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

https://doi.org/10.1016/j.janxdis.2013.09.009Get rights and content

Highlights

  • Anxiety disorders absorb a significant portion of U.S. healthcare resources.

  • Anxiety disorders should be given high priority in developing cost-containment policies under Affordable Care Act.

  • Inpatient visits, prescription medications, and office-based visits are main cost derivatives.

  • Emergency care cost is slightly higher for individuals with anxiety disorders.

  • High hospitalization rate among patients with anxiety disorders needs to be investigated.

Abstract

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.

Section snippets

Data source

Data was collected from Medical Expenditure Panel Survey (MEPS) public use data files. MEPS is a set of large-scale surveys of families, individuals, their medical providers and employers across the United States (Survey Background, 2009). Jointly sponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS), MEPS has been conducted annually since 1996. It has three major components; the Household Component (HC), the Insurance Component

Results

From the total survey respondents in 2009–2010 (n = 66,148), 46,572 (weighted sum = 228,987,954) were adults with positive person weights and non-missing values on all of the independent variables, and were included in the final analysis.

In 2009–2010 MEPS survey, 8.74% (weighted sum = 20,337,553) of adults (95% CI: 8.32% to 9.17%) reported being diagnosed with an anxiety disorder(s). The remaining 91.26% were considered as anxiety-free population.

Discussion

This study used a nationally representative database along with a robust statistical analysis technique to provide the most comprehensive and recent estimates of direct medical costs of anxiety disorders among adults in the U.S. Our results showed that almost 9% of the ambulatory adult population of the U.S. in 2009–2010 were diagnosed with anxiety disorder(s). This estimate is lower than the 18.1% estimate for the 12-month prevalence of any anxiety disorder, reported by the National

Conclusion

In summary, the present study provides estimates of annual direct medical expenditures associated with anxiety disorders in the ambulatory adult population of the U.S. Our results confirmed that anxiety disorders impose a significant economic burden to society. This category of mental illnesses is associated with high overall healthcare cost, as well as higher cost for inpatient care, office-based visits, prescription medication, and emergency care. Our findings suggest that a significant

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