Advertisement

Annual health care costs among Medicare Beneficiaries with essential tremor

  • Kandice A. Kapinos
    Correspondence
    Corresponding author. Department of Population & Data Sciences Department of Internal Medicine University of Texas Southwestern Medical Center 5323 Harry Hines Blvd., Dallas, TX, USA.
    Affiliations
    Peter J. O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA

    RAND Corporation, Arlington, VA, USA
    Search for articles by this author
  • Elan D. Louis
    Affiliations
    Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
    Search for articles by this author

      Highlights

      • There are no published data on the medical costs associated with ET care.
      • Understanding the associated medical costs will help policymakers and researchers.
      • We estimate the average direct medical expenditures attributable to ET.
      • ET beneficiaries have $1068 more annual expenditures relative to comparisons.
      • This aggregates to $1.5 billion to $5.4 billion in additional annual costs for ET.

      Abstract

      Introduction

      Essential tremor (ET) is one of the most common neurological disorders, affecting an estimated 2.2% of the entire US population. Despite its high prevalence and associated morbidity and mortality, there are no published data on the medical costs associated with ET care.

      Methods

      This is a retrospective secondary data analysis using the 5% Medicare claims data from 2016 to study age-eligible Medicare beneficiaries diagnosed with ET (diagnostic code G250) relative to a propensity score-matched group of comparison beneficiaries without ET (27,081 in each arm). Comparisons were matched within age strata and on the full set of Charlson comorbidity indicators, race, and sex. We examined encounter-level costs (amounts paid) and total annual costs of care (in constant $2021 dollars) adjusting for age, sex, race/ethnicity, provider specialty, setting, and the most common comorbidities, using a generalized linear model.

      Results

      The final sample included 54,162 total beneficiaries, with an average age of 75, 65% female and 94% Non-Hispanic White. On average, Medicare beneficiaries with at least one outpatient or physician office visit with an ET diagnosis have $1068 (95% CI: $981, $1154) in additional direct medical care expenditures per year relative to statistically similar comparison beneficiaries of the same age. Across the population, we predicted aggregated additional spending attributable to ET among Medicare beneficiaries between $1.5 billion and $5.4 billion per year.

      Conclusion

      The estimated direct medical costs among Medicare beneficiaries with an ET diagnosis aggregated to the population-level are non-trivial. These data begin to fill a gap in knowledge.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Parkinsonism & Related Disorders
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Louis E.D.
        • McCreary M.
        How common is essential tremor? Update on the worldwide prevalence of essential tremor.
        Tremor and other hyperkinetic movements (New York, NY). 2021; 11 (28): 28
        • Hoadley J.
        • Cubanski J.
        • Neuman T.
        Medicare Part D in 2016 and Trends over Time.
        2016
        • Agency for Healthcare Research Quality
        Using Appropriate Price Indices for Analyses of Health Care Expenditures or Income across Multiple Years.
        2017
      1. Centers for Medicare and Medicaid Services. Physician and Other Medical Provider Grouping and Patient Attribution Methodologies: Generating Medicare Physician Quality Performance Measurement Results (GEM) Project. In.

        • Charlson M.
        • Szatrowski T.P.
        • Peterson J.
        • Gold J.
        Validation of a combined comorbidity index.
        J. Clin. Epidemiol. 1994; 47: 1245-1251
        • Diaz N.L.
        • Louis E.D.
        Survey of medication usage patterns among essential tremor patients: movement disorder specialists vs. general neurologists.
        Park. Relat. Disord. 2010; 16: 604-607
        • Louis E.D.
        • Ottman R.
        How many people in the USA have essential tremor? Deriving a population estimate based on epidemiological data.
        Tremor and other hyperkinetic movements. 2014; 4
        • Song P.
        • Zhang Y.
        • Zha M.
        • et al.
        The global prevalence of essential tremor, with emphasis on age and sex: a meta-analysis.
        J Glob Health. 2021; 1104028
        • Handforth A.
        • Parker G.A.
        Conditions associated with essential tremor in veterans: a potential role for chronic stress.
        Tremor Other Hyperkinet Mov (N Y). 2018; 8: 517
        • Dai D.
        • Samiian A.
        • Fernandes J.
        • Coetzer H.
        Multiple comorbidities, psychiatric disorders, healthcare resource utilization and costs among adults with essential tremor: a retrospective observational study in a large US commercially insured and Medicare advantage population.
        Journal of Health Economics and Outcomes Research. 2022; 9: 37-46
        • Kowal S.L.
        • Dall T.M.
        • Chakrabarti R.
        • Storm M.V.
        • Jain A.
        The current and projected economic burden of Parkinson's disease in the United States.
        Mov. Disord. 2013; 28: 311-318
        • Gooch C.L.
        • Pracht E.
        • Borenstein A.R.
        The burden of neurological disease in the United States: a summary report and call to action.
        Ann. Neurol. 2017; 81: 479-484
        • Louis E.D.
        • Machado D.G.
        Tremor-related quality of life: a comparison of essential tremor vs. Parkinson's disease patients.
        Park. Relat. Disord. 2015; 21: 729-735
        • ProPublica. Prescriber Checkup
        The doctors and drugs in Medicare Part D.
        (Accessed)