jie; Mallow, Peter J; Rizzo, John A; Folger, Alonzo T; Van Ginkel, Judith B

    2016-01-15

    To determine the health care and labor productivity costs associated with major depressive disorder in high-risk, low-income mothers. This study was conducted using the 1996-2011 Medical Expenditure Panel Survey (MEPS). The MEPS is a nationally-representative database that includes information on health care utilization and expenditures for the civilian, non-institutionalized population in the United States. High-risk mothers were between the ages of 18-35 years, and either unmarried, receiving Medicaid, or with incomes less than 300% of the Federal Poverty Level. Mothers were categorized as being depressed if they had an ICD-9 diagnosis code of 296 or 311 (N=2310) or not depressed (N=18,221). Insurer expenditures, out-of-pocket (OOP) expenses, and lost wage earnings were calculated. After controlling for comorbidities, demographics, region, and year, high-risk depressed mothers were more likely to incur insurer (0.84 vs. 0.79) and OOP expenses (0.84 vs. 0.81) and to have higher insurer ($4448 vs. $3072) and OOP expenses ($794 vs. $523). Depression significantly increased the likelihood of missing work days (OR=1.40; p<0.01). Depression increased overall direct health care expenditures by $1.89 billion (range=$1.28-$2.60 billion) and indirect costs by $523 million annually, with a range of $353-$719 million. In this high-risk population, the direct and indirect aggregate costs of depression-related to health care expenditures and lost work productivity were substantial. These findings establish a quantifiable cost for policy makers and highlight the need to target this population for prevention and treatment efforts. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Medical expenditures associated with nonfatal occupational injuries among immigrant and U.S.-born workers.

    PubMed

    Xiang, Huiyun; Shi, Junxin; Lu, Bo; Wheeler, Krista; Zhao, Weiyan; Wilkins, J R; Smith, Gary A

    2012-08-20

    No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups. Using the 2004-2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers. A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P = 0.99). Workers' compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket. Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U

  1. Solar panel

    SciTech Connect

    Bayles, B.R.

    1981-09-29

    A solar panel includes a base within which are mounted transversely extending conduits. A heat collector plate in the base is in heat conductive relationship with the conduits for the heating of a fluid medium. The base additionally supports a transparent cover outwardly spaced from the heat collector plate to provide a protective insulative air space over the plate. A manifold communicates one series of panels with those of an adjacent series. A modified base dispenses with a collector plate and is formed so as to define integral lengthwise extending passageways for the solar heated medium. Inserted nipples interconnect the passageways of adjacent panels.

  2. Comparison of a Household Consumption and Expenditures Survey with Nationally Representative Food Frequency Questionnaire and 24-hour Dietary Recall Data for Assessing Consumption of Fortifiable Foods by Women and Young Children in Cameroon.

    PubMed

    Engle-Stone, Reina; Brown, Kenneth H

    2015-06-01

    Household Consumption and Expenditures Surveys (HCES) are potential sources of data on dietary patterns for planning fortification programs, but they rarely have been compared with individual-level dietary assessment methods. To compare apparent consumption of fortifiable foods estimated from the Third Cameroon Household Survey (ECAM3) with the results of a national dietary survey using food frequency questionnaire (FFQ) and 24-hour recall (24HR) methods among women aged 15 to 49 years and children aged 12 to 59 months. We estimated coverage and frequency of consumption in the previous week (ECAM3 and FFQ) and coverage and amount consumed on the previous day (ECAM3 and 24HR) of refined vegetable oil, wheat flour, sugar, and bouillon cubes. Coverage in the past week as measured by the ECAM3 and FFQ, respectively, was 64% vs. 54% for oil, 60% vs. 92% for flour, 69% vs. 78% for sugar, and 85% vs. 96% for bouillon cubes. The different methods identified similar patterns of coverage among subgroups for oil, but patterns for other foods were variable. Frequency of consumption and previous-day coverage were lower with the ECAM3 than with the FFQ and 24HR, likely reflecting infrequent acquisition relative to intake. For women, the mean amounts consumed on the previous day (among consumers) were 43 vs. 29 g of oil, 71 vs. 83 g of flour, 42 vs. 32 g of sugar, and 5.0 vs. 2.4 g of bouillon cubes (ECAM and 24HR, respectively). HCES provide useful information on patterns of food access but inadequate information on individual consumption amounts to estimate appropriate food fortification levels. © The Author(s) 2015.

  3. What drives public health care expenditure growth? Evidence from Swiss cantons, 1970-2012.

    PubMed

    Braendle, Thomas; Colombier, Carsten

    2016-09-01

    A better understanding of the determinants of public health care expenditures is key to designing effective health policies. We integrate demand and supply-side determinants and factors from political economy into an empirical analysis of the highly decentralized Swiss health care system and control for major health care finance reforms. We compile a novel data set of the cantonal health care expenditure in Switzerland, which currently amounts to about one fifth of total health care expenditure. We analyze the period 1970-2012 and use dynamic panel estimation methods. We find that per capita income, the unemployment rate and the share of foreigners are positively related to public health care expenditure growth. With regard to political economy aspects, public health care expenditures increase with the share of women elected to parliament. However, institutional restrictions for politicians, such as fiscal rules, do not appear to limit public health care expenditure growth. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Impoverishing effects of catastrophic health expenditures in Malawi.

    PubMed

    Mchenga, Martina; Chirwa, Gowokani Chijere; Chiwaula, Levison S

    2017-01-21

    Out of pocket (OOP) health spending can potentially expose households to risk of incurring large medical bills, and this may impact on their welfare. This work investigates the effect of catastrophic OOP on the incidence and depth of poverty in Malawi. The paper is based on data that was collected from 12,271 households that were interviewed during the third Malawi integrated household survey (IHS-3). The paper considered a household to have incurred a catastrophic health expenditure if the share of health expenditure in the household's non-food expenditure was greater than a given threshold ranging between 10 and 40%. As we increase the threshold from 10 to 40%, we found that OOP drives between 9.37 and 0.73% of households into catastrophic health expenditure. The extent by which households exceed a given threshold (mean overshoot) drops from 1.01% of expenditure to 0.08%, as the threshold increased. When OOP is accounted for in poverty estimation, additional 0.93% of the population is considered poor and the poverty gap rises by almost 2.54%. Our analysis suggests that people in rural areas and middle income households are at higher risk of facing catastrophic health expenditure. We conclude that catastrophic health expenditure increases the incidence and depth of poverty in Malawi. This calls for the introduction of social insurance system to minimize the incidence of catastrophic health expenditure especially to the rural and middle income population.

  5. [Private health expenditures and income distribution in Brazil].

    PubMed

    Kilsztajn, Samuel; Camara, Marcelo Bozzini Da; Carmo, Manuela Santos Nunes Do

    2002-01-01

    This paper analyses the share of the family private health expenditures in the Brazilian GDP and in personal income; and the distribution of the family private health expenditures among social groups. The research utilized the 1998 Brazilian Home Sample Survey (Pesquisa Nacional por Amostra de Domicilios) with the division of the population into four social groups according to the family income per capita; and the distribution of the family private health expenditures among health insurance, physicians, other health professionals, medical tests, drugs, orthopedic and other medical durables, vision products, dental services, hospital care, nursing home care and other health spending. In 1998, only 7.2% of the population with family income per capita up to 1 minimum wage had health insurance and the health expenditures of this group, that represented 52.5% of the population, was US$ 4.62 per capita. For the people with 9 and more minimum wages per capita the health insurance coverage was 83.2% and the health expenditures was US$ 114.66 per capita. The implementation of the Brazilian public universal health care system in 1988 denominated "Sistema Unico de Saude" was followed by an expressive expansion of private insurance coverage in the 1990's. Even if all public health expenditures had been exclusively directed to the population without any private insurance, these people's health expenditures would only reach 43% of the health expenditures of those with private insurance.

  6. Households across All Income Quintiles, Especially the Poorest, Increased Animal Source Food Expenditures Substantially during Recent Peruvian Economic Growth

    PubMed Central

    Humphries, Debbie L.; Behrman, Jere R.; Crookston, Benjamin T.; Dearden, Kirk A.; Schott, Whitney; Penny, Mary E.

    2014-01-01

    Background Relative to plant-based foods, animal source foods (ASFs) are richer in accessible protein, iron, zinc, calcium, vitamin B-12 and other nutrients. Because of their nutritional value, particularly for childhood growth and nutrition, it is important to identify factors influencing ASF consumption, especially for poorer households that generally consume less ASFs. Objective To estimate differential responsiveness of ASF consumption to changes in total household expenditures for households with different expenditures in a middle-income country with substantial recent income increases. Methods The Peruvian Young Lives household panel (n = 1750) from 2002, 2006 and 2009 was used to characterize patterns of ASF expenditures. Multivariate models with controls for unobserved household fixed effects and common secular trends were used to examine nonlinear relationships between changes in household expenditures and in ASF expenditures. Results Households with lower total expenditures dedicated greater percentages of expenditures to food (58.4% vs.17.9% in 2002 and 24.2% vs. 21.5% in 2009 for lowest and highest quintiles respectively) and lower percentages of food expenditures to ASF (22.8% vs. 33.9% in 2002 and 30.3% vs. 37.6% in 2009 for lowest and highest quintiles respectively). Average percentages of overall expenditures spent on food dropped from 47% to 23.2% between 2002 and 2009. Households in the lowest quintiles of expenditures showed greater increases in ASF expenditures relative to total consumption than households in the highest quintiles. Among ASF components, meat and poultry expenditures increased more than proportionately for households in the lowest quintiles, and eggs and fish expenditures increased less than proportionately for all households. Conclusions Increases in household expenditures were associated with substantial increases in consumption of ASFs for households, particularly households with lower total expenditures. Increases in ASF

  7. National Beef Tenderness Survey-2010: Warner-Bratzler shear force values and sensory panel ratings for beef steaks from United States retail and food service establishments.

    PubMed

    Guelker, M R; Haneklaus, A N; Brooks, J C; Carr, C C; Delmore, R J; Griffin, D B; Hale, D S; Harris, K B; Mafi, G G; Johnson, D D; Lorenzen, C L; Maddock, R J; Martin, J N; Miller, R K; Raines, C R; VanOverbeke, D L; Vedral, L L; Wasser, B E; Savell, J W

    2013-02-01

    The tenderness and palatability of retail and food service beef steaks from across the United States (12 cities for retail, 5 cities for food service) were evaluated using Warner-Bratzler shear (WBS) and consumer sensory panels. Subprimal postfabrication storage or aging times at retail establishments averaged 20.5 d with a range of 1 to 358 d, whereas postfabrication times at the food service level revealed an average time of 28.1 d with a range of 9 to 67 d. Approximately 64% of retail steaks were labeled with a packer/processor or store brand. For retail, top blade had among the lowest (P < 0.05) WBS values, whereas steaks from the round had the greatest (P < 0.05) values. There were no differences (P > 0.05) in WBS values between moist-heat and dry-heat cookery methods for the top round and bottom round steaks or between enhanced (contained salt or phosphate solution) or nonenhanced steaks. Food service top loin and rib eye steaks had the lowest (P < 0.05) WBS values compared with top sirloin steaks. Retail top blade steaks and food service top loin steaks received among the greatest (P < 0.05) consumer sensory panel ratings compared with the other steaks evaluated. Prime food service rib eye steaks received the greatest ratings (P < 0.05) for overall like, like tenderness, tenderness level, like juiciness, and juiciness level, whereas ungraded rib eye steaks received the lowest ratings (P < 0.05) for like tenderness and tenderness level. The WBS values for food service steaks were greater (P < 0.05) for the Select and ungraded groups compared with the Prime, Top Choice, and Low Choice groups. The WBS values and sensory ratings were comparable to the last survey, signifying that no recent or substantive changes in tenderness have occurred.

  8. National health expenditures, 1991

    PubMed Central

    Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

    1992-01-01

    Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

  9. A Comparative Analysis of Information on National Industrial R&D Expenditures. Special Report.

    ERIC Educational Resources Information Center

    Burke, Mary V.

    The National Science Foundation (NSF) annually publishes information generated by its survey of research and development (R&D) expenditures by United States industry. These data are collected for NSF by the U.S. Bureau of the Census. Other organizations also publish information on industrial R&D expenditures collected by surveys or derived…

  10. Health Care Expenditure and GDP in Oil Exporting Countries: Evidence from OPEC Data, 1995-2012

    PubMed Central

    Fazaeli, Ali Akbar; Ghaderi, Hossein; Salehi, Masoud; Fazaeli, Ali Reza

    2016-01-01

    Background: There is a large body of literature examining income in relation to health expenditures. The share of expenditures in health sector from GDP in developed countries is often larger than in non-developed countries, suggesting that as the level of economic growth increases, health spending increase, too. Objectives: This paper estimates long-run relationships between health expenditures and GDP based on panel data of a sample of 12 countries of the Organization of the Petroleum Exporting Countries (OPEC), using data for the period 1995-2012. Patients & Methods: We use panel data unit root tests, cointegration analysis and ECM model to find long-run and short-run relation. This study examines whether health is a luxury or a necessity for OPEC countries within a unit root and cointegration framework. Results: Panel data analysis indicates that health expenditures and GDP are co-integrated and have Engle and Granger causality. In addition, in oil countries that have oil export income, the share of government expenditures in the health sector is often greater than in private health expenditures similar developed countries. Conclusions: The findings verify that health care is not a luxury good and income has a robust relationship to health expenditures in OPEC countries. PMID:26383195

  11. Health Care Expenditure and GDP in Oil Exporting Countries: Evidence From OPEC Data, 1995-2012.

    PubMed

    Fazaeli, Ali Akbar; Ghaderi, Hossein; Salehi, Masoud; Fazaeli, Ali Reza

    2015-06-11

    There is a large body of literature examining income in relation to health expenditures. The share of expenditures in health sector from GDP in developed countries is often larger than in non-developed countries, suggesting that as the level of economic growth increases, health spending increase, too. This paper estimates long-run relationships between health expenditures and GDP based on panel data of a sample of 12 countries of the Organization of the Petroleum Exporting Countries (OPEC), using data for the period 1995-2012. We use panel data unit root tests, cointegration analysis and ECM model to find long-run and short-run relation. This study examines whether health is a luxury or a necessity for OPEC countries within a unit root and cointegration framework. Panel data analysis indicates that health expenditures and GDP are co-integrated and have Engle and Granger causality. In addition, in oil countries that have oil export income, the share of government expenditures in the health sector is often greater than in private health expenditures similar developed countries. The findings verify that health care is not a luxury good and income has a robust relationship to health expenditures in OPEC countries.

  12. Comparing state-only expenditures for AIDS.

    PubMed Central

    Rowe, M J; Ryan, C C

    1988-01-01

    The State AIDS Policy Center at the Inter-governmental Health Policy Project (IHPP) at George Washington University surveyed all 50 states to determine state AIDS (acquired immunodeficiency syndrome) expenditures, without Medicaid or federal funds, for fiscal 1984-88. During this period, state-only expenditures increased 15-fold, to $156.3 million. Between fiscal 1986-1988, the distribution of state funding for AIDS patient care and support services doubled from 16 to 35 per cent and the number of states supplementing federal funds for testing and counseling increased from eight to 20. Five states continue to account for the largest AIDS appropriations. Of these, California leads in funding research; New York, Florida, and New Jersey have directed funds to provide care and services to IV (intravenous) drug users, prisoners, and children. The average state expenditure per diagnosed AIDS case is $3,323 and an increasing number of states with relatively low case loads are appropriating funds beyond this level. Across states, AIDS expenditures per person average $.65 and $.21 for education, testing and counseling--below the level recommended by the Institute of Medicine for AIDS prevention activities. Some jurisdictions support AIDS activities indirectly by shifting resources, often from their STD (sexually transmitted disease) programs--this trend deserves continuing review given the rise in STD cases and their relationship to diagnosed AIDS. PMID:3126674

  13. Determination of Resting Energy Expenditure After Severe Burn

    DTIC Science & Technology

    2013-02-01

    equation. In a recent survey of 65 burn centers, Graves et al10 discovered that the most commonly used for- mulas include the Harris -Benedict formula11...accuracy by Table 1. Equations for estimating daily energy expenditure for subjects with burns Predictive Equations for Energy Expenditure Harris -Benedict...predicted by using nine pre- dictive equations including 30 kcal/kg, 35 kcal/kg, 40 kcal/kg, the Harris -Benedict equation multiplied by an injury factor

  14. The impact of health insurance on outpatient utilization and expenditure: evidence from one middle-income country using national household survey data

    PubMed Central

    Ekman, Björn

    2007-01-01

    Background Achieving universal health insurance coverage by means of different types of insurance programs may be a pragmatic and feasible approach. However, the fragmentation of the health financing system may imply costs in terms of varying ability of the insurance programs to improve access to and reduce spending on care across different population groups. This study looks at the effect of different types of health insurance programs on the probability of utilizing care, the intensity of utilization, and individual spending on care in Jordan. Methods Using national household survey data collected in 2000 with a sub-sample of around 8,300 individuals, the study applies econometric techniques to a set of specified models along the two-part model approach to the demand for health care. By means of particular tests and other procedures, the robustness of the results is controlled. Results Around 60 percent of the population is covered by some type of insurance. However, the distribution varies across income groups, and importantly, the effect of insurance on the outcome indicators differ substantially across the various programs. Generally, insurance is found to increase the intensity of utilization and reduce out-of-pocket spending, while no general insurance effect on the probability of use is found. More specifically, however, these effects are only found for some programs and not for all. The best performing programs are those to which the somewhat better off groups have access. Conclusion Notwithstanding the empirical nature of the issues, the results point at the need to assess the effect of insurance coverage more profoundly than what is commonly done. Applying rigorous analysis to survey data in other settings will contribute to bringing out better evidence on what types of programs perform most effectively and equitably in different contexts. PMID:17537268

  15. The impact of health insurance on outpatient utilization and expenditure: evidence from one middle-income country using national household survey data.

    PubMed

    Ekman, Björn

    2007-05-30

    Achieving universal health insurance coverage by means of different types of insurance programs may be a pragmatic and feasible approach. However, the fragmentation of the health financing system may imply costs in terms of varying ability of the insurance programs to improve access to and reduce spending on care across different population groups. This study looks at the effect of different types of health insurance programs on the probability of utilizing care, the intensity of utilization, and individual spending on care in Jordan. Using national household survey data collected in 2000 with a sub-sample of around 8,300 individuals, the study applies econometric techniques to a set of specified models along the two-part model approach to the demand for health care. By means of particular tests and other procedures, the robustness of the results is controlled. Around 60 percent of the population is covered by some type of insurance. However, the distribution varies across income groups, and importantly, the effect of insurance on the outcome indicators differ substantially across the various programs. Generally, insurance is found to increase the intensity of utilization and reduce out-of-pocket spending, while no general insurance effect on the probability of use is found. More specifically, however, these effects are only found for some programs and not for all. The best performing programs are those to which the somewhat better off groups have access. Notwithstanding the empirical nature of the issues, the results point at the need to assess the effect of insurance coverage more profoundly than what is commonly done. Applying rigorous analysis to survey data in other settings will contribute to bringing out better evidence on what types of programs perform most effectively and equitably in different contexts.

  16. Illness, medical expenditure and household consumption: observations from Taiwan.

    PubMed

    Fang, Kuangnan; Ma, Chi; Jiang, Yefei; Ye, Linglong; Shia, Benchang; Ma, Shuangge

    2013-08-12

    Illness conditions lead to medical expenditure. Even with various types of medical insurance, there can still be considerable out-of-pocket costs. Medical expenditure can affect other categories of household consumptions. The goal of this study is to provide an updated empirical description of the distributions of illness conditions and medical expenditure and their associations with other categories of household consumptions. A phone-call survey was conducted in June and July of 2012. The study was approved by ethics review committees at Xiamen University and FuJen Catholic University. Data was collected using a Computer-Assisted Telephone Survey System (CATSS). "Household" was the unit for data collection and analysis. Univariate and multivariate analyses were conducted, examining the distributions of illness conditions and the associations of illness and medical expenditure with other household consumptions. The presence of chronic disease and inpatient treatment was not significantly associated with household characteristics. The level of per capita medical expenditure was significantly associated with household size, income, and household head occupation. The presence of chronic disease was significantly associated with levels of education, insurance and durable goods consumption. After adjusting for confounders, the associations with education and durable goods consumption remained significant. The presence of inpatient treatment was not associated with consumption levels. In the univariate analysis, medical expenditure was significantly associated with all other consumption categories. After adjusting for confounding effects, the associations between medical expenditure and the actual amount of entertainment expenses and percentages of basic consumption, savings, and insurance (as of total consumption) remained significant. This study provided an updated description of the distributions of illness conditions and medical expenditure in Taiwan. The findings

  17. Food Expenditure and Nutrient Availability in Elderly Households.

    ERIC Educational Resources Information Center

    Hama, Mary Y.; Chern, Wen S.

    1988-01-01

    A model of food expenditure and nutrient consumption is developed and estimated using the data from the elderly supplemental survey to the 1977-78 USDA Nationwide Food Consumption Survey. Results provide strong evidence that elderly households make concurrent decisions on food budgets and nutritional needs. (Author)

  18. Food Expenditure and Nutrient Availability in Elderly Households.

    ERIC Educational Resources Information Center

    Hama, Mary Y.; Chern, Wen S.

