Rachel Presskreischer1, Joanna E Steinglass2, Kelly E Anderson1. 1. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 2. Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, New York, USA.
Abstract
OBJECTIVE: The social and economic burden of eating disorders is significant and often financially devastating. Medicare is the largest public insurer in the United States and provides coverage for older adults and some disabled individuals. This study explores prevalence, sociodemographic and clinical characteristics, and health care spending for Medicare enrollees with eating disorders. METHOD: A cross-sectional study was conducted with the nationally representative 20% sample of 2016 Medicare inpatient, outpatient, carrier, and home health fee-for-service claims and Medicare Advantage encounter records. Sociodemographic characteristics and comorbid somatic conditions were compared between individuals with versus without an eating disorder diagnosis. Mean spending was compared overall and separately for inpatient, outpatient, home health, and pharmacy claims. RESULTS: The sample included 11,962,287 Medicare enrollees of whom 0.15% had an eating disorder diagnosis. Compared to those without a 2016 eating disorder diagnosis, a greater proportion of individuals with an eating disorder were female (73.8% vs. 54.3%), under age 65 (41.6% vs. 15.5%), and dually eligible for Medicaid due to disability or low-income qualification (48.0% vs. 19.6%). Individuals with eating disorders had higher rates of comorbid conditions, with the greatest differences in cardiac arrythmias (35.3% vs. 19.9%), arthritis (40.1% vs. 26.6%), and thyroid conditions (32.2% vs. 19.4%). Spending was higher for enrollees with eating disorders compared to those without overall ($29,456 vs. $7,418) and across settings. DISCUSSION: The findings establish that eating disorders occur in the Medicare population, and that enrollees with these illnesses have risk factors associated with significant healthcare spending and adverse health outcomes.
OBJECTIVE: The social and economic burden of eating disorders is significant and often financially devastating. Medicare is the largest public insurer in the United States and provides coverage for older adults and some disabled individuals. This study explores prevalence, sociodemographic and clinical characteristics, and health care spending for Medicare enrollees with eating disorders. METHOD: A cross-sectional study was conducted with the nationally representative 20% sample of 2016 Medicare inpatient, outpatient, carrier, and home health fee-for-service claims and Medicare Advantage encounter records. Sociodemographic characteristics and comorbid somatic conditions were compared between individuals with versus without an eating disorder diagnosis. Mean spending was compared overall and separately for inpatient, outpatient, home health, and pharmacy claims. RESULTS: The sample included 11,962,287 Medicare enrollees of whom 0.15% had an eating disorder diagnosis. Compared to those without a 2016 eating disorder diagnosis, a greater proportion of individuals with an eating disorder were female (73.8% vs. 54.3%), under age 65 (41.6% vs. 15.5%), and dually eligible for Medicaid due to disability or low-income qualification (48.0% vs. 19.6%). Individuals with eating disorders had higher rates of comorbid conditions, with the greatest differences in cardiac arrythmias (35.3% vs. 19.9%), arthritis (40.1% vs. 26.6%), and thyroid conditions (32.2% vs. 19.4%). Spending was higher for enrollees with eating disorders compared to those without overall ($29,456 vs. $7,418) and across settings. DISCUSSION: The findings establish that eating disorders occur in the Medicare population, and that enrollees with these illnesses have risk factors associated with significant healthcare spending and adverse health outcomes.
Authors: Haiden A Huskamp; Hillary Samples; Scott E Hadland; Emma E McGinty; Teresa B Gibson; Howard H Goldman; Susan H Busch; Elizabeth A Stuart; Colleen L Barry Journal: Psychiatr Serv Date: 2017-11-15 Impact factor: 3.084
Authors: Brandon K Bellows; Scott L DuVall; Aaron W C Kamauu; Dylan Supina; Thomas Babcock; Joanne LaFleur Journal: Int J Eat Disord Date: 2015-05-08 Impact factor: 4.861
Authors: Hunna J Watson; Andreas Jangmo; Tosha Smith; Laura M Thornton; Yvonne von Hausswolff-Juhlin; Manisha Madhoo; Claes Norring; Elisabeth Welch; Camilla Wiklund; Henrik Larsson; Cynthia M Bulik Journal: J Psychosom Res Date: 2018-03-21 Impact factor: 3.006
Authors: Tamra Keeney; Emmanuelle Belanger; Rich N Jones; Nina R Joyce; David J Meyers; Vincent Mor Journal: J Am Geriatr Soc Date: 2019-08-27 Impact factor: 5.562