Health Care Expenditures of Living with a Disability: Total Expenditures, Out of Pocket Expenses and Burden, 1996-2004

Abstract

Objective -- This paper estimates the healthcare expenditures associated with a disability at the individual level and their recent trends.

Design -- Retrospective analysis of survey data. Participants--Data from multiple years (1996 through 2004) of the Medical Expenditure Panel Survey (MEPS) for a nationally representative sample of civilian, non-institutionalized US population. Interventions - Not applicable. Main Outcome Measures - Healthcare expenditures consisted of: total healthcare expenditures, total out-of-pocket spending (OOP), and burden (the ratio of OOP to individual income). All the analyses accounted for the complex survey design of the MEPS.

Results -- Between 1996 and 2004, 6% to 9% of individuals in the working age group (21-61 years) were identified as having a disability. Persons with disabilities consistently had higher total health expenditures, OOP and burden compared to their counterparts without disabilities. In 2004, the average total expenditures were estimated at $10,508 for persons with disabilities and at $2,256 for those without disabilities. In a multiple regression framework, persons with disabilities were consistently found to have higher expenditures and OOP between 1996 and 2004. Although expenditures, OOP and burden increased over time, after controlling for demographic, socio-economic, and health status, these three healthcare costs were not found to increase disproportionately for individuals with disability.

Conclusions -- Over the 1996-2004 period, persons with disabilities are consistently found to have significantly higher health expenditures and OOP compared to their counterparts without disabilities, which may adversely affect their health and standard of living.

Keywords: Disability, Health Expenditures, Out of Pocket Expenditures, Burden