A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis
Objective: Many patients with osteoarthritis experience pain which can lead to higher healthcare expenditures. It is important to understand the factors that drive the excess expenditures associated with pain in osteoarthritis. Design: Cross-sectional. Study sample: Our study sample consisted of adu...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-10-01
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| Series: | Health Services Insights |
| Online Access: | https://doi.org/10.1177/11786329221133957 |
| _version_ | 1811197397519302656 |
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| author | Mohammad Ikram Nazneen Fatima Shaikh Usha Sambamoorthi |
| author_facet | Mohammad Ikram Nazneen Fatima Shaikh Usha Sambamoorthi |
| author_sort | Mohammad Ikram |
| collection | DOAJ |
| description | Objective: Many patients with osteoarthritis experience pain which can lead to higher healthcare expenditures. It is important to understand the factors that drive the excess expenditures associated with pain in osteoarthritis. Design: Cross-sectional. Study sample: Our study sample consisted of adults (age ⩾ 18 years) from the Medical Expenditure Panel Survey (MEPS, 2018). Methods: Adults who were alive during the calendar year and had pain status were included in this study (N = 2804 weighted N = 32.03 million). Osteoarthritis was identified from the medical conditions file and household file. We used multivariable ordinary least squares regression to identify the statistically significant association of pain with direct healthcare expenditures. The Blinder-Oaxaca post-linear decomposition on log-transformed total direct healthcare expenditures was used to estimate the extent to which differences in characteristics contribute to the excess expenditures associated with pain. Results: Adults with osteoarthritis and pain had higher average expenditures ($21 814 vs $10 827, P < .001; 9.318 vs 8.538 in logtransformed expenditures) compared to those without pain. Pooled regression weights explained 62.9% of excess expenditures differences in characteristics between the 2 groups. The 2 main drivers of excess healthcare expenditures among adults with osteoarthritis and pain were (i) comorbidities (diabetes, asthma, chronic obstructive pulmonary disease, depression, heart diseases, cancer, and non-cancer pain conditions and (ii) prescription medications (NSAIDs, opioids, and polypharmacy). Conclusion: Need factors such as comorbid conditions, and prescription treatment explained the excess healthcare expenditures among adults with osteoarthritis and pain. The study findings suggest that reducing polypharmacy and appropriate management of comorbid conditions may be a pathway to reduce excess expenditures among adults with osteoarthritis and pain. |
| first_indexed | 2024-04-12T01:14:02Z |
| format | Article |
| id | doaj.art-2394a7d77a9c4e919af08a5646d4c7ec |
| institution | Directory Open Access Journal |
| issn | 1178-6329 |
| language | English |
| last_indexed | 2024-04-12T01:14:02Z |
| publishDate | 2022-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Health Services Insights |
| spelling | doaj.art-2394a7d77a9c4e919af08a5646d4c7ec2022-12-22T03:54:01ZengSAGE PublishingHealth Services Insights1178-63292022-10-011510.1177/11786329221133957A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with OsteoarthritisMohammad Ikram0Nazneen Fatima Shaikh1Usha Sambamoorthi2Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USADepartment of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USAPharmacotherapy Department,College of Pharmacy, “Vashisht” Professor of Health Disparities, University of North Texas Health Sciences Center, Fort Worth, TX, USAObjective: Many patients with osteoarthritis experience pain which can lead to higher healthcare expenditures. It is important to understand the factors that drive the excess expenditures associated with pain in osteoarthritis. Design: Cross-sectional. Study sample: Our study sample consisted of adults (age ⩾ 18 years) from the Medical Expenditure Panel Survey (MEPS, 2018). Methods: Adults who were alive during the calendar year and had pain status were included in this study (N = 2804 weighted N = 32.03 million). Osteoarthritis was identified from the medical conditions file and household file. We used multivariable ordinary least squares regression to identify the statistically significant association of pain with direct healthcare expenditures. The Blinder-Oaxaca post-linear decomposition on log-transformed total direct healthcare expenditures was used to estimate the extent to which differences in characteristics contribute to the excess expenditures associated with pain. Results: Adults with osteoarthritis and pain had higher average expenditures ($21 814 vs $10 827, P < .001; 9.318 vs 8.538 in logtransformed expenditures) compared to those without pain. Pooled regression weights explained 62.9% of excess expenditures differences in characteristics between the 2 groups. The 2 main drivers of excess healthcare expenditures among adults with osteoarthritis and pain were (i) comorbidities (diabetes, asthma, chronic obstructive pulmonary disease, depression, heart diseases, cancer, and non-cancer pain conditions and (ii) prescription medications (NSAIDs, opioids, and polypharmacy). Conclusion: Need factors such as comorbid conditions, and prescription treatment explained the excess healthcare expenditures among adults with osteoarthritis and pain. The study findings suggest that reducing polypharmacy and appropriate management of comorbid conditions may be a pathway to reduce excess expenditures among adults with osteoarthritis and pain.https://doi.org/10.1177/11786329221133957 |
| spellingShingle | Mohammad Ikram Nazneen Fatima Shaikh Usha Sambamoorthi A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis Health Services Insights |
| title | A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis |
| title_full | A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis |
| title_fullStr | A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis |
| title_full_unstemmed | A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis |
| title_short | A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis |
| title_sort | linear decomposition approach to explain excess direct healthcare expenditures associated with pain among adults with osteoarthritis |
| url | https://doi.org/10.1177/11786329221133957 |
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