Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures

Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Small, Christina [verfasserIn] Kramer, Holly J. Griffin, Karen A. Vellanki, Kavitha Leehey, David J. Bansal, Vinod K. Markossian, Talar W.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	Chronic Kidney Disease Healthcare Expenditure Medical Expenditure Panel Survey Total Healthcare Expenditure Total Health Care Expenditure

Anmerkung:	© The Author(s). 2017

Übergeordnetes Werk:	Enthalten in: BMC nephrology - London : BioMed Central, 2000, 18(2017), 1 vom: 05. Jan.
Übergeordnetes Werk:	volume:18 ; year:2017 ; number:1 ; day:05 ; month:01

Links:	Volltext

DOI / URN:	10.1186/s12882-016-0432-2

Katalog-ID:	SPR027518345

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520			\|a Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke.
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allfields	10.1186/s12882-016-0432-2 doi (DE-627)SPR027518345 (SPR)s12882-016-0432-2-e DE-627 ger DE-627 rakwb eng Small, Christina verfasserin aut Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. Chronic Kidney Disease (dpeaa)DE-He213 Healthcare Expenditure (dpeaa)DE-He213 Medical Expenditure Panel Survey (dpeaa)DE-He213 Total Healthcare Expenditure (dpeaa)DE-He213 Total Health Care Expenditure (dpeaa)DE-He213 Kramer, Holly J. aut Griffin, Karen A. aut Vellanki, Kavitha aut Leehey, David J. aut Bansal, Vinod K. aut Markossian, Talar W. (orcid)0000-0002-8147-7083 aut Enthalten in BMC nephrology London : BioMed Central, 2000 18(2017), 1 vom: 05. Jan. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:18 year:2017 number:1 day:05 month:01 https://dx.doi.org/10.1186/s12882-016-0432-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2017 1 05 01
spelling	10.1186/s12882-016-0432-2 doi (DE-627)SPR027518345 (SPR)s12882-016-0432-2-e DE-627 ger DE-627 rakwb eng Small, Christina verfasserin aut Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. Chronic Kidney Disease (dpeaa)DE-He213 Healthcare Expenditure (dpeaa)DE-He213 Medical Expenditure Panel Survey (dpeaa)DE-He213 Total Healthcare Expenditure (dpeaa)DE-He213 Total Health Care Expenditure (dpeaa)DE-He213 Kramer, Holly J. aut Griffin, Karen A. aut Vellanki, Kavitha aut Leehey, David J. aut Bansal, Vinod K. aut Markossian, Talar W. (orcid)0000-0002-8147-7083 aut Enthalten in BMC nephrology London : BioMed Central, 2000 18(2017), 1 vom: 05. Jan. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:18 year:2017 number:1 day:05 month:01 https://dx.doi.org/10.1186/s12882-016-0432-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2017 1 05 01
allfields_unstemmed	10.1186/s12882-016-0432-2 doi (DE-627)SPR027518345 (SPR)s12882-016-0432-2-e DE-627 ger DE-627 rakwb eng Small, Christina verfasserin aut Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. Chronic Kidney Disease (dpeaa)DE-He213 Healthcare Expenditure (dpeaa)DE-He213 Medical Expenditure Panel Survey (dpeaa)DE-He213 Total Healthcare Expenditure (dpeaa)DE-He213 Total Health Care Expenditure (dpeaa)DE-He213 Kramer, Holly J. aut Griffin, Karen A. aut Vellanki, Kavitha aut Leehey, David J. aut Bansal, Vinod K. aut Markossian, Talar W. (orcid)0000-0002-8147-7083 aut Enthalten in BMC nephrology London : BioMed Central, 2000 18(2017), 1 vom: 05. Jan. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:18 year:2017 number:1 day:05 month:01 https://dx.doi.org/10.1186/s12882-016-0432-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2017 1 05 01
allfieldsGer	10.1186/s12882-016-0432-2 doi (DE-627)SPR027518345 (SPR)s12882-016-0432-2-e DE-627 ger DE-627 rakwb eng Small, Christina verfasserin aut Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. Chronic Kidney Disease (dpeaa)DE-He213 Healthcare Expenditure (dpeaa)DE-He213 Medical Expenditure Panel Survey (dpeaa)DE-He213 Total Healthcare Expenditure (dpeaa)DE-He213 Total Health Care Expenditure (dpeaa)DE-He213 Kramer, Holly J. aut Griffin, Karen A. aut Vellanki, Kavitha aut Leehey, David J. aut Bansal, Vinod K. aut Markossian, Talar W. (orcid)0000-0002-8147-7083 aut Enthalten in BMC nephrology London : BioMed Central, 2000 18(2017), 1 vom: 05. Jan. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:18 year:2017 number:1 day:05 month:01 https://dx.doi.org/10.1186/s12882-016-0432-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2017 1 05 01
allfieldsSound	10.1186/s12882-016-0432-2 doi (DE-627)SPR027518345 (SPR)s12882-016-0432-2-e DE-627 ger DE-627 rakwb eng Small, Christina verfasserin aut Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. Chronic Kidney Disease (dpeaa)DE-He213 Healthcare Expenditure (dpeaa)DE-He213 Medical Expenditure Panel Survey (dpeaa)DE-He213 Total Healthcare Expenditure (dpeaa)DE-He213 Total Health Care Expenditure (dpeaa)DE-He213 Kramer, Holly J. aut Griffin, Karen A. aut Vellanki, Kavitha aut Leehey, David J. aut Bansal, Vinod K. aut Markossian, Talar W. (orcid)0000-0002-8147-7083 aut Enthalten in BMC nephrology London : BioMed Central, 2000 18(2017), 1 vom: 05. Jan. (DE-627)326643672 (DE-600)2041348-8 1471-2369 nnns volume:18 year:2017 number:1 day:05 month:01 https://dx.doi.org/10.1186/s12882-016-0432-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2017 1 05 01
language	English