    1988-01-01

    A model of food expenditure and nutrient consumption is developed and estimated using the data from the elderly supplemental survey to the 1977-78 USDA Nationwide Food Consumption Survey. Results provide strong evidence that elderly households make concurrent decisions on food budgets and nutritional needs. (Author)

  19. Chronic Diseases, Health Behaviors, and Demographic Characteristics as Predictors of Ill Health Retirement: Findings from the Korea Health Panel Survey (2008–2012)

    PubMed Central

    Kang, Young Joong; Kang, Mo-Yeol

    2016-01-01

    Purpose The research aim was to identify demographic characteristics, chronic diseases, and unhealthy behaviors predicting ill health retirement in South Korea. Methods Data were collected from 15,407 individuals enrolled in the first through the fifth phases of the Korea Health Panel Survey (2008–2012) using structured questionnaires examining retirement, morbidities, and health-related behaviors. The Cox proportional hazard model was used to examine demographic and clinical characteristics’ effects on ill health retirement. Lost years of working life expectancy were calculated for demographic and clinical characteristics. Results Older, female, and manual workers were more likely to experience ill health retirement, as were respondents reporting poor health-related habits (e.g., heavy drinking, irregular meals, less sleep hours, obesity, and no regular exercise). The chronic diseases most closely associated with ill health retirement were, in order, psychiatric disease, ophthalmologic disease, neurologic disease, infectious disease, and musculoskeletal diseases. The average reduction in working life expectancy was 9.73 years. Conclusions Our study results can help contribute to the development of strategies for reducing the risk of ill health retirement and promoting sustainable labor force participation in an aging society. PMID:27930661

  20. College and University Employee Benefits Cost Survey.

    ERIC Educational Resources Information Center

    1980

    Standardized information on expenditures by 605 colleges and universities on employee benefits for 1979 are provided. This benefit cost survey offers two principal measurements of college expenditures for each included benefits category: expenditures as a percentage of total gross payroll and expenditures as dollars per employee per year.…

  1. Financial Burden of Health Care Expenditures: Turkey

    PubMed Central

    Sulku, S Nur; Bernard, D Minbay

    2012-01-01

    In this study, we examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to “The Health Transformation Programme”. Furthermore, we examine the distribution of out of pocket expenditures by demographic characteristics, poverty status, health service type, access to health care and self-reported health status. We employ the 2002/03 National Household Health Expenditure Survey data to analyze financial burden of health care expenditure. Following the literature, we define high burdens as expenses above 10 and 20% of income. We find that 19% of the nonelderly population were living in families spending more than 10% of family income and that 14% of the nonelderly population were living in families spending more than 20% of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. The risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period. Our results are robust to three alternative specifications of the burden measure and including elderly adults in the sample population. We see that prior to the reforms there were not adequate protection against high health expenditures. Our study provides a baseline against which policymakers can measure the success of the health care reform in terms of providing financial protection. PMID:23113149

  2. National Health Expenditures, 1978

    PubMed Central

    Gibson, Robert M.

    1979-01-01

    Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965. PMID:10309049

  3. National Health Expenditures, 1996

    PubMed Central

    Levit, Katharine R.; Lazenby, Helen C.; Braden, Bradley R.; Cowan, Cathy A.; Sensenig, Arthur L.; McDonnell, Patricia A.; Stiller, Jean M.; Won, Darleen K.; Martin, Anne B.; Sivarajan, Lekha; Donham, Carolyn S.; Long, Anna M.; Stewart, Madie W.

    1997-01-01

    The national health expenditures (NHE) series presented in this report for 1960-96 provides a view of the economic history of health care in the United States through spending for health care services and the sources financing that care. In 1996 NHE topped $1 trillion. At the same time, spending grew at the slowest rate, 4.4 percent, ever recorded in the current series. For the first time, this article presents estimates of Medicare managed care payments by type of service, as well as nursing home and home health spending in hospital-based facilities. PMID:10179997

  4. National health expenditures, 1989

    PubMed Central

    Lazenby, Helen C.; Letsch, Suzanne W.

    1990-01-01

    Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988. PMID:10113559

  5. National Health Expenditures, 1979

    PubMed Central

    Gibson, Robert M

    1980-01-01

    Outlays for health care in the nation reached $212.2 billion in calendar year 1979—12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. PMID:10309255

  6. National health expenditures, 1989.

    PubMed

    Lazenby, H C; Letsch, S W

    1990-01-01

    Spending for health care in the United States grew to $604.1 billion in 1989, an increase of 11.1 percent from the 1988 level. Growth in national health expenditures has been edging upward since 1986, when the annual growth in the health care bill was 7.7 percent. Health care spending continues to command a larger and larger proportion of the resources of the Nation: In 1989, 11.6 percent of the Nation's output, as measured by the gross national product, was consumed by health care, up from 11.2 percent in 1988.

  7. Energy Expenditure Ranges and Muscular Work Grades

    PubMed Central

    Brown, J. R.; Crowden, G. P.

    1963-01-01

    This paper is based on the findings of a field study which was planned to ascertain by metabolic measurement the rates of energy expenditure of men and women on productive effort at work in modern factories. The investigation which is described was carried out during a period of peace-time full employment, mainly in factories associated with the Slough Industrial Health Service in which a nutritional survey of the calorie intake of male operatives had been made by the Ministry of Health and the Medical Research Council in 1952. The rates of energy expenditure of 70 men and 54 women in 27 occupational groups were measured by indirect calorimetric methods. On the basis of the criteria for the classification of work according grades to its heaviness, adopted by the Factory Department of the Ministry of Labour, muscular work grades have been ascribed to the occupations studied. From the distribution of 390 metabolic measurements, ranges of energy expenditure have been computed for occupations classed as sedentary, light, moderate, heavy, or very heavy, Observation of recurrent phase variations in types of productive effort in the work-cycle indicated that wider work grades, such as light-to-moderate or moderate-to-heavy, are needed to cover the energy expenditure rates of men and women in many occupations. The data obtained in this study have enabled a table termed the “Slough Scales” to be compiled giving ranges of energy expenditure and pulmonary ventilation rates for the various work grades ascribed to occupations. The mean rates of energy expenditure of 257 workers (in industries in different parts of England and Scotland) which have been calculated from data published by other investigators have been found to fall within the ranges specified in these scales for the work grades of their occupations. It is felt, therefore, that the Slough Scales represent a reasonably true appraisal of the relation between the Ministry of Labour occupational work grades and the

  8. Triangulating health expenditure estimates from different data sources in developing countries: the case of Pakistan's private health expenditure.

    PubMed

    Lorenz, Christian

    2012-01-01

    This article deals with the accuracy of statistical records used for political decision making and international comparative analysis. In developing countries, even major macroeconomic indicators can include data inadequacies and methodological differences in data generation between statistical agencies. Existing data show that total health expenditure as a percentage of GDP is about 50% lower in Pakistan than in other low-income countries (LIC). To determine whether these results reflect the actual situation in Pakistan or whether they are due to statistical error, Pakistan produced National Health Accounts (NHA) for the first time in 2009 to assess health spending in 2005-6. Improved NHA estimates are also being made for 2007-8, which will be based on the following: public expenditure data published with time lags; survey results for 2007-8; and multivariate analyses of data from 2010 and 2011 surveys on health-specific out-of-pocket (OOP) expenditure, healthcare providers, non-profit institutions and census data on autonomous bodies and large hospitals. Since these data are not yet available, a best estimate of health expenditure has to be made to support policy decision making and to provide a point of comparison for future NHA results. Health expenditure data are available from different data sources and estimates have been made by applying different methods, leading to a range of health spending estimates. As a result of this diversity of estimates and data, each with its own inaccuracies or gaps, there was a clear need to triangulate the available information and to identify a best possible estimate. This article compares estimates of household health expenditure from different sources, such as the Household Integrated Economic Survey, the Family Budget Survey and National Accounts (NA). The analysis shows that health expenditure figures for Pakistan have been underestimated by both WHO and the NHA. An adjusted estimate shows OOP spending to be twice as high

  9. Panel Sessions.

    ERIC Educational Resources Information Center

    Proceedings of the ASIS Mid-Year Meeting, 1992

    1992-01-01

    Lists the speakers and summarizes the issues addressed for 12 panel sessions on topics related to networking, including libraries and national networks, federal national resources and energy programs, multimedia issues, telecommuting, remote image serving, accessing the Internet, library automation, scientific information, applications of Z39.50,…

  10. Media Panel.

    ERIC Educational Resources Information Center

    Marklund, Inger, Ed.; Hanse, Mona-Britt, Ed.

    1984-01-01

    The Swedish Media Panel is a research program about children and young persons and their use of mass media. The aim of the ten-year (1975-1985) project is to explain how media habits originate, how they change as children grow older, what factors on the part of children themselves and in their surroundings may be connected with a certain use of…

  11. 11 CFR 100.113 - Independent expenditures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 11 Federal Elections 1 2013-01-01 2012-01-01 true Independent expenditures. 100.113 Section 100...) Definition of Expenditure (2 U.S.C. 431(9)) § 100.113 Independent expenditures. An independent expenditure that meets the requirements of 11 CFR 104.4 or part 109 is an expenditure, and such independent...

  12. 11 CFR 100.113 - Independent expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 11 Federal Elections 1 2014-01-01 2014-01-01 false Independent expenditures. 100.113 Section 100...) Definition of Expenditure (2 U.S.C. 431(9)) § 100.113 Independent expenditures. An independent expenditure that meets the requirements of 11 CFR 104.4 or part 109 is an expenditure, and such independent...

  13. 11 CFR 100.113 - Independent expenditures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Independent expenditures. 100.113 Section 100...) Definition of Expenditure (2 U.S.C. 431(9)) § 100.113 Independent expenditures. An independent expenditure that meets the requirements of 11 CFR 104.4 or part 109 is an expenditure, and such independent...

  14. 11 CFR 100.113 - Independent expenditures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 11 Federal Elections 1 2012-01-01 2012-01-01 false Independent expenditures. 100.113 Section 100...) Definition of Expenditure (2 U.S.C. 431(9)) § 100.113 Independent expenditures. An independent expenditure that meets the requirements of 11 CFR 104.4 or part 109 is an expenditure, and such independent...

  15. 2 CFR 200.13 - Capital expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Capital expenditures. 200.13 Section 200.13... REQUIREMENTS FOR FEDERAL AWARDS Acronyms and Definitions Acronyms § 200.13 Capital expenditures. Capital expenditures means expenditures to acquire capital assets or expenditures to make additions, improvements...

  16. 11 CFR 100.113 - Independent expenditures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Independent expenditures. 100.113 Section 100...) Definition of Expenditure (2 U.S.C. 431(9)) § 100.113 Independent expenditures. An independent expenditure that meets the requirements of 11 CFR 104.4 or part 109 is an expenditure, and such...

  17. Evaluating the Impact of Parent-Reported Medical Home Status on Children's Health Care Utilization, Expenditures, and Quality: A Difference-in-Differences Analysis with Causal Inference Methods.

    PubMed

    Han, Bing; Yu, Hao; Friedberg, Mark W

    2017-04-01

    To evaluate the effects of the parent-reported medical home status on health care utilization, expenditures, and quality for children. Medical Expenditure Panel Survey (MEPS) during 2004-2012, including a total of 9,153 children who were followed up for 2 years in the survey. We took a causal difference-in-differences approach using inverse probability weighting and doubly robust estimators to study how changes in medical home status over a 2-year period affected children's health care outcomes. Our analysis adjusted for children's sociodemographic, health, and insurance statuses. We conducted sensitivity analyses using alternative statistical methods, different approaches to outliers and missing data, and accounting for possible common-method biases. Compared with children whose parents reported having medical homes in both years 1 and 2, those who had medical homes in year 1 but lost them in year 2 had significantly lower parent-reported ratings of health care quality and higher utilization of emergency care. Compared with children whose parents reported having no medical homes in both years, those who did not have medical homes in year 1 but gained them in year 2 had significantly higher ratings of health care quality, but no significant differences in health care expenditures and utilization. Having a medical home may help improve health care quality for children; losing a medical home may lead to higher utilization of emergency care. © Health Research and Educational Trust.

  18. [Factor associated with medicines utilization and expenditure in Mexico].

    PubMed

    Wirtz, Veronika J; Serván-Mori, Edson; Heredia-Pi, Ileana; Dreser, Anahí; Ávila-Burgos, Leticia

    2013-01-01

    To analyze medicine utilization and expenditure and associated factors in Mexico, as well as to discuss their implications for pharmaceutical policy. Analysis of a sample of 193,228 individuals from the Mexican National Health and Nutrition Survey 2012. Probability and amount of expenditure were estimated using logit, probit and quantile regression models, evaluating three dimensions of access to medicines: (1) likelihood of utilization of medicines in the event of a health problem, (2) probability of incurring expenses and (3) amount spent on medicines. Individuals affiliated to IMSS were more likely to use medicines (OR=1.2, p<0.05). Being affiliated to the IMSS, ISSSTE or SP reduced the likelihood of spending compared to those without health insurance (about RM 0.7, p<0.01). Median expenditures varied between 195.3 and 274.2 pesos. Factors associated with the use and expenditure on medicines indicate that inequities in the access to medicines persist.

  19. Willingness to pay for other individuals' healthcare expenditures.

    PubMed

    Borges, A P; Reis, A; Anjos, J

    2017-03-01

    The need to improve the sustainability of public health expenditure, in a climate of growing pressure on national budgets, inevitably leads to a discussion about resource rationing, and the extent of society's responsibility for those expenditures. To contribute to this discussion empirically, this study evaluated the willingness of Portuguese respondents to pay for other individuals' healthcare expenditures through out-of-pocket payments. A questionnaire addressed to the general public was developed, with 296 respondents. The survey was divided into three sections: (i) sociodemographic characteristics of the respondents; (ii) health-related habits; and (iii) willingness to pay other individuals' healthcare expenditures and, if so, how much. Logit and ordered logit models were applied. Respondents were divided fairly even between those who were willing to pay for other individuals' healthcare expenditures and those who were not. Respondents with health insurance contracts were more willing to contribute, and the contribution value was higher. Having a degree-level education was associated with reduced willingness to pay for other individuals' healthcare expenditures, and reduced probability of paying a larger amount, which may be associated with holding individuals accountable for their choices. Considering self-reported risky behaviours, the respondents who consumed alcohol were more likely to be willing to pay for other individuals' healthcare expenditures, and to a greater extent, whereas smokers were less likely to pay larger amounts. These effects suggest that respondents with different unhealthy behaviours are not equally altruistic. These findings highlight the need to combine health policy and social beliefs. The respondents seem to be interested to discuss healthcare funding, given that they agreed to reveal their willingness to pay for other individuals' healthcare expenditures. Moreover, respondents' sociodemographic characteristics and health

  20. Pure, White and Deadly… Expensive: A Bitter Sweetness in Health Care Expenditure.

    PubMed

    Castro, Vitor

    2016-12-15

    This paper analyses the impact of sugar availability/intake on diabetes expenditure and on total health care expenditure. Building this macroeconomic analysis upon the literature on the determinants of health care expenditure, we estimate a dynamic panel data model over a sample of 156 countries for the period 1995-2014. After controlling for the traditional determinants of health care spending, we find that an increase in sugar availability/intake leads to a significant rise in diabetes expenditure (per capita and per diabetic) and in the growth rate of total health care expenditure per capita. Moreover, we show that this causal relation is present in both developed and developing countries. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Energy Expenditure of Sport Stacking

    ERIC Educational Resources Information Center

    Murray, Steven R.; Udermann, Brian E.; Reineke, David M.; Battista, Rebecca A.

    2009-01-01

    Sport stacking is an activity taught in many physical education programs. The activity, although very popular, has been studied minimally, and the energy expenditure for sport stacking is unknown. Therefore, the purposes of this study were to determine the energy expenditure of sport stacking in elementary school children and to compare that value…

  2. Expenditures for Early Intervention Services

    ERIC Educational Resources Information Center

    Hebbeler, Kathleen; Levin, Jesse; Perez, Maria; Lam, Irene; Chambers, Jay G.

    2009-01-01

    What does it cost to provide early intervention services? Data collected as part of the National Early Intervention Longitudinal Study were used to determine expenditures for infants, toddlers, and their families receiving services through Part C programs. The study found that the national average total expenditure for early intervention services…

  3. Energy Expenditure of Sport Stacking

    ERIC Educational Resources Information Center

    Murray, Steven R.; Udermann, Brian E.; Reineke, David M.; Battista, Rebecca A.

    2009-01-01

    Sport stacking is an activity taught in many physical education programs. The activity, although very popular, has been studied minimally, and the energy expenditure for sport stacking is unknown. Therefore, the purposes of this study were to determine the energy expenditure of sport stacking in elementary school children and to compare that value…

  4. Geographical variation in camper expenditures

    Treesearch

    Wilbur F. LaPage; Edward G. Fisher

    1971-01-01

    Daily expenditures by families camping in New Hampshire State parks in 1967 averaged $11.81. Considerable variation was found between the northern, central, and southern regions of the State in both the average amount of money spent and the way in which the money was spent. Daily expenditures in the north were higher, but average visit lengths were shorter, resulting...

  5. National Health Expenditures, 19811

    PubMed Central

    Gibson, Robert M.; Waldo, Daniel R.

    1982-01-01

    The United States spent an estimated $287 billion for health care in 1981 (Figure 1), an amount equal to 9.8 percent of the Gross National Product (GNP). Highlights of the figures that underly this estimate include the following: Health care expenditures continued to grow at a rapid rate in 1981, at a time when the economy as a whole exhibited sluggish growth. The 9.8 percent share of the GNP was a dramatic increase from the 8.9 percent share seen just two years earlier.Health care expenditures amounted to $1,225 per person in 1981 (Table 1). Of that amount, $524, or 42.7 percent, came from public funds.Hospital care accounted for 41.2 percent of total health care spending in 1981 (Table 2). These expenditures increased 17.5 percent from 1980, to a level of $118 billion.Spending for the services of physicians increased 16.9 percent to $55 billion—19.1 percent of all health care spending.Public sources provided 42.7 percent of the money spent on health in 1981, including Federal payments of $84 billion and $39 billion in State and local government funds (Table 3).All third parties combined—private health insurers, governments, private charities, and Industry—financed 67.9 percent of the $255 billion in personal health care in 1981 (Table 4), covering 89.2 percent of hospital care services, 62.1 percent of physicians' services, and 41.3 percent of the remainder (Table 5).Direct patient payments for health care reached $82 billion in 1981, accounting for 32.1 percent of all personal health care expenses (Table 6). Consumers and their employers paid another $73 billion in premiums to private health insurers, $67 billion of which was returned in the form of benefits.Outlays for health care benefits by the Medicare and Medicaid programs totaled $73 billion, including $42 billion for hospital care. The two programs combined paid for 28.6 percent of all personal health care in the nation (Table 7). PMID:10309718

  6. Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys

    PubMed Central

    Doo, Young-Taek

    2016-01-01

    Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only (‘I’-only) and of fixed amount+indemnity-type (‘F+I’) increased, whereas the proportion of holders with fixed amount-type only (‘F’-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with ‘F’-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with ‘I’-only PMI or ‘F+I’ PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for ‘I’-only: 1.39, 1.63, and 1.38, respectively; ORs for ‘F+I’: 1.67, 2.09, and 1.37, respectively). Conclusions: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required. PMID:27055548

  7. Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys.

