Estimating Health Care Expenditure of Americans with Intellectual Disability Using National-Level Data

The rapidly increasing healthcare spending has been a concern for many Americans. Research has shown that people with intellectual disability (ID) have poorer health outcomes in a number of areas, many of which are linked to higher healthcare expenditure in the general population. Thus, it is of interest to study how much Americans with ID spend on healthcare and if the costs are covered by insurance. However, little is known in the current literature. One barrier deterring such research is the lack of reliable identification of individuals of ID in the Medical Expenditure Panel Survey (MEPS), the most comprehensive national data set for health care expenditure research. To resolve this barrier, this study employs reliable intellectual disability identification through linkages to the National Health Interview Survey (NHIS). A nationally representative sample of more than twenty-thousand individuals was used. A two-part cost analysis model was used to estimate the total expenditure conditional on having a positive spending amount. After controlling for age, sex, income, education, insurance status, geographical location, race, ethnicity, marital status, and smoking status, families of individuals with ID were estimated to spend significantly more than families of non-ID Americans.