Health affairs
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We use a regression framework and nationally representative data to compute aggregate overweight- and obesity-attributable medical spending for the United States and for select payers. Combined, such expenditures accounted for 9.1 percent of total annual U. S. medical expenditures in 1998 and may have been as high as dollar 78.5 billion (dollar 92.6 billion in 2002 dollars). Medicare and Medicaid finance approximately half of these costs.
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This paper explores the extent to which community health centers (CHCs) are able to manage their uninsured patient caseloads. We found that CHCs can provide primary care, medications, and medical supplies to most of their uninsured patients on site but are limited in their ability to provide diagnostic, specialty, and behavioral health services. Uninsured patients often fail to receive additional services for which they are referred, and it is much more difficult for CHC physicians to arrange specialty or nonemergency hospital care for their uninsured patients than for their insured patients.
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This study uses a nationally representative survey to identify the most expensive conditions in the United States and to examine the association between spending and disability. The most expensive conditions at a population level were ischemic heart disease and motor vehicle accidents; at the per capita level they were respiratory malignancies. There was not a significant association between rank order of treatment costs and disability; the conditions with the greatest disability relative to expenditures were mood disorders, chronic obstructive pulmonary disease, and arthropathies. We use the findings to discuss the role for cost-of-illness and burden-of-disease estimates in setting priorities.
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Despite a growing consensus that serious quality problems afflict U. S. health care, state and federal governments have done little to improve the quality of care. ⋯ We propose legislative requirements that any new expenditure of federal funds for health benefits be accompanied by public disclosure of performance information regarding quality, effectiveness, and safety. Such disclosure could yield diverse public and institutional benefits.