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

Objective: To estimate the health care expenditures associated with a disability and their recent trends. Design: Retrospective analysis of survey data. Setting: Not applicable. Participants: Data from multiple years (1996-2004) of the Medical Expenditure Panel Survey (MEPS) for a nationally representative sample of civilian, noninstitutionalized U.S. population. Interventions: Not applicable. Main Outcome Measures: Health care expenditures consisted of total health care expenditures, total out-of-pocket (OOP) spending, and burden (the ratio of OOP to family income). All the analyses accounted for the complex survey design of the MEPS. Results: Between 1996 and 2004, 6% to 9% of persons in the working-age group (21-61y) were identified as having a disability. Persons with disabilities consistently had higher total health expenditures, OOP spending, and burden compared with their counterparts without disabilities. In 2004, the average total expenditures were estimated at $10,508 for persons with disabilities and at $2256 for those without disabilities. In a multiple regression framework, persons with disabilities were consistently found to have higher expenditures, OOP spending, and burden between 1996 and 2004. Although expenditures, OOP spending, and burden increased over time, after controlling for demographic, socioeconomic, and health status, these 3 health care costs were not found to change disproportionately for persons with disability. Conclusions: During the 1996 to 2004 period, persons with disabilities were consistently found to have significantly higher health expenditures, OOP spending, and burden compared with their counterparts without disabilities, which may adversely affect their health and standard of living.