Table 2.
Logistic regression of the probabilities of positive health-care insurer cost and positive OOP costs (per annum)
| Explanatory variables | Total OOP
|
Total insurer cost
|
||
|---|---|---|---|---|
| Odds ratio | P-value | Odds ratio | P-value | |
| Type of valvular disease | ||||
| No valve disease | Reference group | Reference group | ||
| Aortic valve disease, symptomatic* | – | – | ||
| Aortic valve disease, asymptomatic* | 3.14 | 0.1 | – | |
| Mitral valve disease, symptomatic | 3.12 | 0.13 | 3.68 | 0.03 |
| Mitral valve disease, asymptomatic | 6.81 | 0 | 2.19 | 0 |
| Medical conditions | ||||
| Malignant neoplasms | ||||
| Skin cancer | 2.43 | 0 | 4.14 | 0 |
| Colon cancer | 2.73 | 0.01 | 4.3 | 0 |
| Lung cancer | 1.28 | 0.42 | 12.74 | 0 |
| Bladder cancer* | – | 33.62 | 0 | |
| Rectal cancer | 0.84 | 0.8 | 0.61 | 0.49 |
| Diseases of the digestive system | ||||
| GERD | 3.71 | 0 | 3.91 | 0 |
| Gastritis | 2.76 | 0 | 1.83 | 0 |
| Gastric ulcer | 1.59 | 0 | 1.97 | 0 |
| Diverticulitis | 2.79 | 0 | 2.64 | 0 |
| Diseases of the genitourinary system | ||||
| Kidney stones | 2.7 | 0 | 2.36 | 0 |
| Cystitis | 4.21 | 0 | 2.34 | 0 |
| Mental disorders | ||||
| Depressive disorders | 1.53 | 0 | 1.44 | 0 |
| Neurotic disorders | 2.12 | 0 | 1.84 | 0 |
| Diseases of the circulatory system | ||||
| Coronary artery disease | 1.14 | 0.34 | 1.95 | 0 |
| Congestive heart failure | 6.93 | 0 | 3.53 | 0 |
| Acute myocardial infarction | 2.13 | 0 | 2.59 | 0 |
| Stroke | 4.31 | 0.01 | 8.73 | 0 |
| Cardiac dysrhythmia | 4.13 | 0 | 3.08 | 0 |
| Diseases of the musculoskeletal system and connective tissue | ||||
| Osteoarthritis | 1.5 | 0.03 | 1.27 | 0.07 |
| Low-back pain | 1.29 | 0 | 1.33 | 0 |
| Osteoporosis | 2.99 | 0 | 2.99 | 0 |
| Diseases of the nervous system | ||||
| Parkinson’s disease | 3.65 | 0 | 4.3 | 0 |
| Multiple sclerosis | 3.66 | 0 | 2.3 | 0.04 |
| Migraine headache | 1.56 | 0 | 1.46 | 0 |
| Diseases of the respiratory system | ||||
| Bronchitis | 1.6 | 0 | 1.39 | 0.01 |
| Emphysema | 1.06 | 0.7 | 1.69 | 0 |
| Asthma | 2.3 | 0 | 1.88 | 0 |
| Metabolic diseases | ||||
| Diabetes | 3.72 | 0 | 2.44 | 0 |
| High cholesterol | 3.03 | 0 | 3.03 | 0 |
| Hypothyroidism | 10.68 | 0 | 2.48 | 0 |
| Health status | ||||
| Physical health: fair or poor | Reference group | Reference group | ||
| Physical health: good | 0.77 | 0 | 0.77 | 0 |
| Physical health: very good or excellent | 0.66 | 0 | 0.66 | 0 |
| Mental health: fair or poor | Reference group | Reference group | ||
| Mental health: good | 1.01 | 0.89 | 0.92 | 0.05 |
| Mental health: very good or excellent | 1.08 | 0.05 | 1 | 0.94 |
| Race/ethnicity | ||||
| Caucasian | Reference group | Reference group | ||