    PubMed

    Ryu, Dong Hee; Kam, Sin; Doo, Young-Taek

    2016-03-01

    The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

  8. Impact of changes in mode of travel to work on changes in body mass index: evidence from the British Household Panel Survey

    PubMed Central

    Martin, Adam; Panter, Jenna; Suhrcke, Marc; Ogilvie, David

    2015-01-01

    Background Active commuting is associated with various health benefits, but little is known about its causal relationship with body mass index (BMI). Methods We used cohort data from three consecutive annual waves of the British Household Panel Survey, a longitudinal study of nationally representative households, in 2004/2005 (n=15 791), 2005/2006 and 2006/2007. Participants selected for the analyses (n=4056) reported their usual main mode of travel to work at each time point. Self-reported height and weight were used to derive BMI at baseline and after 2 years. Multivariable linear regression analyses were used to assess associations between switching to and from active modes of travel (over 1 and 2 years) and change in BMI (over 2 years) and to assess dose–response relationships. Results After adjustment for socioeconomic and health-related covariates, the first analysis (n=3269) showed that switching from private motor transport to active travel or public transport (n=179) was associated with a significant reduction in BMI compared with continued private motor vehicle use (n=3090; −0.32 kg/m2, 95% CI −0.60 to −0.05). Larger adjusted effect sizes were associated with switching to active travel (n=109; −0.45 kg/m2, −0.78 to −0.11), particularly among those who switched within the first year and those with the longest journeys. The second analysis (n=787) showed that switching from active travel or public transport to private motor transport was associated with a significant increase in BMI (0.34 kg/m2, 0.05 to 0.64). Conclusions Interventions to enable commuters to switch from private motor transport to more active modes of travel could contribute to reducing population mean BMI. PMID:25954024

  9. Higher levels of psychological distress are associated with a higher risk of incident diabetes during 18 year follow-up: results from the British household panel survey

    PubMed Central

    2012-01-01

    Background Reviews have shown that depression is a risk factor for the development of type 2 diabetes. However, there is limited evidence for general psychological distress to be associated with incident diabetes. The aim of the present study was to test whether persons who report higher levels of psychological distress are at increased risk to develop type 2 diabetes during 18 years follow up, adjusted for confounders. Methods A prospective analysis using data from 9,514 participants (41 years, SD=14; 44% men) of the British Household Panel Survey. The General Health Questionnaire 12 item version was used to assess general psychological distress, diabetes was measured by means of self-report. Cox proportional hazards regression models were used to calculate the multivariate-adjusted hazard ratio (HR) of incident diabetes during 18 years follow up, comparing participants with low versus high psychological distress at baseline (1991). Results A total of 472 participants developed diabetes 18 year follow up. Those with a high level of psychological distress had a 33% higher hazard of developing diabetes (HR=1.33, 95% CI 1.10–1.61), relative to those with a low level of psychological distress, adjusted for age, sex, education level and household income. After further adjustment for differences in level of energy, health status, health problems and activity level, higher psychological distress was no longer associated with incident diabetes (HR=1.10, 95% CI 0.91-1.34). Conclusions Higher levels of psychological distress are a risk factor for the development of diabetes during an 18 year follow up period. This association may be potentially mediated by low energy level and impaired health status. PMID:23259455

  10. State Action Analysis of Tax Expenditures

    ERIC Educational Resources Information Center

    Brown, Robert Clarke

    1977-01-01

    Recent judicial treatment of tax expenditures in both state action and establishment clause cases is analyzed and it is argued that tax expenditures and direct expenditures should be treated as constitutional equivalents. (LBH)

  11. 61. Upper panel in cornerpower panel lcpa lower panel in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    61. Upper panel in corner-power panel lcpa lower panel in corner-oxygen regeneration unit, at right-air conditioner control panel, on floor-bio-pack 45 for emergency breathing, looking northwest - Ellsworth Air Force Base, Delta Flight, Launch Control Facility, County Road CS23A, North of Exit 127, Interior, Jackson County, SD

  12. Architectural Panels

    NASA Astrophysics Data System (ADS)

    1985-01-01

    Alliance Wall Corporation's Whyteboard, a porcelain enamel on steel panels wall board, owes its color stability to a KIAC engineering background study to identify potential technologies and manufacturers of equipment which could be used to detect surface flaws. One result of the data base search was the purchase of a spectrocolorimeter which enables the company to control some 250 standard colors, and match special colors.

  13. Architectural Panels

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Alliance Wall Corporation's Whyteboard, a porcelain enamel on steel panels wall board, owes its color stability to a KIAC engineering background study to identify potential technologies and manufacturers of equipment which could be used to detect surface flaws. One result of the data base search was the purchase of a spectrocolorimeter which enables the company to control some 250 standard colors, and match special colors.

  14. Neural Control of Energy Expenditure.

    PubMed

    Münzberg, Heike; Qualls-Creekmore, Emily; Berthoud, Hans-Rudolf; Morrison, Christopher D; Yu, Sangho

    2016-01-01

    The continuous rise in obesity is a major concern for future healthcare management. Many strategies to control body weight focus on a permanent modification of food intake with limited success in the long term. Metabolism or energy expenditure is the other side of the coin for the regulation of body weight, and strategies to enhance energy expenditure are a current focus for obesity treatment, especially since the (re)-discovery of the energy depleting brown adipose tissue in adult humans. Conversely, several human illnesses like neurodegenerative diseases, cancer, or autoimmune deficiency syndrome suffer from increased energy expenditure and severe weight loss. Thus, strategies to modulate energy expenditure to target weight gain or loss would improve life expectancies and quality of life in many human patients. The aim of this book chapter is to give an overview of our current understanding and recent progress in energy expenditure control with specific emphasis on central control mechanisms.

  15. Combining panels for forest inventory and analysis estimation

    Treesearch

    Paul L. Patterson; Gregory A. Reams

    2005-01-01

    The term panel denotes a set of samples where the same elements are measured on two or more occasions. Historically, Forest Inventory and Anaysis (FIA) has used a single panel to conduct periodic surveys. Annual panels, however, allow greater flexibility because they can be combined in a variety of ways. Note that FIA assumes complete spatial coverage for each panel...

  16. National health expenditures, 1985

    PubMed Central

    Waldo, Daniel R.; Levit, Katharine R.; Lazenby, Helen

    1986-01-01

    Slower price inflation in 1985 translated into slower growth of national health expenditures, but underlying growth in the use of goods and services continued along historic trends. Coupled with somewhat sluggish growth of the gross national product, this adherence to trends pushed the share of our Nation's output accounted for by health spending to 10.7 percent. Some aspects of health spending changed: Falling use of hospital services was offset by rising hospital profits and increased use of other health care services. Other aspects remained the same: Both the public sector and the private sector continued efforts to contain costs, efforts that have affected and will continue to affect not only the providers of care but the users of care as well. PMID:10311775

  17. Validating self-reported food expenditures against food store and eating-out receipts

    PubMed Central

    Tang, Wesley; Aggarwal, Anju; Liu, Zhongyuan; Acheson, Molly; Rehm, Colin D; Moudon, Anne Vernez; Drewnowski, Adam

    2015-01-01

    Objectives To compare objective food store and eating-out receipts with self-reported household food expenditures. Design and setting The Seattle Obesity Study (SOS II) was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007–2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared to receipts using paired t-tests, Bland-Altman plots, and kappa statistics. Bias by socio-demographics was also examined. Results Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores, or eating out. However, the highest income strata showed weaker agreement. Bland Altman plots confirmed no significant bias across both methods - mean difference: 6.4; agreement limits: −123.5, 143.4 for total food expenditures, mean difference 5.7 for food stores, and mean difference 1.7 for eating-out. Kappa statistics showed good agreement for each (kappa 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. Conclusion Self-reported food expenditures using NHANES questions, both for food stores and eating-out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts. PMID:26486299

  18. Expenditures on Children by Families, 2007. Miscellaneous Publication Number 1528-2007

    ERIC Educational Resources Information Center

    Lino, Mark

    2008-01-01

    Since 1960, the U.S. Department of Agriculture has provided estimates of expenditures on children from birth through age 17. This technical report presents the most recent estimates for husband-wife and single-parent families using data from the 1990-92 Consumer Expenditure Survey, updated to 2007 dollars using the Consumer Price Index. Data and…

  19. An Analysis of Gender Differences in Household Education Expenditure: The Case of Thailand

    ERIC Educational Resources Information Center

    Wongmonta, Sasiwooth; Glewwe, Paul

    2017-01-01

    This study uses data on educational expenditure, including specific types of educational expenditure, from the 2009 Socioeconomic Survey of Thailand to investigate gender bias in the allocation of educational resources. Empirical Engel's curves are estimated to test for gender bias. The results show that girls receive more education expenditure…

  20. 43 CFR 3861.2-3 - Mineral surveyor's report of expenditures and improvements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Mineral surveyor's report of expenditures... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-3 Mineral surveyor's report of expenditures...

  1. 43 CFR 3861.2-3 - Mineral surveyor's report of expenditures and improvements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Mineral surveyor's report of expenditures... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-3 Mineral surveyor's report of expenditures...

  2. 43 CFR 3861.2-3 - Mineral surveyor's report of expenditures and improvements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Mineral surveyor's report of expenditures... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-3 Mineral surveyor's report of expenditures...

  3. Academic Science/Engineering: R&D Expenditures, Fiscal Year 1989.

    ERIC Educational Resources Information Center

    National Science Foundation, Washington, DC.

    The data presented in this report were compiled from the National Science Foundation's fiscal year 1989 Survey of Scientific and Engineering Expenditures at Universities and Colleges. Expenditures include science and engineering (S/E) costs for separately budgeted research and development (R&D). This includes all funds expended for activities…

  4. An Analysis of Gender Differences in Household Education Expenditure: The Case of Thailand

    ERIC Educational Resources Information Center

    Wongmonta, Sasiwooth; Glewwe, Paul

    2017-01-01

    This study uses data on educational expenditure, including specific types of educational expenditure, from the 2009 Socioeconomic Survey of Thailand to investigate gender bias in the allocation of educational resources. Empirical Engel's curves are estimated to test for gender bias. The results show that girls receive more education expenditure…

  5. EU pharmaceutical expenditure forecast

    PubMed Central

    Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    (−€5,589 million), and, far behind them, Germany (−€831 million), Greece (−€808 million), Portugal (−€243 million), and Hungary (−€84 million). The main source of savings came from the cardiovascular, central nervous system, and respiratory areas and from biosimilar entries. Oncology, immunology, and inflammation, in contrast, lead to additional expenditure. The model was particularly sensitive to the time to market of branded products, generic prices, generic penetration, and the distribution of biosimilars. Conclusions The results of this forecast suggested a decrease in pharmaceutical expenditure in the studied period. The model was sensitive to pharmaceutical policy decisions. PMID:27226837

  6. Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool

    PubMed Central

    Streufert, Ben; Reed, Shelby D.; Orlando, Lori A.; Taylor, Dean C.; Huber, Joel C.; Mather, Richard C.

    2017-01-01

    Background: Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. Purpose: To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents’ agreement with results generated by the tool, (3) willingness to share these results with physicians, and (4) association of results with choice of treatment after FTASD. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A tool was designed and tested using members of Amazon Mechanical Turk, an online panel. The tool included an adaptive conjoint analysis exercise, a method to understand individuals’ perceived importance of the following attributes of treatment: (1) chance of recurrent dislocation, (2) cost, (3) short-term limits on shoulder motion, (4) limits on participation in high-risk activities, and (5) duration of physical therapy. Respondents then chose between operative and nonoperative treatment for hypothetical shoulder dislocation. Results: Overall, 374 of 501 (75%) respondents met the inclusion criteria, of which most were young, active males; one-third reported prior dislocation. From the conjoint analysis, the importance of recurrent dislocation and cost of treatment were the most important attributes. A substantial majority agreed with the tool’s ability to generate representative preferences and indicated that they would share these preferences with their physician. Importance of recurrence proved significantly predictive of respondents’ treatment choices

  7. Energy Expenditure and Aging

    PubMed Central

    Manini, Todd M.

    2009-01-01

    The study of energy expenditure (EE) has deep roots in understanding aging and lifespan in all species. In humans, total EE decreases substantially in advanced age resulting from parallel changes in resting metabolic rate (RMR) and activity EE. For RMR, this reduction appears to be due to a reduction in organ mass and specific metabolic rates of individual tissues. However, these anatomical changes explain very little regarding the decline in activity EE, which is governed by both genetic and environmental sources. The biological control centers for activity EE are closely coupled with body mass fluctuations and seem to originate in the brain. Several candidate neuromodulators may be involved in the age-related reduction of activity EE that include: orexin, agouti-related proteins and dopaminergic pathways. Unfortunately, the existing body of research has primarily focused on how neuromodulators influence weight gain and only a few studies have been performed in aging models. Recent evidence suggests that activity EE has an important role in dictating lifespan and thus places emphasis on future research to uncover the underlying biological mechanisms. The study of EE continues to unlock clues to aging. PMID:19698803

  8. [The federal health expenditure on the uninsured population: Mexico 1980-1995].

    PubMed

    Lara, A; Gómez-Dantés, O; Urdapilleta, O; Bravo, M L

    1997-01-01

    In the last fifteen years Mexico suffered several economic crisis which have negatively affected public expenditure in social welfare and, as a consequence, public expenditure in health. This paper discusses the relationship between the adjustment policies adopted to confront these crisis and public expenditure in health care for the non-insured population, as well as the regional distribution of this expenditure. In part one, the evolution of general public expenditure, public expenditure in social welfare, and public expenditure in health between 1980 and 1995 is described. In part two, the distribution of public health expenditure for the non-insured population among the five regions in which the country was divided by the National Health Survey II is discussed. The main conclusion of this paper is that, between 1980 and 1995, the public expenditure gaps that have existed for a long time in Mexico among regions remained unchanged. These gaps basically affect the southern states of the country, are not related to health needs, and may deepen in view of the new relative cuts in public expenditure in social welfare announced by the new administration.

  9. Patterns of Health Expenditures and Financial Protections in Vietnam 1992-2012.

    PubMed

    Hoang, Van Minh; Oh, Juhwan; Tran, Tuan Anh; Tran, Thi Giang Huong; Ha, Anh Duc; Luu, Ngoc Hoat; Nguyen, Thi Kim Phuong

    2015-11-01

    Health financing has been considered as an important building block of a health system and has a key role in promoting universal health coverage in the Vietnam. This paper aims to describe the pattern of health expenditure, including total health expenditure and composition of health expenditure, over the last two decades in Vietnam. The paper mainly uses the data from Vietnam National Health Account and Vietnam Living Standards Survey. We also included data from other relevant published literature, reports and statistics about health care expenditure in Vietnam. The per capita health expenditure in Vietnam increased from US$ 14 in 1995 to US$ 86 in 2012. The total health expenditure as a share of GDP also rose from 5.2% in 1995 to 6.9% in 2012. Public health expenditure as percentage of government expenditure rose from 7.4% in 1995 to nearly 10% in 2012. The coverage of health insurance went up from 10% in 1995 to 68.5% in 2012. However, health financing in Vietnam was depending on private expenditures (57.4% in 2012). As a result, the proportion of households with catastrophic expenditure in 2012 was 4.2%. The rate of impoverishment in 2012 was 2.5%. To ensure equity and efficient goal of health system, policy actions for containing the health care out-of-pocket payments and their poverty impacts are urgently needed in Vietnam.

  10. [Out-of-pocket health care expenditures among population groups in Iceland].

    PubMed

    Vilhjálmsson, Rúnar

    2009-10-01

    Out-of-pocket health expenditures affect access to health care. The study investigated trends in these expenditures, and whether certain population groups spent more than others. The data come from two national health surveys among Icelandic adults from 1998 and 2006. The response rate was 69% in the former survey (N=1924), and 60% in the latter (N= 1532). Average household health expenditures and household expenditure burden (expenditures as % of total household income) were compared over time and between groups. Household health expenditures increased by 29% in real terms between 1998 and 2006. The biggest items in 2006 were drugs and dental care. Women, younger and older individuals, the single and divorced, smaller households, the unemployed and non-employed, individuals with low education and income, the chronically ill, and the disabled, had the highest household expenditure burden. Comparison between 1998 and 2006 indicated increased expenditure burden among young people, students, the unemployed, and the least educated, but decreased burden among the elderly, the widowed, and parents of young children. Household health expenditures differ substantially between groups, suggesting reconsideration of current health insurance policies, especially with regard to disabled, non-employed, low-income, and young individuals.

  11. Impact of healthcare reforms on out-of-pocket health expenditures in Turkey for public insurees.

    PubMed

    Erus, Burcay; Aktakke, Nazli

    2012-06-01

    The Turkish healthcare system has been subject to major reforms since 2003. During the reform process, access to public healthcare providers was eased and private providers were included in the insurance package for public insurees. This study analyzes data on out-of-pocket (OOP) healthcare expenditures to look into the impact of reforms on the size of OOP health expenditures for premium-based public insurees. The study uses Household Budget Surveys that provide a range of individual- and household-level data as well as healthcare expenditures for the years 2003, before the reforms, and 2006, after the reforms. Results show that with the reforms ratio of households with non-zero OOP expenditure has increased. Share and level of OOP expenditures have decreased. The impact varies across income levels. A semi-parametric analysis shows that wealthier individuals benefited more in terms of the decrease in OOP health expenditures.

  12. [Health expenditure related to disability. A study with poor population in Mexico].

    PubMed

    Urquieta-Salomón, José E; Figueroa, José L; Hernández-Prado, Bernardo

    2008-01-01

    To estimate the effect of disability and incapacity in health expenditure in poor households in Mexico. This is an analysis of baseline survey of the Oportunidades evaluation. Households with siblings with structural disability or incapacity were identified, and health expenditure was estimated. In 15314 households analyzed, 10.1% had a sibling with structural disability, and 13.4% with mild or severe incapacity. The presence of structural disability was not associated with a higher expenditure in health care. The presence of mild or severe incapacity was associated with 97% higher expenditure in ambulatory care compared with households without incapacity. The poor households have higher health related expenditures. These results indicate that the incapacity to develop day to day activities has a significant impact on the out of pocket health expenditure. This impact is higher in poor households.

  13. Welfare Attitudes and Social Expenditure: Do Regimes Shape Public Opinion?

    ERIC Educational Resources Information Center

    Jakobsen, Tor Georg

    2011-01-01

    This article examines the link between regime types, social expenditure, and welfare attitudes. By employing data on 19 countries taken from the World Values Survey, the main aim is to see to what degree the institutions of a country affect the attitudes of its citizens. According to Esping-Andersen ("The three worlds of welfare…

  14. Expenditures on O&M at America's Most Beautiful Campuses.

    ERIC Educational Resources Information Center

    Ellertson, Shari L.

    2001-01-01

    Presents survey results on operations and maintenance expenditures and management comparisons among the 50 universities and colleges considered to have "works-of-art" campuses. Among the study's conclusions is the idea that what makes a campus a "work of art" or award winner does not appear to be reflected in what they spend on plant operations…

  15. Expenditures on O&M at America's Most Beautiful Campuses.

    ERIC Educational Resources Information Center

    Ellertson, Shari L.

    2001-01-01

    Presents survey results on operations and maintenance expenditures and management comparisons among the 50 universities and colleges considered to have "works-of-art" campuses. Among the study's conclusions is the idea that what makes a campus a "work of art" or award winner does not appear to be reflected in what they spend on plant operations…

  16. Welfare Attitudes and Social Expenditure: Do Regimes Shape Public Opinion?

    ERIC Educational Resources Information Center

    Jakobsen, Tor Georg

    2011-01-01

    This article examines the link between regime types, social expenditure, and welfare attitudes. By employing data on 19 countries taken from the World Values Survey, the main aim is to see to what degree the institutions of a country affect the attitudes of its citizens. According to Esping-Andersen ("The three worlds of welfare…

  17. 2 CFR 200.34 - Expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Expenditures. 200.34 Section 200.34 Grants... REQUIREMENTS FOR FEDERAL AWARDS Acronyms and Definitions Acronyms § 200.34 Expenditures. Expenditures means... consistently applied. (b) For reports prepared on a cash basis, expenditures are the sum of: (1) Cash...

  18. 10 CFR 440.18 - Allowable expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Allowable expenditures. 440.18 Section 440.18 Energy... expenditures. (a) Except as adjusted, the expenditure of financial assistance provided under this part for... adjusted in paragraph (c) of this section. (b) The expenditure of financial assistance provided under this...

  19. 10 CFR 440.18 - Allowable expenditures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Allowable expenditures. 440.18 Section 440.18 Energy... expenditures. (a) Except as adjusted, the expenditure of financial assistance provided under this part for... adjusted in paragraph (c) of this section. (b) The expenditure of financial assistance provided under this...

  20. The Relationship between Inflation and Defense Expenditures.

    DTIC Science & Technology

    1979-12-01

    All Federal Expenditures .. ......... . 22 2. Defense Expenditures .... ........... 24 3. Suggested Research on the Impact of DoD Spending ...only major study specifically simulating changes in military spending implied that defense and non- defense expenditures have identical impacts upon...analyzed in Chapter I is that defense expenditures are not assigned a central role in generating inflation. Even when defense spending is incorporated

  1. 10 CFR 440.18 - Allowable expenditures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Allowable expenditures. 440.18 Section 440.18 Energy... expenditures. (a) Except as adjusted, the expenditure of financial assistance provided under this part for... adjusted in paragraph (c) of this section. (b) The expenditure of financial assistance provided under...

  2. Minority Transportation Expenditure Allocation Model

    SciTech Connect

    Vyas, Anant D.; Santini, Danilo J.; Marik, Sheri K.

    1993-04-12

    MITRAM (Minority TRansportation expenditure Allocation Model) can project various transportation related attributes of minority (Black and Hispanic) and majority (white) populations. The model projects vehicle ownership, vehicle miles of travel, workers, new car and on-road fleet fuel economy, amount and share of household income spent on gasoline, and household expenditures on public transportation and taxis. MITRAM predicts reactions to sustained fuel price changes for up to 10 years after the change.

