The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64448

Michelle Kennedy, BA¹, Ayse Akincigil, MA², Stephen Crystal, PhD², and Usha Sambamoorthi, PhD². (1) Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, 30 College Avenue, New Brunswick, NJ 08901, 732-932-0366, mvmcgr@rci.rutgers.edu, (2) Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Avenue, New Brunswick, NJ 08901

Objectives: Present the determinants of out of pocket prescription drug expenditures (OOP-PD) and OOP-PD burden among Medicare beneficiaries aged 65 or older, who reported any mental illness.Design: Nationally representative data from the 1996 Medical Expenditure Panel Survey.Main Outcome Variables: Total and out of pocket prescription drug expenditures(OOP-PD and OOP-PD burden. High OOP-PD burden was defined as spending more than 10% of personal income on prescription drugs. Mental illness was based on reports by the household respondent. Results: Overall, 4.1 million elderly (13.7%) reported some type of mental illness. On average, elderly with mental illness spent 70% ($579 vs. $340) more than those without mental illness. The mean and median total and OOP-PD expenditures were higher among those with mental illness than those without mental illness across all subgroups of the elderly. Controlling for other characteristics those with mental illness were about twice as likely to have high burden compared to those without mental illness. Separate logistic regression by mental illness revealed that elderly with mental illness who are dually eligible Medicare/Medicaid are less likely to have high burden. This was not the case with those who did not report any mental illness. Conclusions: The elderly with a mental illness are particularly vulnerable to overall higher OOP-PD expenditures and burden. The predictors of burden were substantially different between the two groups. Policy Implications: Providing prescription coverage through expansion of Medicaid eligibility may help reduce financial burden among the elderly with mental illness.

Learning Objectives:

At the end of the session, participants will be able to
• profile the socioeconomic, clinical, other attributes of elderly with mental illness.
• learn of the magnitude of OOP-PD burden among the elderly with mental illness.
• understand the difference in financial burden between those with and without a self-reported mental illness.

Keywords: Cost Issues, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.