| Hispanic | 0.72 | 0 | 0.83 | 0 |
| African-American | 0.67 | 0 | 0.93 | 0.01 |
| Asian | 0.67 | 0 | 0.63 | 0 |
| Other | 0.51 | 0 | 1.06 | 0.57 |
| Age, years | ||||
| 18–24 | Reference group | Reference group | ||
| 25–34 | 0.98 | 0.56 | 0.88 | 0 |
| 35–44 | 0.98 | 0.46 | 0.87 | 0 |
| 45–54 | 1.29 | 0 | 0.96 | 0.15 |
| 55–64 | 1.62 | 0 | 1.08 | 0.03 |
| 65–74 | 1.92 | 0 | 1.56 | 0 |
| 75+ | 2.2 | 0 | 2.55 | 0 |
| Sex, female | 2.06 | 0 | 1.76 | 0 |
| Marital status, married | 1.1 | 0 | 1.27 | 0 |
| Education | ||||
| No high school | Reference group | Reference group | ||
| High school | 1.2 | 0 | 1.14 | 0 |
| Some college | 1.94 | 0 | 1.68 | 0 |
| College or advanced | 1.77 | 0 | 1.66 | 0 |
| Income/employment status | ||||
| Family income <100% FPL | Reference group | Reference group | ||
| Family income 100%–199% FPL | 0.7 | 0 | 0.84 | 0 |
| Family income ≥200% FPL | 0.78 | 0 | 0.78 | 0 |
| Unemployed | 1.01 | 0.58 | 1.17 | 0 |
| Health insurance | ||||
| Private non-HMO insurance | Reference group | Reference group | ||
| Uninsured | 0.45 | 0 | 0.08 | 0 |
| Medicaid | 0.37 | 0 | 1.43 | 0 |
| Medicare | 1.14 | 0.01 | 0.68 | 0 |
| Other public health insurance | 1.58 | 0 | 0.77 | 0.01 |
| Private HMO insurance | 1.02 | 0.37 | 0.88 | 0 |
| Access to usual source of health care | 2.52 | 0 | 2.75 | 0 |
| Interviewed in English | 1.05 | 0.18 | 1.13 | 0 |
| Location, urban | 0.94 | 0.02 | 1.11 | 0 |
| US census regions | ||||
| Northeast | Reference group | Reference group | ||
| Midwest | 1.01 | 0.71 | 0.9 | 0 |
| South | 1.12 | 0 | 0.84 | 0 |
| West | 0.89 | 0 | 0.87 | 0 |
| Year | ||||
| 1996 | Reference group | Reference group | ||
| 2011 | 0.89 | 0.02 | 1.41 | 0 |
| 2010 | 0.81 | 0 | 1.51 | 0 |
| 2009 | 0.85 | 0 | 1.49 | 0 |
| 2008 | 0.94 | 0.22 | 1.49 | 0 |
| 2007 | 1.01 | 0.79 | 1.44 | 0 |
| 2006 | 1.02 | 0.72 | 1.3 | 0 |
| 2005 | 1.08 | 0.15 | 1.36 | 0 |
| 2004 | 0.99 | 0.84 | 1.32 | 0 |
| 2003 | 1.13 | 0.01 | 1.37 | 0 |
| 2002 | 1.13 | 0.01 | 1.39 | 0 |
| 2001 | 1.21 | 0 | 1.34 | 0 |
| 2000 | 1.21 | 0 | 1.30 | 0 |
| 1999 | 1.18 | 0 | 1.35 | 0 |
| 1998 | 1.06 | 0.3 | 1.13 | 0.02 |
| 1997 | 1.07 | 0.35 | 1.08 | 0.20 |
| Intercept term | 2.75 | 0 | 2.08 | 0 |
Notes:
*
Symptomatic aortic valve disease and bladder cancer had perfect correlation with OOP expenditure, and were dropped from the analysis. Similarly, symptomatic and asymptomatic aortic valve disease had perfect correlation with insurer expenditure, and so were excluded from the insurer expenditure regression.
Abbreviations: FPL, Federal Poverty Level; HMO, health maintenance organization; GERD, gastroesophageal reflux disease; OOP, out of pocket.