  3. Measuring the Displacement and Replacement of Government Health Expenditure

    PubMed Central

    Dieleman, Joseph L; Hanlon, Michael

    2014-01-01

    Research assessing the relationship between government health expenditure and development assistance for health channeled to governments (DAHG) has not considered that this relationship may depend on whether DAHG is increasing or decreasing. We explore this issue using general method of moments estimation and a panel of financial flows data spanning 119 countries and 16 years. Our primary concern is how DAHG affects government health expenditure as source (GHES). We disaggregate the average effect of DAHG and separately identify the effects of increases versus decreases in DAHG. We find that a $1 year-over-year increase in DAHG leads to a $0.62 (90% confidence interval (CI): 0.15, 1.09) decrease in GHES, whereas a $1 year-over-year decrease in DAHG does not have an effect on GHES that is statistically different from zero (CI: −0.67, 1.17). Simulation shows that the displacement of GHES between 1995 and 2010 reduced total government health expenditure by $152.8 billion (CI: 46.9, 277.6). Moreover, the irregular disbursement of DAHG reduced total government expenditure by $96.9 billion (CI: 0.5, 212.4). Thus, this research shows that health aid is fungible and highlights the cost of displacement and erratic aid disbursement. PMID:24327240

  4. Measuring the displacement and replacement of government health expenditure.

    PubMed

    Dieleman, Joseph L; Hanlon, Michael

    2014-02-01

    Research assessing the relationship between government health expenditure and development assistance for health channeled to governments (DAHG) has not considered that this relationship may depend on whether DAHG is increasing or decreasing. We explore this issue using general method of moments estimation and a panel of financial flows data spanning 119 countries and 16 years. Our primary concern is how DAHG affects government health expenditure as source (GHES). We disaggregate the average effect of DAHG and separately identify the effects of increases versus decreases in DAHG. We find that a $1 year-over-year increase in DAHG leads to a $0.62 (90% confidence interval (CI): 0.15, 1.09) decrease in GHES, whereas a $1 year-over-year decrease in DAHG does not have an effect on GHES that is statistically different from zero (CI: -0.67, 1.17). Simulation shows that the displacement of GHES between 1995 and 2010 reduced total government health expenditure by $152.8 billion (CI: 46.9, 277.6). Moreover, the irregular disbursement of DAHG reduced total government expenditure by $96.9 billion (CI: 0.5, 212.4). Thus, this research shows that health aid is fungible and highlights the cost of displacement and erratic aid disbursement.

  5. Heat exchanger panel

    NASA Technical Reports Server (NTRS)

    Warburton, Robert E. (Inventor); Cuva, William J. (Inventor)

    2005-01-01

    The present invention relates to a heat exchanger panel which has broad utility in high temperature environments. The heat exchanger panel has a first panel, a second panel, and at least one fluid containment device positioned intermediate the first and second panels. At least one of the first panel and the second panel have at least one feature on an interior surface to accommodate the at least one fluid containment device. In a preferred embodiment, each of the first and second panels is formed from a high conductivity, high temperature composite material. Also, in a preferred embodiment, the first and second panels are joined together by one or more composite fasteners.

  6. Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2005-06 (Fiscal Year 2006). First Look. NCES 2008-345

    ERIC Educational Resources Information Center

    Zhou, Lei

    2008-01-01

    This brief publication contains basic revenue and expenditure data, by state, for public elementary and secondary education for school year 2005-06. It contains state-level data on revenues by source and expenditures by function, including expenditures per pupil. It presents data from the School District Finance Survey for School Year 2005-06…

  7. Response problems in a vacation panel study

    Treesearch

    Christine A. Vogt; Susan I. Stewart

    2001-01-01

    This paper investigates response problems encountered in a panel study of travel behavior. Though the overall response rate to the three-wave panel study was acceptable (over 60%), three types of response problems were encountered: refusal, non-response, and attrition. In a follow-up phone survey, a sample of individuals from each problem response group was questioned...

  8. Methods for the evaluation and analysis of health expenditure.

    PubMed

    Sandier, S

    1983-01-01

    The purpose of health expenditure evaluation is to give an overall picture of the amounts spent for the functions of the health system; it also allows the analysis of the financial flows between the financiers, producers and consumers of the health system. Principles of evaluation include: monetary evaluation (market prices); avoidance of double accounts; quick communication of data; use of all available reliable statistics; use of rough estimates rather than leaving blanks in tables. Information already available can be used. Statistics also should be collected from financing bodies, providers of medical care, sample surveys, and general sources. Many statistics cannot be used directly but must be processed, adjusted, or broken down. In order to analyze information for health services management, one must ask: who is financing the consumption of medical care, and what is the trend of medical expenditure by sector or activity? Over time, summaries should be used to analyze trends. At the macrolevel, structural trends can be compared, such as demographic factors, gross economic product, inflation, price of medical care, volume of medical care, and contribution of prices and volumes to increases in expenditures. Causes of these trends include factors such as changes in collective financing and developments in the health care system. A brief analysis of the trends in final medical consumption expenditure in France shows 3300 francs per person expended in 1979, (7.3% of the GNP in 1979). Tables for France show: type of expenditure; type of financing in 1979; medical expenditure as a % of the gross domestic product, 1950-1980; and type of financing, 1950-1978. Hospitalization has accounted for an increasing proportion of medical expenditure in France, reflecting improvement in quality of services offered by hospitals. Public financing is shown to be increasing in France.

  9. Savings in Medical Expenditures Associated with Reductions in Body Mass Index Among US Adults with Obesity, by Diabetes Status.

    PubMed

    Cawley, John; Meyerhoefer, Chad; Biener, Adam; Hammer, Mette; Wintfeld, Neil

    2015-07-01

    The prevalence of obesity has more than doubled in the USA in the past 30 years. Obesity is a significant risk factor for diabetes, cardiovascular disease, and other clinically significant co-morbidities. This paper estimates the medical care cost savings that can be achieved from a given amount of weight loss by people with different starting values of body mass index (BMI), for those with and without diabetes. This information is an important input into analyses of the cost effectiveness of obesity treatments and prevention programs. Two-part models of instrumental variables were estimated using data from the Medical Expenditure Panel Survey (MEPS) for 2000-2010. Models were estimated for all adults as well as separately for those with and without diabetes. We calculated the causal impact of changes in BMI on medical care expenditures, cost savings for specific changes in BMI (5, 10, 15, and 20 %) from starting BMI levels ranging from 30 to 45 kg/m(2), as well as the total excess medical care expenditures caused by obesity. In the USA, adult obesity raised annual medical care costs by $US3,508 per obese individual, for a nationwide total of $US315.8 billion (year 2010 values). However, the relationship of medical care costs over BMI is J-shaped; costs rise exponentially in the range of class 2 and 3 obesity (BMI ≥35). The heavier the obese individual, the greater the reduction in medical care costs associated with a given percent reduction in BMI. Medical care expenditures are higher, and rise more with BMI, among individuals with diabetes than among those without diabetes. The savings from a given percent reduction in BMI are greater the heavier the obese individual, and are greater for those with diabetes than for those without diabetes. The results provide health insurers, employers, government agencies, and health economists with accurate estimates of the change in medical care expenditures resulting from weight loss, which is important information for

  10. Household food insecurity and food expenditure in Bolivia, Burkina Faso, And the Philippines.

    PubMed

    Melgar-Quinonez, Hugo R; Zubieta, Ana C; MkNelly, Barbara; Nteziyaremye, Anastase; Gerardo, Maria Filipinas D; Dunford, Christopher

    2006-05-01

    This study examined the association between food insecurity, determined by a modified version of the U.S. Household Food Security Survey Module (US HFSSM), and total daily per capita (DPC) consumption (measured as household expenditures) in Bolivia, Burkina Faso, and the Philippines. Household food insecurity was determined by an adapted 9-item US HFSSM version. A short version of the World Bank's Living Standards Measurement Study (LSMS) consumption module measured household expenditures. Focus groups were used to adapt the survey instrument to each local context. The sample (n approximately 330 per country) includes residents of urban and rural areas. A 12-month food expenditure aggregate was generated as part of the total household expenditures calculation. DPC food expenditure, which represented over 60% of the total household consumption, as well as expenditures on specific food groups correlated with food insecurity both as a continuous Food Insecurity Score (FinSS) and a tricategorical food insecurity status variable. ANOVA and regression analysis were executed adjusting for social and demographic covariates. Food-secure households have significantly higher (P < 0.05) total DPC food expenditures as well as expenditures on animal source foods, vegetables, and fats and oils than moderately and severely food-insecure households. The results offer evidence that the US HFSSM is able to discriminate between households at different levels of food insecurity status in diverse developing world settings.

  11. Drilling expenditures: doldrums, then growth

    SciTech Connect

    Krupp, H.W.; Spadine, F.R.

    1985-07-24

    Projections of US expenditures for oil and gas drilling indicate the current decline will continue another 10 to 15%. If OPEC is able to maintain the existing oil price structure, 1986 expenditures could recover the $27 billion level of 1984, but it is more likely that further erosion of prices will drive spending down another $3 per barrel to $21 billion. The forecast indicates a possible rapid climb starting at the end of the decade and reaching $60 to $65 billion by the mid-1990s as long as oil prices do not collapse, but the $27 billion level of the early 1980s will not be regained. Natural gas drilling will account for most of the increase, rising from 45% to 55% of total expenditures. 3 figures, 3 tables.

  12. Activity limitations predict health care expenditures in the general population in Belgium.

    PubMed

    Van der Heyden, Johan; Van Oyen, Herman; Berger, Nicolas; De Bacquer, Dirk; Van Herck, Koen

    2015-03-19

    Disability and chronic conditions both have an impact on health expenditures and although they are conceptually related, they present different dimensions of ill-health. Recent concepts of disability combine a biological understanding of impairment with the social dimension of activity limitation and resulted in the development of the Global Activity Limitation Indicator (GALI). This paper reports on the predictive value of the GALI on health care expenditures in relation to the presence of chronic conditions. Data from the Belgian Health Interview Survey 2008 were linked with data from the compulsory national health insurance (n = 7,286). The effect of activity limitation on health care expenditures was assessed via cost ratios from multivariate linear regression models. To study the factors contributing to the difference in health expenditure between persons with and without activity limitations, the Blinder-Oaxaca decomposition method was used. Activity limitations are a strong determinant of health care expenditures. People with severe activity limitations (5.1%) accounted for 16.9% of the total health expenditure, whereas those without activity limitations (79.0%), were responsible for 51.5% of the total health expenditure. These observed differences in health care expenditures can to some extent be explained by chronic conditions, but activity limitations also contribute substantially to higher health care expenditures in the absence of chronic conditions (cost ratio 2.46; 95% CI 1.74-3.48 for moderate and 4.45; 95% CI 2.47-8.02 for severe activity limitations). The association between activity limitation and health care expenditures is stronger for reimbursed health care costs than for out-of-pocket payments. In the absence of chronic conditions, activity limitations appear to be an important determinant of health care expenditures. To make projections on health care expenditures, routine data on activity limitations are essential and complementary to data

  13. Spatial Structure and Climatic Adaptation in African Maize Revealed by Surveying SNP Diversity in Relation to Global Breeding and Landrace Panels

    PubMed Central

    Westengen, Ola T.; Berg, Paul R.; Kent, Matthew P.; Brysting, Anne K.

    2012-01-01

    Background Climate change threatens maize productivity in sub-Saharan Africa. To ensure food security, access to locally adapted genetic resources and varieties is an important adaptation measure. Most of the maize grown in Africa is a genetic mix of varieties introduced at different historic times following the birth of the trans-Atlantic economy, and knowledge about geographic structure and local adaptations is limited. Methodology A panel of 48 accessions of maize representing various introduction routes and sources of historic and recent germplasm introductions in Africa was genotyped with the MaizeSNP50 array. Spatial genetic structure and genetic relationships in the African panel were analysed separately and in the context of a panel of 265 inbred lines representing global breeding material (based on 26,900 SNPs) and a panel of 1127 landraces from the Americas (270 SNPs). Environmental association analysis was used to detect SNPs associated with three climatic variables based on the full 43,963 SNP dataset. Conclusions The genetic structure is consistent between subsets of the data and the markers are well suited for resolving relationships and admixture among the accessions. The African accessions are structured in three clusters reflecting historical and current patterns of gene flow from the New World and within Africa. The Sahelian cluster reflects original introductions of Meso-American landraces via Europe and a modern introduction of temperate breeding material. The Western cluster reflects introduction of Coastal Brazilian landraces, as well as a Northeast-West spread of maize through Arabic trade routes across the continent. The Eastern cluster most strongly reflects gene flow from modern introduced tropical varieties. Controlling for population history in a linear model, we identify 79 SNPs associated with maximum temperature during the growing season. The associations located in genes of known importance for abiotic stress tolerance are

  14. Energy expenditure of nonexercise activity.

    PubMed

    Levine, J A; Schleusner, S J; Jensen, M D

    2000-12-01

    We found recently that changes in nonexercise activity thermogenesis (NEAT) mediate resistance to weight gain with overfeeding in sedentary adults. A potentially important, yet seldom investigated, component of NEAT is the energy expenditure of fidgeting-like activities. Our goal was to measure changes in energy expenditure with fidgeting-like activities. Energy expenditure was measured in 24 subjects (17 women and 7 men x+/- SD body weight: 76 +/- 21 kg) while recumbent at rest, sitting motionless, standing motionless, partaking of self-selected fidgeting-like movements while seated and while standing, and walking on a treadmill at 1.6, 3.2, and 4.8 km/h (1, 2, and 3 mph). Measurements were performed by using a high-precision, indirect calorimeter connected to the subject via a transparent, lightweight facemask that enabled almost unrestricted movement. Compared with metabolic rate in the supine position (5.4 +/- 1.5 kJ/min), energy expenditure increased while sitting motionless by 4 +/- 6%, while fidgeting while seated by 54 +/- 29% (P: < 0.0001), while standing motionless by 13 +/- 8% (P: < 0.0001), while fidgeting while standing by 94 +/- 38% (P: < 0.0001), while walking at 1.6 km/h by 154 +/- 38% (P: < 0.0001), while walking at 3.2 km/h by 202 +/- 45% (P: < 0.0001), and while walking at 4.8 km/h by 292 +/- 81% (P: < 0.0001). There was a significant, positive correlation between changes in energy expenditure and body weight for fidgeting-like activities while standing (r = 0.43, P: = 0.02) but not while seated. There is marked variance between subjects in the energy expenditure associated with self-selected fidgeting-like activities. The thermogenic potential of fidgeting-like and low-grade activities is sufficiently great to substantively contribute to energy balance.

  15. Energy expenditure in HIV infection.

    PubMed

    Kosmiski, Lisa

    2011-12-01

    Energy intake recommendations for adults should be based preferably on direct measurements of total daily energy expenditure (TDEE) in corresponding populations who are maintaining healthy body weight and satisfactory physical activity levels. During adolescence, pregnancy, and lactation, energy requirements should be based on TDEE plus the additional energy required to advance these physiologic states. With illness, energy expenditure and energy intake change, but nutritional intervention is not necessarily beneficial. This article reviews data on energy expenditure in HIV infection with a focus on adults, adolescents aged ≥14 y, and pregnant and lactating women. Resting energy expenditure (REE) in adults with untreated asymptomatic HIV is ~ 10% higher than in healthy control subjects. In asymptomatic adults receiving antiretroviral therapy, REE may be similarly increased. HIV wasting and secondary infections are also associated with increased REE. In contrast, TDEE is typically normal in asymptomatic HIV and decreased in HIV wasting and secondary infection. No direct measurements of REE or TDEE are available in adolescents or in pregnant or lactating women with HIV. On the basis of current data, energy intake may need to increase by ~ 10% in adults with asymptomatic HIV to maintain body weight. In adolescents and in pregnant and lactating women with asymptomatic HIV, energy requirements should approximate recommendations for their uninfected counterparts until further data are available. In the resource-rich world, the energy expenditure changes associated with HIV are unlikely to contribute to significant weight loss. More data are needed on energy expenditure in HIV-infected populations from developing nations, where concurrent malnutrition and coinfections are common.

  16. Assessing the Relationship between Physical Illness and Mental Health Service Use and Expenditures among Older Adults from Racial/Ethnic Minority Groups

    PubMed Central

    Jimenez, Daniel E; Cook, Benjamin; Kim, Giyeon; Reynolds, Charles F.; Alegria, Margarita; Coe-Odess, Sarah; Bartels, Stephen J.

    2015-01-01

    Objective The association of physical illness and mental health service use in older adults from racial/ethnic minority groups is an important area of study given the mental and physical health disparities and the low use of mental health services in this population. The purpose of this study is to describe the impact of comorbid physical illness on mental health service use and expenditures in older adults; and to evaluate disparities in mental health service use and expenditures among a racially/ethnically diverse sample of older adults with and without comorbid physical illness. Methods Data were obtained from the Medical Expenditure Panel Survey (years 2004–2011). The sample included 1563 whites, 519 African-Americans, and 642 Latinos and (N=2,724) aged 65+ with probable mental illness. Using two-part generalized linear models, we estimated and compared mental health service use among those with and without a comorbid physical illness. Results Mental health service use was greater for older adults with comorbid physical illness compared to those without a comorbid physical illness. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid physical illness increased the likelihood of mental health service use in older whites and Latinos. However, the presence of a comorbidity did not impact racial/ethnic disparities in mental health service use. Conclusions This study highlighted the important role of comorbid physical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial/ethnic minority groups. PMID:25772763

  17. High quality nutrient intake is associated with higher household expenditures by Japanese adults.

    PubMed

    Fukuda, Yoshiharu; Hiyoshi, Ayako

    2012-08-01

    There is little evidence of socioeconomic differences in dietary intake in the Japanese population. This study examined the association between household expenditures and dietary intake using nationally representative surveys of Japan. We analyzed data from the Comprehensive Survey of Living Conditions and National Health and Nutrition Survey, 2003-2007. For subjects ages 18 to 74 years (11,240 men and 11,472 women), the sex-specific association between household expenditure quartiles and selected nutrient intake was examined using comparison of means and prevalence of a healthy intake. Higher household expenditures were associated with an increase in the mean levels of total energy, fat, protein, carbohydrates, calcium, vitamins A and C, niacin, and fiber for both men and women and salt for men. Prevalence comparison indicated that most of the recommendations for dietary intake were met for people with higher household expenditures than for those with lower household expenditures. There was no clear association between fat intake and expenditures. Higher household expenditures were associated with a healthy and balanced nutrient intake in Japanese adults. The findings suggest that socioeconomic differences in dietary patterns contribute to socioeconomic inequalities in mortality and morbidity in Japan.

  18. Catastrophic expenditure on medicines in Brazil.

    PubMed

    Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Oliveira, Maria Auxiliadora; Arrais, Paulo Sergio Dourado; Ramos, Luiz Roberto; Pizzol, Tatiane da Silva Dal; Mengue, Sotero Serrate; Farias, Mareni Rocha; Bertoldi, Andréa Dâmaso

    2016-12-01

    To describe the magnitude of the expenditure on medicines in Brazil according to region, household size and composition in terms of residents in a situation of dependency. Population-based data from the national household survey were used, with probabilistic sample, applied between September 2013 and February 2014 in urban households. The expenditure on medicines was the main outcome of interest. The prevalence and confidence intervals (95%CI) of the outcomes were stratified according to socioeconomic classification and calculated according to the region, the number of residents dependent on income, the presence of children under five years and residents in a situation of dependency by age. In about one of every 17 households (5.3%) catastrophic health expenditure was reported and, in 3.2%, the medicines were reported as one of the items responsible for this situation. The presence of three or more residents (3.6%) and resident in a situation of dependency (3.6%) were the ones that most reported expenditure on medicines. Southeast was the region with the lowest prevalence of expenditure on medicines. The prevalence of households with catastrophic health expenditure and on medicines in relation to the total of households showed a regressive tendency for economic classes. Catastrophic health expenditure was present in 5.3%, and catastrophic expenditure on medicines in 3.2% of the households. Multi-person households, presence of residents in a situation of economic dependency and belonging to the class D or E had the highest proportion of catastrophic expenditure on medicines. Although the problem is important, permeated by aspects of iniquity, Brazilian policies seem to be protecting families from catastrophic expenditure on health and on medicine. Descrever a magnitude do gasto catastrófico em medicamentos no Brasil segundo região, tamanho das famílias e composição familiar em termos de moradores em situação de dependência. Utilizados dados de inqu

  19. 44 CFR 361.8 - Ineligible expenditures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HOMELAND SECURITY PREPAREDNESS NATIONAL EARTHQUAKE HAZARDS REDUCTION ASSISTANCE TO STATE AND LOCAL GOVERNMENTS Earthquake Hazards Reduction Assistance Program § 361.8 Ineligible expenditures. (a) Expenditures... annual negotiation process with FEMA how this equipment will support the earthquake hazards reduction...

  20. The impact of changes in county public health expenditures on general health in the population.

    PubMed

    Brown, Timothy T; Martinez-Gutierrez, Maria S; Navab, Bahar

    2014-07-01

    We estimate the effect of changes in the per capita expenditures of county departments of public health on county-level general health status. Using panel data on 40 counties in California (2001-2009), dynamic panel estimation techniques are combined with the Lewbel instrumental variable technique to estimate an aggregate demand for health function that measures the causal cumulative impact that per capita public health expenditures have on county-level general health status. We find that a $10 long-term increase in per capita public health expenditures would increase the percentage of the population reporting good, very good or excellent health by 0.065 percentage points. Each year expenditures were increased would result in ∼24,000 individuals moving from the 'poor or fair health' category to the 'good, very good or excellent health' category across these 40 counties. In terms of the overall impact of county public health departments on general health status, at current funding levels, each annual expenditure cycle results in over 207,000 individuals being in the 'good, very good or excellent' categories of health status rather than the 'poor or fair' categories.