source	Enthalten in BMC nephrology 18(2017), 1 vom: 05. Jan. volume:18 year:2017 number:1 day:05 month:01
sourceStr	Enthalten in BMC nephrology 18(2017), 1 vom: 05. Jan. volume:18 year:2017 number:1 day:05 month:01
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institution	findex.gbv.de
topic_facet	Chronic Kidney Disease Healthcare Expenditure Medical Expenditure Panel Survey Total Healthcare Expenditure Total Health Care Expenditure
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container_title	BMC nephrology
authorswithroles_txt_mv	Small, Christina @@aut@@ Kramer, Holly J. @@aut@@ Griffin, Karen A. @@aut@@ Vellanki, Kavitha @@aut@@ Leehey, David J. @@aut@@ Bansal, Vinod K. @@aut@@ Markossian, Talar W. @@aut@@
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This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. 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author	Small, Christina
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topic_title	Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures Chronic Kidney Disease (dpeaa)DE-He213 Healthcare Expenditure (dpeaa)DE-He213 Medical Expenditure Panel Survey (dpeaa)DE-He213 Total Healthcare Expenditure (dpeaa)DE-He213 Total Health Care Expenditure (dpeaa)DE-He213
topic	misc Chronic Kidney Disease misc Healthcare Expenditure misc Medical Expenditure Panel Survey misc Total Healthcare Expenditure misc Total Health Care Expenditure
topic_unstemmed	misc Chronic Kidney Disease misc Healthcare Expenditure misc Medical Expenditure Panel Survey misc Total Healthcare Expenditure misc Total Health Care Expenditure
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title	Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures
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title_full	Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures
author_sort	Small, Christina
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author_browse	Small, Christina Kramer, Holly J. Griffin, Karen A. Vellanki, Kavitha Leehey, David J. Bansal, Vinod K. Markossian, Talar W.
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author-letter	Small, Christina
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title_sort	non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures
title_auth	Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures
abstract	Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. © The Author(s). 2017
abstractGer	Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. © The Author(s). 2017
abstract_unstemmed	Background Previous studies have documented the high costs of non-dialysis dependent chronic kidney disease (CKD) but out-of-pocket healthcare expenditures remain poorly explored. This study described total direct and out-of-pocket expenditures for adults with non-dialysis dependent CKD and compared expenditures with those for cancer or stroke. Methods This study used data from the 2011–2013 Medical Expenditure Panel Survey, a national survey of healthcare expenditures in the U.S. population. Expenditures were determined for adults with the following chronic diseases: CKD defined by 585 ICD9 codes (n = 52), cancer (colon, breast or bronchus/lung) (n = 870), or stroke (n = 1104). These represent adults who were aware of their conditions or visited a healthcare provider for the condition during the study period. Generalized linear models were used to estimate the marginal effects of CKD, cancer or stroke on adjusted expenditures compared to adults without CKD, cancer or stroke (n = 72,241) while controlling for demographics and co-morbidities and incorporating the sample weights of the complex survey design. Results The mean age for group with CKD, cancer or stroke was 65.5, 66.1, and 68.2 years, respectively, while mean age for group without CKD, cancer or stroke was 47.8 years. Median values of total direct and out of pocket healthcare expenditures ranged from as high as $12,877 (Interquartile Range [IQR] $5031-$19,710) and $1439 ($688–$2732), respectively, with CKD, to as low as $1189 (IQR $196-$4388) and $226 (IQR $20-$764) in the group without CKD, cancer or stroke. After adjusting for demographics and comorbidities, the adjusted difference in total direct healthcare expenditures was $4746 (95% CI $1775-$7718) for CKD, $8608 (95% CI $6167-$11,049) for cancer and $5992 (95% CI $4208-$7775) for stroke vs. group without CKD, cancer or stroke. Adjusted difference in out-of-pocket healthcare expenditures was highest for adults with CKD ($760; 95% CI 0-$1745) and was larger than difference noted for cancer ($419; 95% CI 158–679) or stroke ($246; 95% CI 87–406) relative to group without CKD, cancer or stroke. Conclusions Total and out of pocket health expenditures for adults with non-dialysis dependent CKD are high and may be equal to or higher than expenditures incurred by adults with cancer or stroke. © The Author(s). 2017
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title_short	Non-dialysis dependent chronic kidney disease is associated with high total and out-of-pocket healthcare expenditures
url	https://dx.doi.org/10.1186/s12882-016-0432-2
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author2	Kramer, Holly J. Griffin, Karen A. Vellanki, Kavitha Leehey, David J. Bansal, Vinod K. Markossian, Talar W.
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