Evidence map›Paper›PMID 38267358›Full record

ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2024

Health Care Spending, Use, and Financial Hardship Among Traditional Medicare and Medicare Advantage Enrollees With Mental Health Symptoms.

Sungchul Park, David J Meyers, Daniel Enrique Jimenez, Nattalie Gualdrón, Benjamin Le Cook

Abstract read
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In one paragraph

Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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  3. Observational
  4. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Sungchul ParkDepartment of Health Policy and Management (SP), College of Health Science, Korea University, Seoul, Republic of Korea; BK21 FOUR R&E Center for Learning Health Systems (SP), Korea University, Seoul, Republic of Korea. Electronic address: sungchul_park@korea.ac.kr.
David J MeyersDepartment of Health Services, Policy, and Practice (DJM), School of Public Health, Brown University, Providence, RI, USA.
Daniel Enrique JimenezDepartment of Psychiatry and Behavioral Sciences (DEJ), Miller School of Medicine, University of Miami, Coral Gables, FL, USA.
Nattalie GualdrónHealth Equity Research Lab (NG, BLC), Cambridge Health Alliance, Cambridge, MA, USA; Department of Community Health (NG), School of Arts and Sciences, Tufts University, Medford, MA, USA.
Benjamin Le CookHealth Equity Research Lab (NG, BLC), Cambridge Health Alliance, Cambridge, MA, USA; Center for Health Equity (BLC), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Psychiatry (BLC), Harvard Medical School, Cambridge, MA, USA.

Funding

Health Promotion in the Prevention of Anxiety and Depression: The Happy Older Latinos are Active (HOLA Study)R01MD012610 · NIMHD · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI JIMENEZ, DANIEL ENRIQUE · 2019 to 2023
$3.5M
Medicaid Value Based Payment Models and Healthcare Equity for Adults with Serious Mental IllnessesR01MH122199 · NIMH · CAMBRIDGE HEALTH ALLIANCE · PI COOK, BENJAMIN LE, HORVITZ-LENNON, MARCELA V · 2020 to 2023
$2.9M
NIMHD NIH HHS R01 MD012610NIMH NIH HHS R01 MH122199
6 · The paper itself

Abstract

objectiveWe examined the differences in health care spending and utilization, and financial hardship between Traditional Medicare (TM) and Medicare Advantage (MA) enrollees with mental health symptoms.

designCross-sectional study.

participantsWe identified Medicare beneficiaries with mental health symptoms using the Patient Health Questionnaire-2 and the Kessler-6 Psychological Distress Scale in the 2015-2021 Medical Expenditure Panel Survey. MEASUREMENTS: Outcomes included health care spending and utilization (both general and mental health services), and financial hardship. The primary independent variable was MA enrollment.

resultsMA enrollees with mental health symptoms were 2.3 percentage points (95% CI: -3.4, -1.2; relative difference: 16.1%) less likely to have specialty mental health visits than TM enrollees with mental health symptoms. There were no significant differences in total health care spending, but annual out-of-pocket spending was $292 (95% CI: 152-432; 18.2%) higher among MA enrollees with mental health symptoms than TM enrollees with mental health symptoms. Additionally, MA enrollees with mental health symptoms were 5.0 (95% CI: 2.9-7.2; 22.3%) and 2.5 percentage points (95% CI: 0.8-4.2; 20.9%) more likely to have difficulty paying medical bills over time and to experience high financial burden than TM enrollees with mental health symptoms.

conclusionOur findings suggest that MA enrollees with mental health symptoms were more likely to experience limited access to mental health services and high financial hardship compared to TM enrollees with mental health symptoms. There is a need to develop policies aimed at improving access to mental health services while reducing financial burden for MA enrollees.

Indexed as

Financial StressHealth ExpendituresMedicareMedicare Part CAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMental DisordersMental Health ServicesPatient Acceptance of Health CareUnited Statesfinancial hardshiphealth care spendingMedicare Advantagemental healthmental health services utilizationtraditional Medicare

Identifiers

PMID38267358
PMCPMC12854063

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.