  1. Socioeconomic inequalities in the healthiness of food choices: Exploring the contributions of food expenditures.

    PubMed

    Pechey, Rachel; Monsivais, Pablo

    2016-07-01

    Investigations of the contribution of food costs to socioeconomic inequalities in diet quality may have been limited by the use of estimated (vs. actual) food expenditures, not accounting for where individuals shop, and possible reverse mediation between food expenditures and healthiness of food choices. This study aimed to explore the extent to which food expenditure mediates socioeconomic inequalities in the healthiness of household food choices. Observational panel data on take-home food and beverage purchases, including expenditure, throughout 2010 were obtained for 24,879 UK households stratified by occupational social class. Purchases of (1) fruit and vegetables and (2) less-healthy foods/beverages indicated healthiness of choices. Supermarket choice was determined by whether households ever visited market-defined high-price and/or low-price supermarkets. Results showed that higher occupational social class was significantly associated with greater food expenditure, which was in turn associated with healthier purchasing. In mediation analyses, 63% of the socioeconomic differences in choices of less-healthy foods/beverages were mediated by expenditure, and 36% for fruit and vegetables, but these figures were reduced to 53% and 31% respectively when controlling for supermarket choice. However, reverse mediation analyses were also significant, suggesting that 10% of socioeconomic inequalities in expenditure were mediated by healthiness of choices. Findings suggest that lower food expenditure is likely to be a key contributor to less-healthy food choices among lower socioeconomic groups. However, the potential influence of cost may have been overestimated previously if studies did not account for supermarket choice or explore possible reverse mediation between expenditure and healthiness of choices. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  2. 76 FR 50887 - Elections Regarding Start-Up Expenditures, Corporation Organizational Expenditures, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BE77 Elections Regarding Start-Up Expenditures, Corporation Organizational Expenditures, and Partnership Organizational Expenses AGENCY: Internal Revenue Service (IRS... final regulations relating to elections to deduct start-up expenditures, organizational expenditures...

  3. Survey of the World Agricultural Documentation Services, Draft; Prepared on Behalf of the FAO Panel of Experts on "AGRIS" (International Information System for the Agricultural Sciences and Technology).

    ERIC Educational Resources Information Center

    Buntrock, H.

    The purpose of the survey was: (1) to evaluate existing agricultural information services and (2) to propose possible frameworks for an improved world-wide agricultural information service. The principal statistical results of the survey are summarized in the following figures which are based on data collected in nearly all instances for the year…

  4. 18 CFR 154.402 - ACA expenditures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false ACA expenditures. 154....402 ACA expenditures. Link to an amendment published at 78 FR 19412, Apr. 1, 2013. (a) Requirements... revised text is set forth as follows: § 154.402 ACA expenditures. (a) Requirements. Upon approval by the...

  5. Quality Indicators for Continuous Monitoring to Improve Maternal and Infant Health in Maternity Departments: A Modified Delphi Survey of an International Multidisciplinary Panel

    PubMed Central

    Boulkedid, Rym; Sibony, Olivier; Goffinet, François; Fauconnier, Arnaud; Branger, Bernard; Alberti, Corinne

    2013-01-01

    Objective Measuring the quality of inpatient obstetrical care using quality indicators is becoming increasingly important for both patients and healthcare providers. However, there is no consensus about which measures are optimal. We describe a modified Delphi method to identify a set of indicators for continuously monitoring the quality of maternity care by healthcare professionals. Methodology and Main Findings An international French-speaking multidisciplinary panel comprising 22 obstetricians-gynaecologists, 12 midwives, and 1 paediatrician assessed potential indicators extracted from a medical literature search, using a two-round Delphi procedure followed by a physical meeting. Each panellist rated each indicator based on validity and feasibility. In the first round, 35 panellists from 5 countries and 20 maternity units evaluated 26 indicators including 15 related to the management of the overall population of pregnant women, 3 to the management of women followed from the first trimester of pregnancy, 2 to the management of low-risk pregnant women, and 6 to the management of neonates. 25 quality indicators were kept for next step. In the second round, 27 (27/35: 77%) panellists selected 17 indicators; the remaining 8 indicators were discussed during a physical meeting. The final set comprised 18 indicators. Conclusion A multidisciplinary panel selected indicators that reflect the quality of obstetrical care. This set of indicators could be used to assess and monitor obstetrical care, with the goal of improving the quality of care in maternity units. PMID:23577143

  6. Health Care Expenditure among People with Disabilities: Potential Role of Workplace Health Promotion and Implications for Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Karpur, Arun; Bruyere, Susanne M.

    2012-01-01

    Workplace health-promotion programs have the potential to reduce health care expenditures, especially among people with disabilities. Utilizing nationally representative survey data, the authors provide estimates for health care expenditures related to secondary conditions, obesity, and health behaviors among working-age people with disabilities.…

  7. Health Care Expenditure among People with Disabilities: Potential Role of Workplace Health Promotion and Implications for Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Karpur, Arun; Bruyere, Susanne M.

    2012-01-01

    Workplace health-promotion programs have the potential to reduce health care expenditures, especially among people with disabilities. Utilizing nationally representative survey data, the authors provide estimates for health care expenditures related to secondary conditions, obesity, and health behaviors among working-age people with disabilities.…

  8. Body weight status and health-care expenditure among university retirees in Beijing, China.

    PubMed

    Jiang, Ning; Yu, Hongjun; An, Ruopeng

    2017-09-01

    This study examined the impact of overweight and obesity on health-care expenditure among university retirees in Beijing, China. Annual health surveys of retirees were conducted at Tsinghua University during 2011-2016. Individual random-effect regressions were performed to estimate incremental health-care expenditures attributable to overweight/obesity, adjusting for various individual characteristics. Compared to their normal-weight counterparts, obesity was associated with an increase in annual out-of-pocket expenditure on outpatient care by 27%, inpatient care 19% and medication 15%, and an increase in annual total out-of-pocket health-care expenditure by 33%. Overweight was associated with an increase in annual out-of-pocket expenditure on inpatient care by 13%, and an increase in annual total out-of-pocket health-care expenditure by 13%. The impact of obesity on health-care expenditure was statistically significant among men but not women. Overweight, and obesity in particular, was associated with substantial increases in out-of-pocket health-care expenditures among Chinese older adults. © 2017 AJA Inc.

  9. Social Welfare Expenditures and Infant Mortality.

    PubMed

    Shim, Joyce

    2015-01-01

    This study examines the effects of social welfare expenditures on infant mortality (deaths younger than age 1 per 1,000 live births) across 19 Organisation for Economic Co-operation and Development (OECD) countries from 1980 to 2010. Data are obtained from various sources including the OECD, World Health Organization, and World Bank. The findings indicate that among three social welfare expenditure measures for families, the expenditures on family cash allowances are predicted to reduce infant mortality. However, the other two measures-the expenditures on parental and maternity leave and expenditures on family services-have no significant effects on infant mortality.

  10. Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.

    PubMed

    Torio, Celeste Marie; Encinosa, William; Berdahl, Terceira; McCormick, Marie C; Simpson, Lisa A

    2015-01-01

    To examine national trends in hospital utilization, costs, and expenditures for children with mental health conditions. The analyses of children aged 1 to 17 are based on AHRQ's 2006 and 2011 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) databases, and on AHRQ's pooled 2006 to 2011 Medical Expenditure Panel Survey (MEPS). All estimates are nationally representative, and standard errors account for the complex survey designs. Although overall all-cause children's hospitalizations did not increase between 2006 and 2011, hospitalizations for all listed mental health conditions increased by nearly 50% among children aged 10 to 14 years, and by 21% for emergency department (ED) visits. Behavioral disorders experienced a shift in underlying patterns between 2006 and 2011: inpatient stays for alcohol-related disorders declined by 44%, but ED visits increased by 34% for substance-related disorders and by 71% for impulse control disorders. Inpatient visits for suicide, suicidal ideation, and self-injury increased by 104% for children ages 1 to 17 years, and by 151% for children ages 10 to 14 years during this period. A total of $11.6 billion was spent on hospital visits for mental health during this period. Medicaid covered half of the inpatient visits, but with 50% to 30% longer length of stays in 2006 and 2011, respectively, than private payers. Medicaid's overall share of the ED visits increased from 45% in 2006 to 53% in 2011. These alarming trends highlight the renewed need for research on mental health care for children. This study also provides a baseline for evaluating the impact of the Affordable Care Act and the mental health parity legislation on mental health utilization and expenditures for children. Published by Elsevier Inc.

  11. Determinants of out-of-pocket health expenditure on children: an analysis of the 2004 Pelotas Birth Cohort.

    PubMed

    da Silva, Marcelo Torres; Barros, Aluísio J D; Bertoldi, Andréa D; de Andrade Jacinto, Paulo; Matijasevich, Alicia; Santos, Iná S; Tejada, Cesar Augusto Oviedo

    2015-06-09

    The present study aimed to examine the impact of socioeconomic, demographic, and health status-related factors on out-of-pocket expenditure on health care for children. Data were obtained from a birth cohort study conducted in the city of Pelotas, state of Rio Grande do Sul (RS), southern Brazil, in 2004. The final sample is a result of adjusts made in order to keep in the analysis only those that attended to 3 follow-ups (at 12, 24 and 48 months of age). Estimates were carried out using the Panel Data Tobit Model with random effects. The study showed that expenditure on medicines was 20 % less likely in those considered healthy children by their mothers and, if there was any expenditure with healthy children, the expected expenditure was reduced by 58 %. A 1 % increase in household income increased the expected expenditure on medicines by 16 %, and by 23 % in children with private health insurance coverage. All types of health care expenditures examined were higher for children covered by private health insurance. Although total health care expenditure was higher for children of better-off families, it represented a lower share of these families' income evidencing income inequality in health care expenditures.

  12. Estimation of own and cross price elasticities of alcohol demand in the UK--A pseudo-panel approach using the Living Costs and Food Survey 2001-2009.

    PubMed

    Meng, Yang; Brennan, Alan; Purshouse, Robin; Hill-McManus, Daniel; Angus, Colin; Holmes, John; Meier, Petra Sylvia

    2014-03-01

    The estimation of price elasticities of alcohol demand is valuable for the appraisal of price-based policy interventions such as minimum unit pricing and taxation. This study applies a pseudo-panel approach to the cross-sectional Living Cost and Food Survey 2001/2-2009 to estimate the own- and cross-price elasticities of off- and on-trade beer, cider, wine, spirits and ready-to-drinks in the UK. A pseudo-panel with 72 subgroups defined by birth year, gender and socioeconomic status is constructed. Estimated own-price elasticities from the base case fixed effect models are all negative and mostly statically significant (p<0.05). Off-trade cider and beer are most elastic (-1.27 and -0.98) and off-trade spirits and on-trade ready-to-drinks are least elastic (-0.08 and -0.19). Estimated cross-price elasticities are smaller in magnitude with a mix of positive and negative signs. The results appear plausible and robust and could be used for appraising the estimated impact of price-based interventions in the UK. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Estimation of own and cross price elasticities of alcohol demand in the UK—A pseudo-panel approach using the Living Costs and Food Survey 2001–2009☆

    PubMed Central

    Meng, Yang; Brennan, Alan; Purshouse, Robin; Hill-McManus, Daniel; Angus, Colin; Holmes, John; Meier, Petra Sylvia

    2014-01-01

    The estimation of price elasticities of alcohol demand is valuable for the appraisal of price-based policy interventions such as minimum unit pricing and taxation. This study applies a pseudo-panel approach to the cross-sectional Living Cost and Food Survey 2001/2–2009 to estimate the own- and cross-price elasticities of off- and on-trade beer, cider, wine, spirits and ready-to-drinks in the UK. A pseudo-panel with 72 subgroups defined by birth year, gender and socioeconomic status is constructed. Estimated own-price elasticities from the base case fixed effect models are all negative and mostly statically significant (p < 0.05). Off-trade cider and beer are most elastic (−1.27 and −0.98) and off-trade spirits and on-trade ready-to-drinks are least elastic (−0.08 and −0.19). Estimated cross-price elasticities are smaller in magnitude with a mix of positive and negative signs. The results appear plausible and robust and could be used for appraising the estimated impact of price-based interventions in the UK. PMID:24508846

  14. Exploring the spatial pattern of mental health expenditure.

    PubMed

    Moscone, Francesco; Knapp, Martin

    2005-12-01

    coefficients could be explained by the evident spatial pattern of the phenomenon, since the omission of the lagged dependent variable induces bias in the OLS estimates. These results help central and local decision makers understand the factors that influence local spending levels, including variations between municipalities in their achievement of expenditure-related and perhaps other performance targets. The actual patterns of spatial interaction may well be more complex than simple contiguity (the structure assumed here), but there seems little doubt that positive interdependence is an important feature of decision making. Statistical interrogation of a panel dataset would allow exploration of both time-series and cross-municipality variation in mental health expenditure. Subsequent analysis would also benefit from more disaggregated data (e.g. at a census ward level) and the accompanying use of spatial multilevel techniques.

  15. Determinants of Catastrophic Dental Health Expenditure in China

    PubMed Central

    Liu, Xuenan; Gallagher, Jennifer Elizabeth; Zheng, Shuguo

    2016-01-01

    This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors. We pooled data from 31,566 adults who participated in the third National Oral Health Survey with province-level data from different sources. We defined catastrophic dental health expenditure (CDHE) as payments for dental services and/or medication for dental problems during the last year that exceeded the 10% and 20% of the household income. The association of individual and contextual factors with catastrophic dental health expenditure was evaluated using two-level logistic regression models with individuals nested within provinces. Socioeconomic position (education and household income), household size and dental status (pain in teeth or mouth and number of teeth) were the individual-level factors associated with CDHE among the full sample of participants; and, also, among those who used dental services in the past year. Greater gross domestic product per capita was the only contextual factor associated with CDHE, and only at the lower income threshold. This study shows that out-of-pocket expenses for dental services may put a considerable, and unnecessary, burden on households’ finances. Our findings also help characterise those households more likely to face catastrophic expenditure on health if they have to pay for dental services. PMID:27977756

  16. Determinants of Catastrophic Dental Health Expenditure in China.

    PubMed

    Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer Elizabeth; Zheng, Shuguo

    2016-01-01

    This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors. We pooled data from 31,566 adults who participated in the third National Oral Health Survey with province-level data from different sources. We defined catastrophic dental health expenditure (CDHE) as payments for dental services and/or medication for dental problems during the last year that exceeded the 10% and 20% of the household income. The association of individual and contextual factors with catastrophic dental health expenditure was evaluated using two-level logistic regression models with individuals nested within provinces. Socioeconomic position (education and household income), household size and dental status (pain in teeth or mouth and number of teeth) were the individual-level factors associated with CDHE among the full sample of participants; and, also, among those who used dental services in the past year. Greater gross domestic product per capita was the only contextual factor associated with CDHE, and only at the lower income threshold. This study shows that out-of-pocket expenses for dental services may put a considerable, and unnecessary, burden on households' finances. Our findings also help characterise those households more likely to face catastrophic expenditure on health if they have to pay for dental services.

  17. Out-of-pocket expenditure for seeking health care for sick children younger than 5 years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012.

    PubMed

    Tahsina, Tazeen; Ali, Nazia Binte; Hoque, D M Emdadul; Huda, Tanvir M; Salam, Shumona Sharmin; Hasan, Mohammad Mehedi; Hossain, Md Altaf; Matin, Ziaul; Kuppen, Lianne; Garnett, Sarah P; Arifeen, Shams El

    2017-09-11

    Bangladesh has committed to universal health coverage, and options to decrease household out-of-pocket expenditure (OPE) are being explored. Understanding the determinants of OPE is an essential step. This study aimed to estimate and identify determinants of OPE in seeking health care for sick under-five children. Cross-sectional data was collected by structured questionnaire in 2009 (n = 7362) and 2012 (n = 6896) from mothers of the under-five children. OPE included consultation fees and costs of medicine, diagnostic tests, hospital admission, transport, accommodation, and food. Expenditure is expressed in US dollars and adjusted for inflation. Linear regression was used for ascertaining the determinants of OPE. Between 2009 and 2012, the median OPE for seeking care for a sick under-five child increased by ~ 50%, from USD 0.82 (interquartile range 0.39-1.49) to USD 1.22 (0.63-2.36) per child/visit. Increases were observed in every component OPE measured, except for consultation fees which decreased by 12%. Medicine contributed the major portion of overall OPE. Higher overall OPE for care seeking was associated with a priority illness (20% increase), care from trained providers (90% public/~ 2-fold private), residing in hilly/wet lands areas (20%), and for mothers with a secondary education (19%). OPE is a major barrier to quality health care services and access to appropriate medicine is increasing in rural Bangladesh. To support the goal of universal health care coverage, geographic imbalances as well as expanded health financing options need to be explored.

  18. Health Insurance Dynamics: Methodological Considerations and a Comparison of Estimates from Two Surveys.

    PubMed

    Graves, John A; Mishra, Pranita

    2016-10-01

    To highlight key methodological issues in studying insurance dynamics and to compare estimates across two commonly used surveys. Nonelderly uninsured adults and children sampled between 2001 and 2011 in the Medical Expenditure Panel Survey and the Survey of Income and Program Participation. We utilized nonparametric Kaplan-Meier methods to estimate quantiles (25th, 50th, and 75th percentiles) in the distribution of uninsured spells. We compared estimates obtained across surveys and across different methodological approaches to address issues like attrition, seam bias, censoring and truncation, and survey weighting method. All data were drawn from publicly available household surveys. Estimated uninsured spell durations in the MEPS were longer than those observed in the SIPP. There were few changes in spell durations between 2001 and 2011, with median durations of 14 months among adults and 5-7 months among children in the MEPS, and 8 months (adults) and 4 months (children) in the SIPP. The use of panel survey data to study insurance dynamics presents a unique set of methodological challenges. Researchers should consider key analytic and survey design trade-offs when choosing which survey can best suit their research goals. © Health Research and Educational Trust.

  19. Hepatitis virus panel

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003558.htm Hepatitis virus panel To use the sharing features on this page, please enable JavaScript. The hepatitis virus panel is a series of blood tests used ...

  20. Control of energy expenditure in humans.

    PubMed

    Westerterp, K R

    2017-03-01

    Energy expenditure is determined by body size and body composition and by food intake and physical activity. Body size and body composition are the determinants of resting energy expenditure. Higher weight results in higher energy requirement through a higher resting requirement because of a higher maintenance cost of a larger body. Activity-induced energy expenditure is the most variable component of total energy expenditure. Smaller and leaner subjects generally move more as activity energy expenditure in larger subjects is not higher in proportion to the cost of moving with a higher body weight. Food intake induces changes in energy expenditure as a function of changes in body size and body composition. In addition, energy restriction induces an adaptive reduction of energy expenditure through a lowering of tissue metabolism and a reduction of body movement. An exercise-induced increase in activity expenditure is a function of the training status. In untrained subjects, exercise induces a larger increase in total energy expenditure than can be attributed to the energy cost of a training program. Trained subjects have a higher performance at the same expenditure through a higher exercise economy.

  1. Advanced concentrator panels

    NASA Technical Reports Server (NTRS)

    Bell, D. M.; Bedard, R. J., Jr.

    1981-01-01

    The prototype fabrication of a lightweight, high-quality cellular glass substrate reflective panel for use in an advanced point-focusing solar concentrator was completed. The reflective panel is a gore shaped segment of an 11-m paraboloidal dish. The overall concentrator design and the design of the reflective panels are described. prototype-specific panel design modifications are discussed and the fabrication approach and procedure outlined.

  2. Computerisation in Public Libraries. A Report of the Survey Carried Out by the Technical Panel of the Association of London Chief Librarians during 1982.

    ERIC Educational Resources Information Center

    Association of London Chief Librarians (England).

