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STATISTICAL BRIEF #146:
Proportion and Medical Expenditures of Adults Being Treated for Diabetes, 1996 and 2003

October 2006

Gary Olin, PhD

Highlights

Between 1996 and 2003, the proportion of adults with at least one medical event for the treatment of diabetes increased from 7.0 percent to 9.0 percent in the 45 to 64 age group and from 13.1 percent to 15.8 percent in the 65 or older age group.
Between 1996 and 2003, the average constant dollar expenditure on all types of prescription medicines by adults with at least one medical event for the treatment for diabetes increased 87.3 percent in the 18 to 44 age group, 114.9 percent in the 45 to 64 age group, and 61.4 percent in the 65 or older age group. The average constant dollar expenditure for all types of office-based medical provider care increased 46.3 percent in the 45 to 64 age group and 45.2 percent in the age 65 or older age group.
The average constant dollar expenditure for prescription medicines to treat diabetes increased in all age groups between 1996 and 2003--70.7 percent in the 18 to 44 age group, 99.6 percent in the 45 to 64 age group, and 74.2 percent in the 65 or older age group. In addition, the average constant dollar expenditure for hospital and physician care and prescription medicines to treat diabetes increased 73.0 percent in the 65 or older age group.

Introduction

Using data from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC), this Statistical Brief provides estimates on the changes between 1996 and 2003 in the proportion and medical expenditures of adults in the U.S. civilian noninstitutionalized population who had at least one medical event for the treatment of diabetes. The 1996 expenditures have been inflated to 2003 dollars for comparisons of the average quantity of health care services delivered to adults being treated for diabetes during these years. Only differences between estimates for the selected years that are statistically significant at the 0.05 level are discussed in the text.

Findings

Distribution and expenditure shares of diabetic adults
Table 1 shows the percentage of adults in the U.S. civilian noninstitutionalized population with at least one medical event for the treatment of diabetes and its share of medical expenditures by all adults in the years 1996 and 2003. Between 1996 and 2003, the proportion of adults who were treated for diabetes increased 1.3 percentage points (from 5.0 percent to 6.3 percent of all adults). The increase reflects change between the two years in the proportion of adults receiving treatment for diabetes in the 45 to 64 age group (from 7.0 percent to 9.0 percent) and the 65 or older age group (from 13.1 percent to 15.8 percent). During this period, no significant change was noted in the share of total expenditures attributable to adults being treated for diabetes. Undiagnosed and untreated cases of diabetes are not reflected in these estimates.

Medical expenditures of adults receiving care for diabetes
Table 2 shows 1996 and 2003 average expenditures (in constant 2003 dollars) for selected types of care among adults who had at least one medical event for the treatment of diabetes. The constant dollar estimates of per capita expenditures on health care capture change in the average quantity of services delivered to diabetics for the treatment of diabetes, comorbidities of diabetes, and unrelated conditions. Between the years 1996 and 2003, the average constant dollar expenditure on prescription medicines for all types of medical problems increased 87.3 percent for adults age 18 to 44, 114.9 percent for adults age 45 to 64, and 61.4 percent for adults age 65 or older. The average constant dollar expenditure for problems treated by office-based medical providers increased 46.3 percent for adults age 45 to 64 and 45.2 percent for adults age 65 or older.

Medical expenditures for diabetes
Table 3 shows 1996 and 2003 average expenditures (in constant 2003 dollars) of adults being treated for diabetes when the care was restricted to events where diabetes was identified as the reason or one of the reasons for the care. The average constant dollar expenditure for prescription medicines to treat diabetes increased 70.7 percent in the 18 to 44 age group, 99.6 percent in the 45 to 64 age group, and 74.2 percent in the 65 or older age group between 1996 and 2003. In addition, the average constant dollar expenditure for hospital and physician care and prescription medicines to treat diabetes increased 73.0 percent in the 65 or older age group.

Data Source

This Statistical Brief uses data from the 1996 and 2003 Full Year Consolidated Data Files (HC-012 and HC-079) and the 1996 and 2003 event files for prescription medicines (HC-010A and HC-077A), inpatient hospital stays (HC-010D and HC-077D), emergency room visits (HC-010E and HC-077E), outpatient department visits (HC-010F and HC-077F), and office-based medical provider visits (HC-010G and HC-077G). These files are available on the MEPS Web site at http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files.jsp.

Definitions/Methodologies

Population
The estimates provided in this Statistical Brief are for adults age 18 or older who lived in the community for all or part of the year. Anyone who reported having a medical event--hospital stay, outpatient department visit, emergency room visit, office visit, or prescription medicine purchase--for the treatment of diabetes mellitus (ICD-9 code 250) in 1996 or 2003 was counted as being treated for diabetes. Persons in the military and those residing in nursing homes or other institutions for the entire year are not included in the comparisons.

