National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedCarlton EF, Becker NV, Moniz MH
Out-of-pocket spending for non-birth-related hospitalizations of privately insured US children, 2017 to 2019.
This study’s goal was to estimate out-of-pocket spending for non-birth pediatric hospitalizations of privately insured children from 2017 to 2019. This study used data from the IBM MarketScan Commercial Database. Among 183,780 hospitalizations, half were for female children, with a median age of 12 (4-16) years. Most (79.0%) hospitalizations were for children with a chronic condition and 24.1% were covered by a high-deductible health plan. Mean (SD) and median (IQR) out-of-pocket spending per hospitalization was $1313 and $656 respectively. Out-of-pocket spending exceeded $3000 for 14.0% of hospitalizations. Factors associated with higher out-of-pocket spending included hospitalization in quarter 1 compared with quarter 4 (average marginal effect [AME], $637) and lack of chronic conditions compared with having a complex chronic condition (AME, $732). Hospitalizations covered by the least generous plans (deductible of $3000 or more and coinsurance of 20% or more) found mean out-of-pocket spending was $1974, while the most generous plans (deductible less than $1000 and coinsurance of 1-19%), mean out-of-pocket spending was found to be $826.
AHRQ-funded; HS025465; HS028817.
Citation: Carlton EF, Becker NV, Moniz MH .
Out-of-pocket spending for non-birth-related hospitalizations of privately insured US children, 2017 to 2019.
JAMA Pediatr 2023 May; 177(5):516-25. doi: 10.1001/jamapediatrics.2023.0130..
Keywords: Children/Adolescents, Healthcare Costs, Hospitalization, Health Insurance
Regenbogen SE, Cain-Nielsen AH, Syrjamaki JD
Spending on postacute care after hospitalization in commercial insurance and Medicare around age sixty-five.
Postacute care costs are the primary determinant of episode spending around hospitalization. Yet there is little evidence that greater spending on postacute care improves readmission rates or functional recovery. In a population-based, statewide collaborative of Michigan hospitals, the investigators used regression discontinuity design among propensity-weighted, age-adjusted cohorts to compare postacute care spending between patients with commercial insurance and those with Medicare around age sixty-five. This paper describes the study.
AHRQ-funded; HS024698.
Citation: Regenbogen SE, Cain-Nielsen AH, Syrjamaki JD .
Spending on postacute care after hospitalization in commercial insurance and Medicare around age sixty-five.
Health Aff 2019 Sep;38(9):1505-13. doi: 10.1377/hlthaff.2018.05445..
Keywords: Healthcare Costs, Health Insurance, Medicare, Hospitalization
Adrion ER, Kocher KE, Nallamothu BK
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Using multipayer commercial claims for the period 2009-13, the investigators evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In their study period, the use of observation care increased relative to that of short-stay hospitalizations. In addition, total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly--and at rates much higher than spending in the inpatient setting--over the study period.
AHRQ-funded; HS000053.
Citation: Adrion ER, Kocher KE, Nallamothu BK .
Rising use of observation care among the commercially insured may lead to total and out-of-pocket cost savings.
Health Aff 2017 Dec;36(12):2102-09. doi: 10.1377/hlthaff.2017.0774..
Keywords: Health Insurance, Healthcare Costs, Healthcare Delivery, Healthcare Utilization, Hospitalization, Hospitals, Medicare
Adrion ER, Ryan AM, Seltzer AC
Out-of-pocket spending for hospitalizations among nonelderly adults.
The researchers evaluated out-of-pocket spending associated with hospitalizations in order to assess how this spending varied over time and by patient characteristics, region, and type of insurance. They found that from 2009 to 2013, total cost sharing per inpatient hospitalization increased by 37 percent, from $738 in 2009 to $1013 in 2013 after adjusting for inflation and case-mix differences.
AHRQ-funded; HS000053.
Citation: Adrion ER, Ryan AM, Seltzer AC .
Out-of-pocket spending for hospitalizations among nonelderly adults.
JAMA Intern Med 2016 Sep;176(9):1325-32. doi: 10.1001/jamainternmed.2016.3663.
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Keywords: Hospitalization, Healthcare Costs, Health Insurance