    A survey of public library authorities located in the 34 London boroughs was conducted during the summer of 1982 to determine the characteristics and extent of library automation and to assess changes since a similar 1978/79 study. Replies were received from 33 authorities, of whom 30 reported using computerized techniques. Information on library…

  3. Alcohol consumption and household expenditure on alcohol in a rural district in Vietnam

    PubMed Central

    Giang, Kim Bao; Van Minh, Hoang; Allebeck, Peter

    2013-01-01

    Introduction Alcohol use and alcohol-related problems are on the rise in low- and middle-income countries. Expenditure on alcohol is an important problem for families and communities and needs to be assessed. Aim This study examines level of alcohol consumption and expenditure on alcohol in a district in Vietnam. Methods A cross-sectional survey was conducted in a rural district in northern Vietnam. Multi-stage sampling was employed to randomly select participants from 20 communities and a town in the same district. One thousand five hundred and sixty-four adults (765 males and 799 females) aged 18–60 years were interviewed. Information about alcohol use as well as expenditure on alcohol consumption four weeks prior to the interview was gathered. Non-parametric tests and log-linear regression were employed to compare expenditure on alcohol consumption across socioeconomic groups. Results The prevalence of alcohol use one month prior to interview was 35% (66% among men and 5% among women). The median alcohol consumption among those who reported use of alcohol in the week prior to the interview was 7.9 standard drinks. Excessive drinking (more than 14 standard drinks per week for men and more than seven standard drinks per week for women) occurred among 35% of those who used alcohol. Median expenditure for alcohol consumption during one month by those who drank alcohol was USD 3.5, accounting for 4.6% of household food expenditure, 2.7% of total household expenditure, and 1.8% of household income. The differences in alcohol consumption and expenditure between sexes and between socioeconomic groups are also presented. Conclusion Our study confirms that alcohol consumption and alcohol-related problems are common among men in Vietnam. The share of alcohol expenditure in total household expenditure is substantial, especially among poor households. This should be considered an important public health issue, which needs to be taken into account in the alcohol policy

  4. Alcohol consumption and household expenditure on alcohol in a rural district in Vietnam.

    PubMed

    Giang, Kim Bao; Van Minh, Hoang; Allebeck, Peter

    2013-01-28

    Alcohol use and alcohol-related problems are on the rise in low- and middle-income countries. Expenditure on alcohol is an important problem for families and communities and needs to be assessed. This study examines level of alcohol consumption and expenditure on alcohol in a district in Vietnam. A cross-sectional survey was conducted in a rural district in northern Vietnam. Multi-stage sampling was employed to randomly select participants from 20 communities and a town in the same district. One thousand five hundred and sixty-four adults (765 males and 799 females) aged 18-60 years were interviewed. Information about alcohol use as well as expenditure on alcohol consumption four weeks prior to the interview was gathered. Non-parametric tests and log-linear regression were employed to compare expenditure on alcohol consumption across socioeconomic groups. The prevalence of alcohol use one month prior to interview was 35% (66% among men and 5% among women). The median alcohol consumption among those who reported use of alcohol in the week prior to the interview was 7.9 standard drinks. Excessive drinking (more than 14 standard drinks per week for men and more than seven standard drinks per week for women) occurred among 35% of those who used alcohol. Median expenditure for alcohol consumption during one month by those who drank alcohol was USD 3.5, accounting for 4.6% of household food expenditure, 2.7% of total household expenditure, and 1.8% of household income. The differences in alcohol consumption and expenditure between sexes and between socioeconomic groups are also presented. Our study confirms that alcohol consumption and alcohol-related problems are common among men in Vietnam. The share of alcohol expenditure in total household expenditure is substantial, especially among poor households. This should be considered an important public health issue, which needs to be taken into account in the alcohol policy debate.

  5. TRMM Solar Array Panels

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This final report presents conclusions/recommendations concerning the TRMM Solar Array; deliverable list and schedule summary; waivers and deviations; as-shipped performance data, including flight panel verification matrix, panel output detail, shadow test summary, humidity test summary, reverse bias test panel; and finally, quality assurance summary.

  6. Revenues and Expenditures of Institutions of Higher Education: Fiscal Years 1983-1985. OERI Bulletin.

    ERIC Educational Resources Information Center

    Center for Education Statistics (ED/OERI), Washington, DC.

    Information on revenues and expenditures at U.S. colleges and universities are reported for fiscal years (FY) 1983, 1984, and 1985, based on findings from the Financial Statistics of Institutions of Higher Education survey, which is part of the Higher Education General Information Survey. Narrative and statistical information is presented on:…

  7. 43 CFR 3861.2-2 - Certificate of expenditures and improvements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... survey, as filed, furnish such an accurate description of the claim as will, if incorporation in a patent...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-2 Certificate of expenditures and improvements. (a) The claimant at...

  8. 43 CFR 3861.2-2 - Certificate of expenditures and improvements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... survey, as filed, furnish such an accurate description of the claim as will, if incorporation in a patent...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-2 Certificate of expenditures and improvements. (a) The claimant at...

  9. 43 CFR 3861.2-2 - Certificate of expenditures and improvements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... survey, as filed, furnish such an accurate description of the claim as will, if incorporation in a patent...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-2 Certificate of expenditures and improvements. (a) The claimant at...

  10. 43 CFR 3861.2-4 - Supplemental proof of expenditures and improvements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-4 Supplemental proof of expenditures and improvements. If the value of the labor and improvements upon a mineral claim is less than $500 at the time of survey the...

  11. 43 CFR 3861.2-2 - Certificate of expenditures and improvements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... survey, as filed, furnish such an accurate description of the claim as will, if incorporation in a patent...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-2 Certificate of expenditures and improvements. (a) The claimant at...

  12. 43 CFR 3861.2-4 - Supplemental proof of expenditures and improvements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-4 Supplemental proof of expenditures and improvements. If the value of the labor and improvements upon a mineral claim is less than $500 at the time of survey the...

  13. 43 CFR 3861.2-4 - Supplemental proof of expenditures and improvements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL PATENT APPLICATIONS Surveys and Plats § 3861.2-4 Supplemental proof of expenditures and improvements. If the value of the labor and improvements upon a mineral claim is less than $500 at the time of survey the...

  14. What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited.

    PubMed

    Hartwig, Jochen

    2008-05-01

    The share of health care expenditure in GDP rises rapidly in virtually all OECD countries, causing increasing concern among politicians and the general public. Yet, economists have to date failed to reach an agreement on what the main determinants of this development are. This paper revisits Baumol's [Baumol, W.J., 1967. Macroeconomics of unbalanced growth: the anatomy of urban crisis. American Economic Review 57 (3), 415-426] model of 'unbalanced growth', showing that the latter offers a ready explanation for the observed inexorable rise in health care expenditure. The main implication of Baumol's model in this context is that health care expenditure is driven by wage increases in excess of productivity growth. This hypothesis is tested empirically using data from a panel of 19 OECD countries. Our tests yield robust evidence in favor of Baumol's theory.

  15. Engaging inner city middle school students in development of an energy expenditure food label.

    PubMed

    Spaulding, Carol J; Mcneal, Catherine J; Coppin, John David; Shimek, Christine; Field, Lindsey; Murano, Peter S

    2015-01-01

    Using food labels can be an important component of maintaining healthy weight, but young adolescents are unlikely to have the requisite skills to make use of food labeling information. Our objectives were to determine knowledge about calories and comprehension and use of the Nutrition Facts Panel among a group of inner city African-American and Hispanic middle school students, and to engage the students in refining a Calorie Converter energy expenditure food label. We used quantitative and qualitative methods including questionnaires, focus groups, and hands-on graphic design activities. Correctly defining the word "calorie" was associated with correct answers to three of four questions requiring interpretation of the Nutrition Facts Panel [χ(2)(1, 138, p < .05) = 4.56, 4.14, and 5.61.] We incorporated students' design and content modifications for the Calorie Converter label, and the majority indicated that the energy expenditure label would influence their food selection practices.

  16. State energy price and expenditure report 1994

    SciTech Connect

    1997-06-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1994. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1994, Consumption Estimates (SEDR), published in October 1996. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources. Documentation is included describing the development of price estimates, data sources, and calculation methods. 316 tabs.

  17. [Health care expenditures and the aging population].

    PubMed

    Felder, S

    2012-05-01

    The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures.

  18. Safety Panel Resources

    NASA Technical Reports Server (NTRS)

    Stewart, Christine E.

    2008-01-01

    The goal of this paper is to explore what resources are potentially available to safety panels and to provide some guidance on how to utilize those resources. While the examples used in this paper will concentrate on the Flight Equipment and Reliability Review Panel (FESRRP) and Extravehicular Activity (EVA) hardware that have come through that panel, as well as resources at Johnson Space Center, the paper will address how this applies to safety panels in general, and where possible cite examples for other safety panels.

  19. Attendance of cultural events and involvement with the arts-impact evaluation on health and well-being from a Swiss household panel survey.

    PubMed

    Węziak-Białowolska, D

    2016-10-01

    Although there is strong uptake of active or passive engagement with the cultural and creative activities as determinants of individual health, well-being and social participation, few population studies report any causal influence on self-reported and physical health or life satisfaction from voluntary engagement with the arts (playing an instrument or singing, painting, sculpture) or passive cultural participation (attending the cinema, theatre, opera and exhibitions). This study set out to investigate any potential derived benefits to the Swiss population. The 2010 and 2013 waves of the Swiss Household Panel study were used for analysis. The data are representative for the Swiss population aged 14 years and older with respect to major demographic variables. Using longitudinal data, the strengths of the two approaches to evaluating causal inference were simultaneously applied: propensity score matching and difference-in-differences. Propensity score matching attempted to eliminate selection bias by conditioning on confounding variables. Difference-in-differences estimator was applied to remove unobserved fixed effects via intra-individual comparisons over time by comparing the trends in a matched treatment and control group. The study showed that voluntary cultural activity-of any type, passive or active-did not seem to have any causative influence on health and well-being. Results showed that long-term health and well-being did not improve significantly as a result of any specific activity in the cultural arena. The investigation provided little evidence to justify health promotion messages for involvement with the arts. Nevertheless, these findings do not contest that active or passive participation in cultural- and arts-related activities may be beneficial to health and well-being when guided by qualified therapists to treat specific health-related problems. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  20. Development of Self-Management Indicators for Chronic Hepatitis B Patients on Antiviral Therapy: Results of a Chinese Delphi Panel Survey

    PubMed Central

    Kong, Ling-Na; Guo, Ying; Qin, Bo; Peng, Xin; Zhu, Wen-Fen

    2015-01-01

    Objective This study aimed to develop a set of indicators that could be used to measure and monitor the self-management performance for chronic hepatitis B (CHB) patients on antiviral therapy in China. Methods A two-round Delphi study via e-mail correspondence was conducted, with a group of 30 Chinese experts. The Delphi questionnaire consisted of 53 indicators identified from a literature review. Experts rated and scored the importance of indicators on a five-point Likert scale. Consensus was considered to be reached if a median score in the top tertile (4-5) and ≥80% of panel ratings in the top tertile (4-5) after Round 2. The included indicators were validated with a group of 106 CHB patients. Results The response rates for the first and second rounds were 90.9% (n=30) and 86.7% (n=26), respectively. Three new indicators were suggested in the first round. 55 indicators were included in the second round after modified. 45 (81.8%) indicators achieved on the level of consensus, all of which had an inter-quartile range of 1 or below. The final set included 4 domains and 45 indicators which were well accepted and understandable by CHB patients. Conclusion This Delphi study produced a set of 45 self-management indicators for CHB patients on antiviral therapy in China. These indicators could be used to measure and monitor the patients’ self-management performance, with the goal of improving the quality of life in this population. PMID:26327606

  1. State energy price and expenditure report 1992

    SciTech Connect

    Not Available

    1994-12-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates are provided by energy source and economic sector and are published for the years 1970, 1980, and 1985 through 1992. Data for all years, 1970 through 1992, are available on personal computer diskettes.

  2. Resting energy expenditure among Japanese.

    PubMed

    Hosoya, N; Mitsuhashi, F; Sugiyama, M

    2002-10-01

    1. Resting energy expenditure (REE) provides appropriate basic data for the calculation of energy requirements. 2. The REE of 6498 subjects according to sex and age (1 year stratification), with a minimum of 10 subjects per group, was measured systematically using the easy portable calorimeter (Metavine; Vine, Tokyo, Japan). 3. The REE or the REE/kg according to age and sex was observed to obtain the amount of standard deviation (20-25%). 4. The REE/kg for male and female subjects was maintained at a steady level after the age of 15 years and was estimated to be around 29 kcal/kg.

  3. Interactive optical panel

    DOEpatents

    Veligdan, James T.

    1995-10-03

    An interactive optical panel assembly 34 includes an optical panel 10 having a plurality of ribbon optical waveguides 12 stacked together with opposite ends thereof defining panel first and second faces 16, 18. A light source 20 provides an image beam 22 to the panel first face 16 for being channeled through the waveguides 12 and emitted from the panel second face 18 in the form of a viewable light image 24a. A remote device 38 produces a response beam 40 over a discrete selection area 36 of the panel second face 18 for being channeled through at least one of the waveguides 12 toward the panel first face 16. A light sensor 42,50 is disposed across a plurality of the waveguides 12 for detecting the response beam 40 therein for providing interactive capability.

  4. ICFA neutrino panel report

    NASA Astrophysics Data System (ADS)

    Long, K.

    2015-07-01

    In the summer of 2013 the International Committee on Future Accelerators (ICFA) established a Neutrino Panel with the mandate: "To promote international cooperation in the development of the accelerator-based neutrino-oscillation program and to promote international collaboration in the development of a neutrino factory as a future intense source of neutrinos for particle physics experiments." In its first year the Panel organised a series of regional Town Meetings to collect input from the community and to receive reports from the regional planning exercises. The Panel distilled its findings and presented them in a report to ICFA [1]. In this contribution the formation and composition of the Panel are presented together with a summary of the Panel's findings from the three Regional Town Meetings. The Panel's initial conclusions are then articulated and the steps that the Panel seeks to take are outlined.

  5. Interactive optical panel

    DOEpatents

    Veligdan, J.T.

    1995-10-03

    An interactive optical panel assembly includes an optical panel having a plurality of ribbon optical waveguides stacked together with opposite ends thereof defining panel first and second faces. A light source provides an image beam to the panel first face for being channeled through the waveguides and emitted from the panel second face in the form of a viewable light image. A remote device produces a response beam over a discrete selection area of the panel second face for being channeled through at least one of the waveguides toward the panel first face. A light sensor is disposed across a plurality of the waveguides for detecting the response beam therein for providing interactive capability. 10 figs.

  6. State public health agency expenditures: categorizing and comparing to performance levels.

    PubMed

    Honoré, Peggy A; Schlechte, Tricia

    2007-01-01

    For optimal effectiveness, assessments of public health agency and system performance should include analysis to measure the amount of financial resources consumed to achieve performance levels. This pilot study was conducted to test a methodology in a state health department for comparing financial resources consumed to performance scores in each of the 10 Essential Public Health Services categories. An additional feature was to quantify the percentage of total agency expenditures utilized for administrative functions as well. The allocation of all fiscal year 2004 expenditures to the 10 Essential Public Health Services and administration categories was based on assessments of employee job functions and scope of services performed under agency contracts. Performance scores were obtained through a 2-month process of completing self-assessment surveys with system partners using the National Public Health Performance Standards Program Assessment Instrument. Investigators found no clear consistency between performance scores and agency expenditure levels. Two categories, essential service 5 (develop policies and plans) and essential service 10 (research), did have low performance and low expenditure levels. Overall though, categories with high performance scores consumed low percentages of agency expenditures and expenditure patterns were relatively high in categories with low performance scores. The study did quantify that the percentage of expenditures in the administration category was low compared to previous studies in other health departments. This knowledge was particularly useful for informing policymakers.

  7. State energy price and expenditure report 1991

    SciTech Connect

    Not Available

    1993-09-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates are provided by energy source and economic sector and are published for the years 1970, 1975, 1980, and 1985 through 1991. Data for all years, 1970 through 1991, are available on personal computer diskettes. Documentation in Appendix A describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied. This report is an update of the State Energy Price and Expenditure Report 1990, published in September 1992.

  8. Surgical weight loss: impact on energy expenditure.

    PubMed

    Thivel, David; Brakonieki, Katrina; Duche, Pascale; Morio, Béatrice; Béatrice, Morio; Boirie, Yves; Yves, Boirie; Laferrère, Blandine

    2013-02-01

    Diet-induced weight loss is often limited in its magnitude and often of short duration, followed by weight regain. On the contrary, bariatric surgery now commonly used in the treatment of severe obesity favors large and sustained weight loss, with resolution or improvement of most obesity-associated comorbidities. The mechanisms of sustained weight loss are not well understood. Whether changes in the various components of energy expenditure favor weight maintenance after bariatric surgery is unclear. While the impact of diet-induced weight loss on energy expenditure has been widely studied and reviewed, the impact of bariatric surgery on total energy expenditure, resting energy expenditure, and diet-induced thermogenesis remains unclear. Here, we review data on energy expenditure after bariatric surgery from animal and human studies. Bariatric surgery results in decreased total energy expenditure, mainly due to reduced resting energy expenditure and explained by a decreased in both fat-free mass and fat mass. Limited data suggest increased diet-induced thermogenesis after gastric bypass, a surgery that results in gut anatomical changes and modified the digestion processes. Physical activity and sustained intakes of dietary protein may be the best strategies available to increase non-resting and then total energy expenditure, as well as to prevent the decline in lean mass and resting energy expenditure.

  9. Surgical Weight Loss: Impact on Energy Expenditure

    PubMed Central

    Brakonieki, Katrina; Duche, Pascale; Béatrice, Morio; Yves, Boirie; Laferrère, Blandine

    2016-01-01

    Diet-induced weight loss is often limited in its magnitude and often of short duration, followed by weight regain. On the contrary, bariatric surgery now commonly used in the treatment of severe obesity favors large and sustained weight loss, with resolution or improvement of most obesity-associated comorbidities. The mechanisms of sustained weight loss are not well understood. Whether changes in the various components of energy expenditure favor weight maintenance after bariatric surgery is unclear. While the impact of diet-induced weight loss on energy expenditure has been widely studied and reviewed, the impact of bariatric surgery on total energy expenditure, resting energy expenditure, and diet-induced thermogenesis remains unclear. Here, we review data on energy expenditure after bariatric surgery from animal and human studies. Bariatric surgery results in decreased total energy expenditure, mainly due to reduced resting energy expenditure and explained by a decreased in both fat-free mass and fat mass. Limited data suggest increased diet-induced thermogenesis after gastric bypass, a surgery that results in gut anatomical changes and modified the digestion processes. Physical activity and sustained intakes of dietary protein may be the best strategies available to increase non-resting and then total energy expenditure, as well as to prevent the decline in lean mass and resting energy expenditure. PMID:23224568

  10. State energy price and expenditure report 1990

    SciTech Connect

    Not Available

    1992-09-11

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The estimates are provided by energy source and economic sector. This report is an update of the State Energy Price and Expenditure Report 1989 published in September 1991. Energy price and expenditure estimates are published for the years 1970, 1975, 1980, and 1985 through 1990. Documentation follows the tables and describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied.

  11. Determinants and Equity Evaluation for Health Expenditure Among Patients with Rare Diseases in China

    PubMed Central

    Xin, Xiao-Xiong; Zhao, Liang; Guan, Xiao-Dong; Shi, Lu-Wen

    2016-01-01

    Background: China has not established social security system for rare diseases. Rare diseases could easily impoverish patients and their families. Little research has studied the equity and accessibility of health services for patients with rare diseases in China. This study aimed to explore the factors that influence health expenditure of rare diseases and evaluate its equity. Methods: Questionnaire survey about living conditions and cost burden of patients with rare diseases was conducted. Individual and family information, health expenditure and reimbursement in 2014 of 982 patients were collected. The impact of medical insurance, individual sociodemographic characteristics, family characteristics, and healthcare need on total and out-of-pocket (OOP) health expenditures was analyzed through the generalized linear model. Equity of health expenditure was evaluated by both concentration index and Lorenz curve. Results: Of all the surveyed patients, 11.41% had no medical insurance and 92.10% spent money to seek medical treatment in 2014. It was suggested female (P = 0.048), over 50 years of age (P = 0.062), high-income group (P = 0.021), hospitalization (P = 0.000), and reimbursement ratio (RR) (P = 0.000) were positively correlated with total health expenditure. Diseases not needing long-term treatment (P = 0.000) was negatively correlated with total health expenditure. Over 50 years of age (P = 0.065), high-income group (P = 0.018), hospitalization (P = 0.000) and having Urban Employee Basic Medical Insurance (UEBMI) (P = 0.022) were positively correlated with OOP health expenditure. Patient or the head of the household having received higher education (P = 0.044 and P = 0.081) and reimbursement ratio (P = 0.078) were negatively correlated with OOP health expenditure. The equity evaluation found concentration indexes of health expenditure before and after reimbursement were 0.0550 and 0.0539, respectively. Conclusions: OOP health expenditure of patients with UEBMI

  12. Determinants and Equity Evaluation for Health Expenditure Among Patients with Rare Diseases in China.

    PubMed

    Xin, Xiao-Xiong; Zhao, Liang; Guan, Xiao-Dong; Shi, Lu-Wen

    2016-06-20

    China has not established social security system for rare diseases. Rare diseases could easily impoverish patients and their families. Little research has studied the equity and accessibility of health services for patients with rare diseases in China. This study aimed to explore the factors that influence health expenditure of rare diseases and evaluate its equity. Questionnaire survey about living conditions and cost burden of patients with rare diseases was conducted. Individual and family information, health expenditure and reimbursement in 2014 of 982 patients were collected. The impact of medical insurance, individual sociodemographic characteristics, family characteristics, and healthcare need on total and out-of-pocket (OOP) health expenditures was analyzed through the generalized linear model. Equity of health expenditure was evaluated by both concentration index and Lorenz curve. Of all the surveyed patients, 11.41% had no medical insurance and 92.10% spent money to seek medical treatment in 2014. It was suggested female (P = 0.048), over 50 years of age (P = 0.062), high-income group (P = 0.021), hospitalization (P = 0.000), and reimbursement ratio (RR) (P = 0.000) were positively correlated with total health expenditure. Diseases not needing long-term treatment (P = 0.000) was negatively correlated with total health expenditure. Over 50 years of age (P = 0.065), high-income group (P = 0.018), hospitalization (P = 0.000) and having Urban Employee Basic Medical Insurance (UEBMI) (P = 0.022) were positively correlated with OOP health expenditure. Patient or the head of the household having received higher education (P = 0.044 and P = 0.081) and reimbursement ratio (P = 0.078) were negatively correlated with OOP health expenditure. The equity evaluation found concentration indexes of health expenditure before and after reimbursement were 0.0550 and 0.0539, respectively. OOP health expenditure of patients with UEBMI was significantly more than that of

  13. Medical and non-medical expenditure for breast cancer diagnosis and treatment in China: a multicenter cross-sectional study.

