BACKGROUND Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS) experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. METHODS Australian patients admitted to hospital with ACS during 2-week period in ...

Vietnam aims to achieve full coverage of health insurance in 2015. An increasing type of health insurance in Vietnam is voluntary health insurance. Although there are many studies on the implementation of voluntary health insurance in Vietnam, little is known on the causal impact of voluntary health insurance. This paper measures the impact of voluntary health insurance on health care utilizati...

Using data from the 2001-2005 Medical Expenditure Panel Survey, this study shows that nearly 40 percent of nonelderly adults with three or more chronic conditions had out-of-pocket expenses and premiums exceeding 5 percent of income for two consecutive years, compared with 20 percent of people who had a single chronic condition and 14 percent who had no chronic conditions. Prescription drug spe...

Medicaid provides health insurance for 54 million Americans. Using the Census Bureau's Supplemental Poverty Measure (which subtracts out-of-pocket medical expenses from family resources), we estimated the impact of eliminating Medicaid. In our counterfactual, Medicaid beneficiaries would become uninsured or gain other insurance. Counterfactual medical expenditures were drawn stochastically from...

PURPOSE This study compared the official poverty rate for adults aged 65 years and older with alternative measures that portray the true resources and needs of older adults. DESIGN AND METHODS The analysis used data from the 2004 Health and Retirement Study on income, assets, in-kind transfers, and out-of-pocket medical expenses. It also incorporated the effects of federal and state income ta...

Prior analyses have estimated the lifetime total societal costs of a person with Down syndrome (DS); however, no studies capture the expected medical costs that patients with DS can expect to incur during childhood. The study utilized the OptumHealth Reporting and Insights administrative claims database from 1999 to 2013. Children with a diagnosis of DS were identified, and their time was divid...

 This study separates the more predictable health care expenses in retirement for older Americans (ages 65 and above) from the less predictable ones. Based on utilization patterns and expenses, doctor visits, dentist visits and usage of prescription drugs are categorized as recurring health care services. Overnight hospital stays, overnight nursing-home stays, outpatient surgery, home health c...

Health-care spending in the United States accounts for approximately 18% of our economy, and per capita spending on health care far exceeds that of other industrialized countries. Yet, we are not necessarily spending wisely because by some measures we are no better off than other nations that spend far less. That said, most Americans are satisfied with their health care, and our collective deci...

This paper presents and compares two threshold approaches to measuring the fairness of health care payments, one requiring that payments do not exceed a pre-specified proportion of pre-payment income, the other that they do not drive households into poverty. We develop indices for 'catastrophe' that capture the intensity of catastrophe as well as its incidence and also allow the analyst to capt...

A fter rapid government payment increases in the midto late 1990s, Medicare+Choice plans now face sharply reduced annual increases in government payments for basic Medicare benefits (Gold 2001a). In response, Medicare+Choice plans are cutting back on supplemental benefits and raising premiums (Gold and Achman 2001; Achman and Gold 2002a, 2002c).These changes have increased outof-pocket spending...