Age
Age is that of the sample person as of December 31st of the reported year.

Expenditures
The MEPS includes expenditures for eight types of medical events: hospital stays, emergency room visits, outpatient department visits, office-based medical provider visits, dental visits, home health care, other medical expenses, and prescription medicines. Expenditures for these events include all direct payments by individuals, private insurance (including TRICARE), Medicare, Medicaid, and other sources such as the Veterans' Administration, Workers' Compensation, and miscellaneous public sources to providers of the services.

The 1996 per capita expenditures for all medical events were inflated to 2003 dollars using the Personal Health Care Expenditure (PHCE) price index published by the National Health Accounts, Office of the Actuary, Centers for Medicare and Medicaid Services (http://www.cms.hhs.gov/NationalHealthExpendData/downloads/nhestatespecific2004.pdf). The 1996 per capita expenditures for selected categories of medical events (such as hospital care, office-based medical provider care, and prescription medicines) were inflated to 2003 dollars using the corresponding components of the PHCE price index.

About MEPS-HC

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or visit the MEPS Web site at http://www.meps.ahrq.gov/.

References

For a detailed description of the MEPS survey design, sample design, and methods used to minimize sources of nonsampling error, see the following publications:

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and Research, 1997.

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and Research, 1997.

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, July 2003: 41(7) Supplement: III-5-III-12.

Suggested Citation

Olin, G. Proportion and Medical Expenditures of Adults Being Treated for Diabetes, 1996 and 2003. Statistical Brief #146. October 2006. Agency for Healthcare Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st146/stat146.shtml

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AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. Please e-mail us at mepspd@ahrq.gov or send a letter to the address below:

Steven B. Cohen, PhD, Director
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850

	Adults receiving care for diabetes
Table 1. Percentage of U.S. civilian noninstitutionalized adults being treated for diabetes and its share of medical expenditures by all adults, by age group, 1996 and 2003
	Percent of population		Percent of total expenditures
Age group	1996	2003	1996	2003
All adults	5.0	6.3	14.8	17.0
18 to 44	1.5	1.5	3.5	4.5
45 to 64	7.0	9.0	16.6	19.4
65 and older	13.1	15.8	22.7	24.4
Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 1996 and 2003

Age and type of expenditure	Average expenditure (in 2003 dollars)		Percent change
Table 2. Average constant dollar expenditures of adults in the U.S. civilian noninstitutionalized population with at least one medical event for diabetes, by age group and type of expenditure, 1996 and 2003
	1996	2003	1996 to 2003
All adults - All medical care¹	8942	10092	12.9
All adults - All hospital care²	4910	4804	(2.2)
All adults - All office care³	1027	1506	46.6
All adults - All prescription medicines⁴	1508	2798	85.5
18-44 years old - All medical care¹	3990	6128	53.6
18-44 years old - All hospital care²	1876	2507	33.6
18-44 years old - All office care³	806	1171	45.3
18-44 years old - All prescription medicines⁴	1120	2098	87.3
45-64 years old - All medical care¹	8122	9169	12.9
45-64 years old - All hospital care²	5036	4165	(17.3)
45-64 years old - All office care³	1017	1488	46.3
45-64 years old - All prescription medicines⁴	1355	2912	114.9
65 or older - All medical care¹	11486	12238	6.6
65 or older - All hospital care²	5934	6160	3.8
65 or older - All office care³	1118	1623	45.2
65 or older - All prescription medicines⁴	1782	2876	61.4
¹Expenditures are for all types of care. ²Expenditures are for all inpatient, outpatient, and emergency room care. ³Expenditures are for all office-based medical provider care. ⁴Expenditures are for all prescription medicine purchases. ( ) indicates a negative change Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 1996 and 2003

Age and type of expenditure	Average expenditure (in 2003 dollars)		Percent change
Table 3. Average constant dollar expenditures of adults in the U.S. civilian noninstitutionalized population for the treatment of diabetes, by age group and type of expenditure, 1996 and 2003
	1996	2003	1996 to 2003
All adults - All diabetes care¹	1299	1714	32.0
All adults - Prescription medicines²	476	883	85.5
18-44 years old - All diabetes care¹	1155	1525	32.0
18-44 years old - Prescription medicines²	533	910	70.7
45-64 years old - All diabetes care¹	1568	1552	(1.0)
45-64 years old - Prescription medicines²	488	974	99.6
65 or older - All diabetes care¹	1124	1945	73.0
65 or older - Prescription medicines²	445	775	74.2
¹Expenditures are for all hospital and office-based medical provider events and prescription medicines to treat diabetes. ²Expenditures are for all prescription medicines to treat diabetes. ( ) indicates a negative change Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 1996 and 2003

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STATISTICAL BRIEF #146: Proportion and Medical Expenditures of Adults Being Treated for Diabetes, 1996 and 2003