    PubMed

    Liao, Xian-Zhen; Shi, Ju-Fang; Liu, Jing-Shi; Huang, Hui-Yao; Guo, Lan-Wei; Zhu, Xin-Yu; Xiao, Hai-Fan; Wang, Le; Bai, Ya-Na; Liu, Guo-Xiang; Mao, A-Yan; Ren, Jian-Song; Sun, Xiao-Jie; Mai, Ling; Liu, Yu-Qin; Song, Bing-Bing; Gong, Ji-Yong; Zhou, Jin-Yi; Du, Ling-Bing; Zhou, Qi; Cao, Rong; Zhu, Lin; Ren, Ying; Lou, Pei-An; Lan, Li; Sun, Xiao-Hua; Qi, Xiao; Wang, Yuan-Zheng; Zhang, Kai; He, Jie; Dai, Min

    2017-07-03

    We aimed to assess economic burden of breast cancer (BC) diagnosis and treatment in China through a multicenter cross-sectional study, and to obtain theoretical evidence for policy-making. This survey was conducted in 37 hospital centers across 13 provinces in China from September 2012 to December 2014. We collected information on the subject characteristics. We then assessed the medical and non-medical expenditure for BC diagnosis and treatment, factors influencing the average case expense, variations between medical and non-medical expenditure at different clinical stages, economic impact of overall expenditure in newly diagnosed course after reimbursement to the patient's family, composition of non-medical expenditure and time loss for the patient and family. Among 2746 women with BC (72.6% were admitted to specialized hospitals), the overall average expenditure was US $8450 (medical expenditure: $7527; non-medical expenditure: $922). Significant differences were found among the overall expenditure in the four clinical stages (P < 0.0001); the expenditure was higher in stages III and IV than that in stages I and II, whereas the stage IV was the highest (P < 0.0001). Moreover, a higher self-reported predicted reimbursement ratio was associated with a less economic impact on the patient's family, and the average time lost was estimated as $1529. Early detection and treatment of breast cancer might be effective for decreasing the economic burden, because costs escalate as the degree of malignancy increases. © 2017 John Wiley & Sons Australia, Ltd.

  14. 2 CFR 200.439 - Equipment and other capital expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Equipment and other capital expenditures... of Cost § 200.439 Equipment and other capital expenditures. (a) See §§ 200.13 Capital expenditures... and other capital expenditures: (1) Capital expenditures for general purpose equipment, buildings, and...

  15. Household catastrophic health expenditures: a comparative analysis of twelve Latin American and Caribbean Countries.

    PubMed

    Knaul, Felicia Marie; Wong, Rebeca; Arreola-Ornelas, Héctor; Méndez, Oscar

    2011-01-01

    Compare patterns of catastrophic health expenditures in 12 countries in Latin America and the Caribbean. Prevalence of catastrophic expenses was estimated uniformly at the household level using household surveys. Two types of prevalence indicators were used based on out-of-pocket health expense: a) relative to an international poverty line, and b) relative to the household's ability to pay net of their food basket. Ratios of catastrophic expenditures were estimated across subgroups defined by economic and social variables. The percent of households with catastrophic health expenditures ranged from 1 to 25% in the twelve countries. In general, rural residence, lowest quintile of income, presence of older adults, and lack of health insurance in the household are associated with higher propensity of catastrophic health expenditures. However, there is vast heterogeneity by country. Cross national studies may serve to examine how health systems contribute to the social protection of Latin American households.

  16. Health seeking behaviour and the related household out-of-pocket expenditure for chronic non-communicable diseases in rural Malawi.

    PubMed

    Wang, Qun; Brenner, Stephan; Leppert, Gerald; Banda, Thomas Hastings; Kalmus, Olivier; De Allegri, Manuela

    2015-03-01

    Malawi is facing a rising chronic non-communicable disease (CNCD) epidemic. This study explored health seeking behaviour and related expenditure on CNCDs in rural Malawi, with specific focus on detecting potential differences across population groups. We used data from the first round of a panel household health survey conducted in rural Malawi between August and October 2012 on a sample of 1199 households. Multinomial logistic regression was used to analyse factors associated with health seeking choices for CNCDs, distinguishing between no care, informal care and formal care. Descriptive statistics (mean, standard deviation and median) were used to describe related household out-of-pocket expenditure. There were 475 individuals (equivalent to 8.4% of all respondents) reporting at least one CNCD. Among them, 37.3% did not seek any care, 42.5% sought formal care (facility-based care), and 20.2% opted for informal care (traditional or home treatment). Regression analysis showed that illness severity and duration, socio-economic status, being a household head, and the proportion of household members living with a CNCD were significantly associated with health care utilization. Among those seeking care, 65.8% incurred out-of-pocket expenditure with an average of USD 1.49 spent on medical treatment and an additional USD 0.50 spent on transport. Further qualitative inquiry is needed to understand the reasons for low service utilization and to explore the potential role of supply-side factors. To increase access to care for people suffering from CNCDs, the provision of a free Essential Health Package in Malawi ought to be strengthened through the integration of system-wide screening, risk factor modification and continuity of care options for people suffering from CNCDs. This would ensure affordable services to modulate health seeking behaviour of patients at risk of major chronic illnesses. Published by Oxford University Press in association with The London School of

  17. Working Papers: Astronomy and Astrophysics Panel Reports

    NASA Technical Reports Server (NTRS)

    Bahcall, John N.; Beichman, Charles A.; Canizares, Claude; Cronin, James; Heeschen, David; Houck, James; Hunten, Donald; Mckee, Christopher F.; Noyes, Robert; Ostriker, Jeremiah P.

    1991-01-01

    The papers of the panels appointed by the Astronomy and Astrophysics survey Committee are compiled. These papers were advisory to the survey committee and represent the opinions of the members of each panel in the context of their individual charges. The following subject areas are covered: radio astronomy, infrared astronomy, optical/IR from ground, UV-optical from space, interferometry, high energy from space, particle astrophysics, theory and laboratory astrophysics, solar astronomy, planetary astronomy, computing and data processing, policy opportunities, benefits to the nation from astronomy and astrophysics, status of the profession, and science opportunities.

  18. Association between periodontitis and medical expenditure in older adults: A 33-month follow-up study.

    PubMed

    Sato, Misuzu; Iwasaki, Masanori; Yoshihara, Akihiro; Miyazaki, Hideo

    2016-07-01

    Along with rapid aging, medical expenditure for older adults has been increasing in Japan. Research has shown that periodontitis is a useful predictor for excess medical expenditure; however, limited information is available on the elderly population after adequately considering confounding factors. The aim of the present study was to evaluate the association between periodontitis and long-term medical expenditure in elderly Japanese. Baseline health and periodontal examinations were carried out in June 2008. Japanese adults (n = 245) aged 80 years were classified into quartiles based on periodontal inflamed surface area (PISA), which quantifies the degree of periodontal inflammation. Medical care use and costs were monitored by assessment of the National Health Insurance claim files from the baseline survey through the end of February 2011. Multivariable analysis of the differences in medical expenditure among PISA quartiles was carried out using linear regression with robust standard errors. The participants in the fourth (with the largest PISA) and third quartiles had significantly higher inpatient medical expenditure compared with those of the first quartile (P < 0.01 and = 0.04, respectively). Participants in the fourth quartile had significantly higher total medical expenditure (P < 0.01) compared with the first quartile. A trend was observed of higher inpatient and total medical expenditure with increasing PISA. A significant association was found between periodontitis and future increase in medical expenditure, suggesting that periodontitis might be a modifiable factor for the reduction of excess medical expenditure among elderly Japanese. Geriatr Gerontol Int 2016; 16: 856-864. © 2015 Japan Geriatrics Society.

  19. Titanium honeycomb panel testing

    NASA Technical Reports Server (NTRS)

    Richards, W. L.; Thompson, Randolph C.

    1991-01-01

    The paper describes the procedures of thermal mechanical tests carried out at the NASA Dryden Flight Research Facility on two tianium honeycomb wing panels bonded using liquid interface diffusion (LID) technique, and presents the results of these tests. The 58.4 cm square panels consisted of two 0.152-cm-thick Ti 6-2-4-2 face sheets LID-bonded to a 1.9-cm-thick honeycomb core, with bearing plates fastened to the perimeter of the upper and the lower panel surfaces. The panels were instrumented with sensors for measuring surface temperature, strain, and deflections to 315 C and 482 C. Thermal stress levels representative of those encountered during aerodynamic heating were produced by heating the upper panel surface and restraining all four edges. After more than 100 thermal cycles from room temperature to 315 C and 50 cycles from room temperature to 482 C, no significant structural degradation was detected in the panels.

  20. Titanium honeycomb panel testing

    NASA Astrophysics Data System (ADS)

    Richards, W. L.; Thompson, Randolph C.

    The paper describes the procedures of thermal mechanical tests carried out at the NASA Dryden Flight Research Facility on two tianium honeycomb wing panels bonded using liquid interface diffusion (LID) technique, and presents the results of these tests. The 58.4 cm square panels consisted of two 0.152-cm-thick Ti 6-2-4-2 face sheets LID-bonded to a 1.9-cm-thick honeycomb core, with bearing plates fastened to the perimeter of the upper and the lower panel surfaces. The panels were instrumented with sensors for measuring surface temperature, strain, and deflections to 315 C and 482 C. Thermal stress levels representative of those encountered during aerodynamic heating were produced by heating the upper panel surface and restraining all four edges. After more than 100 thermal cycles from room temperature to 315 C and 50 cycles from room temperature to 482 C, no significant structural degradation was detected in the panels.

  1. State energy price and expenditure report 1989

    SciTech Connect

    Not Available

    1991-09-30

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates for the 50 States, the District of Columbia, and the United States. The estimates are provided by energy source (e.g., petroleum, natural gas, coal, and electricity) and by major consuming or economic sector. This report is an update of the State Energy Price and Expenditure Report 1988 published in September 1990. Changes from the last report are summarized in a section of the documentation. Energy price and expenditure estimates are published for the years 1970, 1975, 1980, and 1985 through 1989. Documentation follows the tables and describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied. Consumption estimates used to calculate expenditures, and the documentation for those estimates, are from the State Energy Data Report, Consumption Estimates, 1960--1989 (SEDR), published in May 1991. Expenditures are calculated by multiplying the price estimates by the consumption estimates, adjusted to remove process fuel and intermediate product consumption. All expenditures are consumer expenditures, that is, they represent estimates of money directly spent by consumers to purchase energy, generally including taxes. 11 figs., 43 tabs.

  2. 44 CFR 361.8 - Ineligible expenditures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF HOMELAND SECURITY PREPAREDNESS NATIONAL EARTHQUAKE HAZARDS REDUCTION ASSISTANCE TO STATE AND LOCAL GOVERNMENTS Earthquake Hazards Reduction Assistance Program § 361.8 Ineligible expenditures. (a) Expenditures... annual negotiation process with FEMA how this equipment will support the earthquake hazards reduction...

  3. 44 CFR 361.8 - Ineligible expenditures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF HOMELAND SECURITY PREPAREDNESS NATIONAL EARTHQUAKE HAZARDS REDUCTION ASSISTANCE TO STATE AND LOCAL GOVERNMENTS Earthquake Hazards Reduction Assistance Program § 361.8 Ineligible expenditures. (a) Expenditures... annual negotiation process with FEMA how this equipment will support the earthquake hazards reduction...

  4. 44 CFR 361.8 - Ineligible expenditures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF HOMELAND SECURITY PREPAREDNESS NATIONAL EARTHQUAKE HAZARDS REDUCTION ASSISTANCE TO STATE AND LOCAL GOVERNMENTS Earthquake Hazards Reduction Assistance Program § 361.8 Ineligible expenditures. (a) Expenditures... annual negotiation process with FEMA how this equipment will support the earthquake hazards reduction...

  5. 44 CFR 361.8 - Ineligible expenditures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF HOMELAND SECURITY PREPAREDNESS NATIONAL EARTHQUAKE HAZARDS REDUCTION ASSISTANCE TO STATE AND LOCAL GOVERNMENTS Earthquake Hazards Reduction Assistance Program § 361.8 Ineligible expenditures. (a) Expenditures... annual negotiation process with FEMA how this equipment will support the earthquake hazards reduction...

  6. Aggregrate consumer expenditures on energy. Final report

    SciTech Connect

    Jorgenson, D.W.

    1984-08-01

    This report presents a new economic model for the allocation of aggregate consumer expenditures on energy in the United States. Our model is based on a theory of consumer behavior involving two stages. In the first stage total expenditures are allocated between and nonenergy commodities. Allocation depends on the price of energy, prices of all nonenergy commodities, and the level of total expenditure. Total energy expenditure in the second stage is allocated among individual types of energy. The second stage allocation depends on the prices of individual types of energy and the level of total energy expenditure. Our econometric model can be applied to the generation of projection of aggregrate energy demand in the United States. Projected future energy prices, the future level and distribution of total energy expenditure, and the future demographic development of the population for projections. The model can also be used to make projections for individual consumer groups within the United States, classified by total energy expenditure and by demographic characteristics. Finally, it can be integrated into a model of energy and nonenergy expenditures to provide a complete model of aggregate consumer behavior. Our econometric model of aggregate consumer behavior can be applied to the generation of projection of demand individual types of energy and for all nonenergy commodities in the United States.

  7. 29 CFR 452.74 - Expenditures permitted.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 2 2012-07-01 2012-07-01 false Expenditures permitted. 452.74 Section 452.74 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT... DISCLOSURE ACT OF 1959 Campaign Safeguards § 452.74 Expenditures permitted. The Act does not prohibit...

  8. 29 CFR 452.74 - Expenditures permitted.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Expenditures permitted. 452.74 Section 452.74 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT... DISCLOSURE ACT OF 1959 Campaign Safeguards § 452.74 Expenditures permitted. The Act does not prohibit...

  9. 29 CFR 452.74 - Expenditures permitted.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 2 2014-07-01 2014-07-01 false Expenditures permitted. 452.74 Section 452.74 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT... DISCLOSURE ACT OF 1959 Campaign Safeguards § 452.74 Expenditures permitted. The Act does not prohibit...

  10. 29 CFR 452.74 - Expenditures permitted.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 2 2013-07-01 2013-07-01 false Expenditures permitted. 452.74 Section 452.74 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT... DISCLOSURE ACT OF 1959 Campaign Safeguards § 452.74 Expenditures permitted. The Act does not prohibit...

  11. Manpower Impact of Federal Pollution Control Expenditures

    ERIC Educational Resources Information Center

    Hecker, Daniel

    1975-01-01

    The primary objective of the study was to develop an analytical technique capable of measuring the impact of Federal expenditures by measuring the employment requirements created by expenditures for pollution control, and secondly to examine the transferability of scientific and technical skills from the aerospace industry to the pollution control…

  12. 34 CFR 300.133 - Expenditures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....133 Expenditures. (a) Formula. To meet the requirement of § 300.132(a), each LEA must spend the... 34 Education 2 2010-07-01 2010-07-01 false Expenditures. 300.133 Section 300.133 Education... spend on providing special education and related services to parentally-placed private school...

  13. 29 CFR 452.74 - Expenditures permitted.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Expenditures permitted. 452.74 Section 452.74 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR-MANAGEMENT... DISCLOSURE ACT OF 1959 Campaign Safeguards § 452.74 Expenditures permitted. The Act does not...

  14. Titanium Honeycomb Panel Testing

    NASA Technical Reports Server (NTRS)

    Richards, W. Lance; Thompson, Randolph C.

    1996-01-01

    Thermal-mechanical tests were performed on a titanium honeycomb sandwich panel to experimentally validate the hypersonic wing panel concept and compare test data with analysis. Details of the test article, test fixture development, instrumentation, and test results are presented. After extensive testing to 900 deg. F, non-destructive evaluation of the panel has not detected any significant structural degradation caused by the applied thermal-mechanical loads.

  15. Aerospace safety advisory panel

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This report from the Aerospace Safety Advisory Panel (ASAP) contains findings, recommendations, and supporting material concerning safety issues with the space station program, the space shuttle program, aeronautics research, and other NASA programs. Section two presents findings and recommendations, section three presents supporting information, and appendices contain data about the panel membership, the NASA response to the March 1993 ASAP report, and a chronology of the panel's activities during the past year.

  16. Solar reflection panels

    DOEpatents

    Diver, Jr., Richard B.; Grossman, James W.; Reshetnik, Michael

    2006-07-18

    A solar collector comprising a glass mirror, and a composite panel, wherein the back of the mirror is affixed to a front surface of the composite panel. The composite panel comprises a front sheet affixed to a surface of a core material, preferably a core material comprising a honeycomb structure, and a back sheet affixed to an opposite surface of the core material. The invention may further comprise a sealing strip, preferably comprising EPDM, positioned between the glass mirror and the front surface of the composite panel. The invention also is of methods of making such solar collectors.

  17. PANEL LIBRARY AND EDITOR

    NASA Technical Reports Server (NTRS)

    Raible, E.

    1994-01-01

    The Panel Library and Editor is a graphical user interface (GUI) builder for the Silicon Graphics IRIS workstation family. The toolkit creates "widgets" which can be manipulated by the user. Its appearance is similar to that of the X-Windows System. The Panel Library is written in C and is used by programmers writing user-friendly mouse-driven applications for the IRIS. GUIs built using the Panel Library consist of "actuators" and "panels." Actuators are buttons, dials, sliders, or other mouse-driven symbols. Panels are groups of actuators that occupy separate windows on the IRIS workstation. The application user can alter variables in the graphics program, or fire off functions with a click on a button. The evolution of data values can be tracked with meters and strip charts, and dialog boxes with text processing can be built. Panels can be stored as icons when not in use. The Panel Editor is a program used to interactively create and test panel library interfaces in a simple and efficient way. The Panel Editor itself uses a panel library interface, so all actions are mouse driven. Extensive context-sensitive on-line help is provided. Programmers can graphically create and test the user interface without writing a single line of code. Once an interface is judged satisfactory, the Panel Editor will dump it out as a file of C code that can be used in an application. The Panel Library (v9.8) and Editor (v1.1) are written in C-Language (63%) and Scheme, a dialect of LISP, (37%) for Silicon Graphics 4D series workstations running IRIX 3.2 or higher. Approximately 10Mb of disk space is required once compiled. 1.5Mb of main memory is required to execute the panel editor. This program is available on a .25 inch streaming magnetic tape cartridge in UNIX tar format for an IRIS, and includes a copy of XScheme, the public-domain Scheme interpreter used by the Panel Editor. The Panel Library Programmer's Manual is included on the distribution media. The Panel Library and

  18. PANEL LIBRARY AND EDITOR

    NASA Technical Reports Server (NTRS)

    Raible, E.

    1994-01-01

    The Panel Library and Editor is a graphical user interface (GUI) builder for the Silicon Graphics IRIS workstation family. The toolkit creates "widgets" which can be manipulated by the user. Its appearance is similar to that of the X-Windows System. The Panel Library is written in C and is used by programmers writing user-friendly mouse-driven applications for the IRIS. GUIs built using the Panel Library consist of "actuators" and "panels." Actuators are buttons, dials, sliders, or other mouse-driven symbols. Panels are groups of actuators that occupy separate windows on the IRIS workstation. The application user can alter variables in the graphics program, or fire off functions with a click on a button. The evolution of data values can be tracked with meters and strip charts, and dialog boxes with text processing can be built. Panels can be stored as icons when not in use. The Panel Editor is a program used to interactively create and test panel library interfaces in a simple and efficient way. The Panel Editor itself uses a panel library interface, so all actions are mouse driven. Extensive context-sensitive on-line help is provided. Programmers can graphically create and test the user interface without writing a single line of code. Once an interface is judged satisfactory, the Panel Editor will dump it out as a file of C code that can be used in an application. The Panel Library (v9.8) and Editor (v1.1) are written in C-Language (63%) and Scheme, a dialect of LISP, (37%) for Silicon Graphics 4D series workstations running IRIX 3.2 or higher. Approximately 10Mb of disk space is required once compiled. 1.5Mb of main memory is required to execute the panel editor. This program is available on a .25 inch streaming magnetic tape cartridge in UNIX tar format for an IRIS, and includes a copy of XScheme, the public-domain Scheme interpreter used by the Panel Editor. The Panel Library Programmer's Manual is included on the distribution media. The Panel Library and

  19. Health care expenditures among Asian American subgroups.

    PubMed

    Chen, Jie; Vargas-Bustamante, Arturo; Ortega, Alexander N

    2013-06-01

    Using two nationally representative data sets, this study examined health care expenditure disparities between Caucasians and different Asian American subgroups. Multivariate analyses demonstrate that Asian Americans, as a group, have significantly lower total expenditures compared with Caucasians. Results also point to considerable heterogeneities in health care spending within Asian American subgroups. Findings suggest that language assistance programs would be effective in reducing disparities among Caucasians and Asian American subgroups with the exception of Indians and Filipinos, who tend to be more proficient in English. Results also indicate that citizenship and nativity were major factors associated with expenditure disparities. Socioeconomic status, however, could not explain expenditure disparities. Results also show that Asian Americans have lower physician and pharmaceutical costs but not emergency department or hospital expenditures. These findings suggest the need for culturally competent policies specific to Asian American subgroups and the necessity to encourage cost-effective treatments among Asian Americans.

  20. Health Care Expenditures Among Asian American Subgroups

    PubMed Central

    Chen, Jie; Vargas-Bustamante, Arturo; Ortega, Alexander N.

    2014-01-01

    Using two nationally representative data sets, this study examined health care expenditure disparities between Caucasians and different Asian American subgroups. Multivariate analyses demonstrate that Asian Americans, as a group, have significantly lower total expenditures compared with Caucasians. Results also point to considerable heterogeneities in health care spending within Asian American subgroups. Findings suggest that language assistance programs would be effective in reducing disparities among Caucasians and Asian American subgroups with the exception of Indians and Filipinos, who tend to be more proficient in English. Results also indicate that citizenship and nativity were major factors associated with expenditure disparities. Socioeconomic status, however, could not explain expenditure disparities. Results also show that Asian Americans have lower physician and pharmaceutical costs but not emergency department or hospital expenditures. These findings suggest the need for culturally competent policies specific to Asian American subgroups and the necessity to encourage cost-effective treatments among Asian Americans. PMID:23223329

  1. State energy price and expenditure report, 1995

    SciTech Connect

    1998-08-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the US. The estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1995. Data for all years are available on a CD-ROM and via Internet. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1995, Consumption Estimates (SEDR), published in December 1997. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources.

  2. World military expenditures and global cardiovascular mortality.

    PubMed

    Brenner, M Harvey

    2016-02-01

    Can we estimate the consequences of world military expenditures for the physical and mental health of nations that produce and purchase armaments? If anxiety and fear are promoting military expenditures, then those sentiments may well reflect poorer mental health and war-related stress as it influences cardiovascular illness rates. Further, extensive military expenditure by a society implies that other societal needs are allocated fewer resources, including nutrition, water and sanitation, health care, and economic development. We use a model focused on military expenditures to predict cardiovascular mortality in world samples of industrialized and developing countries over 2000-2011. The cardiovascular mortality model controls for economic development, smoking, body mass index, systolic blood pressure, and carbon dioxide emissions. Military expenditures as proportion of gross domestic product show significant positive relations to cardiovascular disease mortality in linear multiple regression analyses, using both cross-sectional and pooled cross-sectional time-series approaches.

  3. Incidence and correlates of 'catastrophic' maternal health care expenditure in India.

    PubMed

    Bonu, Sekhar; Bhushan, Indu; Rani, Manju; Anderson, Ian

    2009-11-01

    Using data from the 60(th) round of the National Sample Survey of India (2004), the study investigates the incidence and correlates of 'catastrophic' maternal expenditure (ME) in India. Data on ME come from 6879 births that took place during 365 days prior to the survey. The study adapts earlier definitions and methods for catastrophic total health care expenditure to measure 'catastrophic' ME as: (i) maternal health care expenditure more than 10% of the annual normative household consumption expenditure (ME-1), and (ii) maternal health care expenditure more than 40% of the annual 'capacity to pay' (ME-2). The 'capacity to pay' was derived by subtracting state-wise poverty-line household expenditure from household consumption expenditure. The average maternal expenditure varied by place of delivery: US dollar 9.5, US dollar 24.7 and US dollar 104.3 for birth at home, in a public facility and in a private facility, respectively. Sixteen per cent of households incurred ME of more than 10% of total household consumption expenditure (ME-1), while 51% households incurred ME of more than 40% of household 'capacity to pay' (ME-2). While incidence of ME-1 increased with income decile, the reverse was observed for ME-2, reflecting higher non-utilization of institutional maternal care and its non-affordability among poorer households. All the households from the poorest decile and 99% from the second poorest decile paid more than 40% of their capacity to pay. Multivariate regression results indicate that antenatal care and delivery care in private facilities increased the chances of ME-1 and ME-2 (P < 0.001). Measuring maternal expenditure against 'capacity to pay' (ME-2) may be better than measuring it as a proportion of overall household expenditure when assessing financial constraints in the use of maternal services. Improving the performance of the public sector, appropriate regulation of and partnership with the private sector, and effective direct cash transfers to

  4. Change in psychological distress following change in workplace social capital: results from the panel surveys of the J-HOPE study.

    PubMed

    Tsuboya, Toru; Tsutsumi, Akizumi; Kawachi, Ichiro

    2015-03-01

    Research on the longitudinal association of workplace social capital and mental health is limited. The purpose of the present study was to investigate the prospective association of social capital in the workplace with mental distress, measured by K6, adjusting for individuals factors as well as workplace-related factors among employees in Japan. The participants included 6387 men and 1825 women from 12 private companies in Japan. Questionnaires, inquiring about workplace social capital, K6, job strain and effort-reward imbalance were administered at the baseline survey between October 2010 and December 2011 (response rate=77.4%). At 1-year follow-up, social capital and K6 were assessed again (follow-up rate=79.5%), and a generalised linear model was used to estimate the association between changes in workplace social capital and change in K6. After adjusting for baseline demographic characteristics and workplace-related factors (Job Content Questionnaire (JCQ), Effort-Reward Imbalance Questionnaire (ERIQ)), increased workplace social capital between waves was associated with improved psychological distress (β=-0.2327, p<0.0001). An inverse association was found in both men and women, all age groups, and among employees with high or low baseline mental health. The association was stronger among those who reported higher stress at baseline. Boosting workplace social capital may promote mental health in the workplace. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain

    PubMed Central

    Brose, Leonie S.; Brown, Jamie; Robson, Debbie; McNeill, Ann

    2015-01-01

    Introduction: E-cigarettes can be categorized into two basic types, (1) cigalikes, that are disposable or use pre-filled cartridges and (2) tanks, that can be refilled with liquids. The aims of this study were to examine: (1) predictors of using the two e-cigarette types, and (2) the association between type used, frequency of use (daily vs. non-daily vs. no use), and quitting. Methods: Online longitudinal survey of smokers in Great Britain was first conducted in November 2012. Of 4064 respondents meeting inclusion criteria at baseline, this study included (N = 1643) current smokers followed-up 1 year later. Type and frequency of e-cigarette use were measured at follow-up. Results: At follow-up, 64% reported no e-cigarette use, 27% used cigalikes, and 9% used tanks. Among e-cigarette users at follow-up, respondents most likely to use tanks versus cigalikes included: 40–54 versus 18–24 year olds and those with low versus moderate/high education. Compared to no e-cigarette use at follow-up, non-daily cigalike users were less likely to have quit smoking since baseline (P = .0002), daily cigalike or non-daily tank users were no more or less likely to have quit (P = .3644 and P = .4216, respectively), and daily tank users were more likely to have quit (P = .0012). Conclusions: Whether e-cigarette use is associated with quitting depends on type and frequency of use. Compared with respondents not using e-cigarettes, daily tank users were more likely, and non-daily cigalike users were less likely, to have quit. Tanks were more likely to be used by older respondents and respondents with lower education. PMID:25896067

  6. Neuropathic pain phenotyping by international consensus (NeuroPPIC) for genetic studies: a NeuPSIG systematic review, Delphi survey, and expert panel recommendations

    PubMed Central

    van Hecke, Oliver; Kamerman, Peter R.; Attal, Nadine; Baron, Ralf; Bjornsdottir, Gyda; Bennett, David L.H.; Bennett, Michael I.; Bouhassira, Didier; Diatchenko, Luda; Freeman, Roy; Freynhagen, Rainer; Haanpää, Maija; Jensen, Troels S.; Raja, Srinivasa N.; Rice, Andrew S.C.; Seltzer, Ze'ev; Thorgeirsson, Thorgeir E.; Yarnitsky, David; Smith, Blair H.

    2015-01-01

    Abstract For genetic research to contribute more fully to furthering our knowledge of neuropathic pain, we require an agreed, valid, and feasible approach to phenotyping, to allow collaboration and replication in samples of sufficient size. Results from genetic studies on neuropathic pain have been inconsistent and have met with replication difficulties, in part because of differences in phenotypes used for case ascertainment. Because there is no consensus on the nature of these phenotypes, nor on the methods of collecting them, this study aimed to provide guidelines on collecting and reporting phenotypes in cases and controls for genetic studies. Consensus was achieved through a staged approach: (1) systematic literature review to identify all neuropathic pain phenotypes used in previous genetic studies; (2) Delphi survey to identify the most useful neuropathic pain phenotypes and their validity and feasibility; and (3) meeting of experts to reach consensus on the optimal phenotype(s) to be collected from patients with neuropathic pain for genetic studies. A basic “entry level” set of phenotypes was identified for any genetic study of neuropathic pain. This set identifies cases of “possible” neuropathic pain, and controls, and includes: (1) a validated symptom-based questionnaire to determine whether any pain is likely to be neuropathic; (2) body chart or checklist to identify whether the area of pain distribution is neuroanatomically logical; and (3) details of pain history (intensity, duration, any formal diagnosis). This NeuroPPIC “entry level” set of phenotypes can be expanded by more extensive and specific measures, as determined by scientific requirements and resource availability. PMID:26469320

  7. Neuropathic pain phenotyping by international consensus (NeuroPPIC) for genetic studies: a NeuPSIG systematic review, Delphi survey, and expert panel recommendations.

    PubMed

    van Hecke, Oliver; Kamerman, Peter R; Attal, Nadine; Baron, Ralf; Bjornsdottir, Gyda; Bennett, David L H; Bennett, Michael I; Bouhassira, Didier; Diatchenko, Luda; Freeman, Roy; Freynhagen, Rainer; Haanpää, Maija; Jensen, Troels S; Raja, Srinivasa N; Rice, Andrew S C; Seltzer, Zeʼev; Thorgeirsson, Thorgeir E; Yarnitsky, David; Smith, Blair H

    2015-11-01

    For genetic research to contribute more fully to furthering our knowledge of neuropathic pain, we require an agreed, valid, and feasible approach to phenotyping, to allow collaboration and replication in samples of sufficient size. Results from genetic studies on neuropathic pain have been inconsistent and have met with replication difficulties, in part because of differences in phenotypes used for case ascertainment. Because there is no consensus on the nature of these phenotypes, nor on the methods of collecting them, this study aimed to provide guidelines on collecting and reporting phenotypes in cases and controls for genetic studies. Consensus was achieved through a staged approach: (1) systematic literature review to identify all neuropathic pain phenotypes used in previous genetic studies; (2) Delphi survey to identify the most useful neuropathic pain phenotypes and their validity and feasibility; and (3) meeting of experts to reach consensus on the optimal phenotype(s) to be collected from patients with neuropathic pain for genetic studies. A basic "entry level" set of phenotypes was identified for any genetic study of neuropathic pain. This set identifies cases of "possible" neuropathic pain, and controls, and includes: (1) a validated symptom-based questionnaire to determine whether any pain is likely to be neuropathic; (2) body chart or checklist to identify whether the area of pain distribution is neuroanatomically logical; and (3) details of pain history (intensity, duration, any formal diagnosis). This NeuroPPIC "entry level" set of phenotypes can be expanded by more extensive and specific measures, as determined by scientific requirements and resource availability.

  8. Expenditure patterns of older Americans, 2001-2009.

    PubMed

    Banerjee, Sudipto

    2012-02-01

    PRE- AND POSTRETIREMENT EXPENSES: Before retirement, people pay FICA taxes, incur work-related expenses, and set aside money for retirement. But after retirement, most people have different financial obligations, and, as a result, retirees may still be able to maintain their level of preretirement well-being with very different income levels. Studying income, expenditures, and wealth-holding patterns together provides a more complete idea of how people are doing in terms of being able to afford retirement than arbitrary estimates such as income replacement ratios. UNIQUE DATA: This Issue Brief examines the expenditure patterns of the older section of the population. It uses data from the Consumption and Activities Mail Survey (CAMS), a supplement to the Health and Retirement Study (HRS), conducted by the Institute for Social Research at the University of Michigan, contains detailed expenditure data on 32 categories, and follows the same group of individuals over eight years In addition, the income and wealth data available in the HRS are used to establish the financial standing of older households. DECLINING EXPENSES: Household expenses steadily decline with age. With the age 65 expenditure as a benchmark, household expenditure falls by 19 percent by age 75, 34 percent by age 85, and 52 percent by age 95. HOME EXPENSES: Home and home-related expenses remain the single largest spending category for older Americans. On average, those over age 50 spend around 40-45 percent of their budget on home and home-related items. RISING HEALTH CARE EXPENSES: Health-related expenses are the second-largest component in the budget of older Americans. It is the only component which steadily increases with age. Health care expenses capture around 10 percent of the budget for those between 50-64, but increase to about 20 percent for those age 85 and over. DEMOGRAPHIC GROUPS: Singles, blacks, and high school dropouts do not have a sound financial standing in retirement. Their

  9. Fabrication of prepackaged superalloy honeycomb Thermal Protection System (TPS) panels

    NASA Technical Reports Server (NTRS)

    Blair, W.; Meaney, J. E.; Rosenthal, H. A.

    1985-01-01

    High temperature materials were surveyed, and Inconel 617 and titanium were selected for application to a honeycomb TPS configuration designed to withstand 2000 F. The configuration was analyzed both thermally and structurally. Component and full-sized panels were fabricated and tested to obtain data for comparison with analysis. Results verified the panel design. Twenty five panels were delivered to NASA Langley Research Center for additional evaluation.

  10. Can eHealth Reduce Medical Expenditures of Chronic Diseases?

    PubMed

    Tsuji, Masatsugu; Taher, Sheikh Abu; Kinai, Yusuke

    2015-01-01

    The objective of this research is to evaluate empirically the effectiveness of eHealth in Nishi-aizu Town, Fukushima Prefecture, based on a mail survey to the residents and their receipt data of National Health Insurance from November 2006 to February 2007. The residents were divided into two groups, users and non-users, and sent questionnaires to ask their characteristics or usage of the system. Their medical expenditures paid by National Health Insurance for five years from 2002 to 2006 are examined. The effects were analyzed by comparison of medical expenditures between users and non-users. The interests are focused on four chronic diseases namely heart diseases, high blood pressure, diabetes, and strokes. A regression analysis is employed to estimate the effect of eHealth to users who have these diseases and then calculate the monetary effect of eHealth on reduction of medical expenditures. The results are expected to be valid for establishment of evidence-based policy such as reimbursement from medical insurance to eHealth.

  11. Catastrophic healthcare expenditure - drivers and protection: the Portuguese case.

    PubMed

    Kronenberg, Christoph; Barros, Pedro Pita

    2014-03-01

    The objective of this paper is to assess the extent of catastrophic healthcare expenditure, which can lead to impoverishment, even in a country with a National Health Service, such as Portugal. The level of catastrophic healthcare expenditure will be identified before the determinants of these catastrophic payments are analyzed. Afterwards, the effects of existing exemptions to copayments in health care use will be tested and the relationship between catastrophe and impoverishment will be discussed. Catastrophe is calculated from the Portuguese Household Budget Surveys of 2000 and 2005, and then analyzed using logistic regression models. The results show that catastrophe due to healthcare out-of-pocket payments are a sizeable issue in Portugal. Exemptions from out-of-pocket expenses for medical care should be created to prevent vulnerable groups from facing catastrophic healthcare spending. These vulnerable groups include children, people with disabilities and individuals suffering from chronic conditions. Disability proxies offer straightforward policy options for an exemption for the elderly with recognized disabilities. An exemption of retired people with disabilities is therefore recommended to policymakers as it targets a vulnerable group with high risk of facing catastrophic healthcare expenditure.

  12. Hospital–Physician Affiliations and Patient Treatments, Expenditures, and Outcomes

    PubMed Central

    Madison, Kristin

    2004-01-01

    Objective To determine the relationship between hospital–physician affiliations and the treatments, expenditures, and outcomes of patients. Data Sources Sources include the Medicare Provider Analysis and Review dataset, the American Hospital Association (AHA) Annual Survey, and the Area Resource File (ARF). Study Design A multivariate regression analysis of the relationship between hospital–physician affiliations (such as physician–hospital organizations [PHOs] or salaried employment) and the treatment of Medicare patients with a diagnosis of acute myocardial infarction admitted to general medical-surgical hospitals between 1994 and 1998. Dependent variables include whether the patient received a catheterization or angioplasty or bypass surgery; whether a patient was readmitted, or died within 90 days of initial admission; and expenditures. Independent variables include patient, admission hospital, and market characteristics, as well as hospital and year fixed effects. Principal Findings The integrated salary model form of hospital–physician affiliation is associated with slightly higher procedure rates, and higher patient expenditures. At the same time, there is little evidence that hospital–physician affiliations in the aggregate have had any measurable impact on patient treatment or outcomes. Conclusions The limited effect of hospital–physician affiliations on patient outcomes is consistent with previous research showing that affiliations have not much changed the nature of health care delivery. However, the finding that the integrated salary model is associated with higher treatment intensity suggests that affiliations may have had some impact on patients, and could have more in the future. PMID:15032954

  13. Durability of structural panels

    Treesearch

    Eddie W. Price; [Editor

    1984-01-01

    Twenty papers from the proceedings of a workshop are presented on the durability of a group of structural panels for use in roof, wall, and floor sheathing applications. The panel types are waferboard,flakeboard, strandboard, oriented structural board, and structural particleboard. A summary of the proceedings is given as the final presentation.

  14. New mineral physics panels

    NASA Astrophysics Data System (ADS)

    The AGU Committee on Mineral Physics has formed itself into six panels. The committee chairman is Orson L. Anderson of the Department of Earth and Space Sciences, University of California, Los Angeles; foreign secretary is Robert Liebermann, Department of Earth and Space Sciences, State University of New York, Stony Brook. The six panels are as follows.

  15. Stereoscopic Flat Panel Display

    DTIC Science & Technology

    2004-12-01

    the display of stereo imagery have been demonstrated. Stereoscopic displays typically require the user to wear special headgear. Autostereoscopic ...components and the resulting changes in the encoding algorithm. Keywords: Stereoscopic display, LCD, 3D , polarization encoding, flat panel 1...panel display when viewing non-stereoscopic imagery or data. Remotely operated vehicles do not represent the only potential application for 3D

  16. SNP panels/Imputation

    USDA-ARS?s Scientific Manuscript database

    Participants from thirteen countries discussed services that Interbull can perform or recommendations that Interbull can make to promote harmonization and assist member countries in improving their genomic evaluations in regard to SNP panels and imputation. The panel recommended: A mechanism to shar...

  17. Flexible optical panel

    DOEpatents

    Veligdan, James T.

    2001-01-01

    A flexible optical panel includes laminated optical waveguides, each including a ribbon core laminated between cladding, with the core being resilient in the plane of the core for elastically accommodating differential movement thereof to permit winding of the panel in a coil.

  18. Reinventing the solar panel

    SciTech Connect

    Scanlon, M.

    1995-08-01

    This article discusses new technology in solar panels. PowerSource is a solar collector which not only is less expensive than conventional panels to purchase and install, but also increases the electrical output by almost 20%. This article describes the results of testing this system.

  19. Microgravity Science Research Panel

    NASA Technical Reports Server (NTRS)

    Carpenter, Bradley M.; Trinh, Eugene H.; DeLucas, Lawrence J.; Larson, David; Koss, Matthew; Ostrach, Simon

    2000-01-01

    This document is a transcription of the Microgravity Science Research Panel's discussion about their research and about some of the contributions that they feel have been important to the field during their time with the program. The panel includes Dr. Eugene Trinh, Dr. Lawrence DeLucas, Dr. Charles Bugg, Dr. David Larson, and Dr. Simon Ostrach.

  20. [Fair health financing and catastrophic health expenditures: potential impact of the coverage extension of the popular health insurance in Mexico].

    PubMed

    Knaul, Felicia; Arreola-Ornelas, Héctor; Méndez, Oscar; Martínez, Alejandra

    2005-01-01

    To assess the impact on fair health financing and household catastrophic health expenditures of the implementation of the Popular Health Insurance (Seguro Popular de Salud). Data analyzed in this study come from the National Income and Expenditure Household Survey (Encuesta Nacional de Ingresos y Gastos de los Hogares, ENIGH), 2000, and the National Health Insurance and Expenditure Survey, (Encuesta Nacional de Aseguramiento y Gasto en Salud, ENAGS), 2001. Estimations are based on projections of extension of the Popular Health Insurance under different conditions of coverage and out-of-pocket expenditure reductions in the uninsured population. The mathematic simulation model assumes applying the new Popular Health Insurance financial structure to the 2000 expenditure values reported by ENIGH, given the probability of affiliation by households. The model of determinants of affiliation to the Popular Health Insurance yielded three significant variables: being in income quintiles I and II, being a female head of household, and that a household member had a medical visit in the past year. Simulation results show that important impacts on the performance of the Mexican Health System will occur in terms of fair financing and catastrophic expenditures, even before achieving the universal coverage goal in 2010. A reduction of 40% in out-of-pocket expenditures and a Popular Health Insurance coverage of 100% will decrease catastrophic health expenditures from 3.4% to 1.6%. Our results show that the reduction of out-of-pocket expenditures generated by the new financing and health provision Popular Health Insurance model, will improve the financial fairness index and the financial contribution to the health system, and will decrease the percentage of households with catastrophic expenditures, even before reaching universal coverage. A greater impact may be expected due to coverage extension initiating in the poorest communities that have a very restricted and progressive