Background
Methods
Study population
CCS diagnosis categories | ICD-9-CM diagnosis codes | Definition |
---|---|---|
aChronic Kidney Disease (CKD) | ||
158 | 585, 5853, 5854, 5855, 5856, 5859 | CKD |
Cancer | ||
14 | 1530 1531 1532 1533 1534 1535 1536 1537 1538 1539 1590 2303 V1005 | Colon Cancer |
24 | 1740 1741 1742 1743 1744 1745 1746 1748 1749 1750 1759 2330 V103 | Breast Cancer |
19 | 1622 1623 1624 1625 1628 1629 2312 V1011 | Lung Cancer |
Stroke | ||
109 | 430 431 4320 4321 4329 43301 43311 43321 43331 43381 43391 4340 43400 43401 4341 43410 43411 4349 43490 43491 436 | Acute cerebrovascular disease |
112 | 4350 4351 4352 4353 4358 4359 | Transient cerebral ischemia |
Healthcare expenditures
Covariates
Statistical analysis
Results
Chronic Kidney Disease (CKD)a
| Cancerb
| Stroke | No CKD, cancer or strokec
| |
---|---|---|---|---|
Study sample, n = 74,267 | 52 | 870 | 1104 | 72,241 |
Study population estimate over 3 year period, N = 940,337,592 | 607,506 | 9,206,890 | 10,520,699 | 650,226,082 |
Age (years) | 65.5 | 66.1 | 68.2 | 47.8 |
Race | ||||
Non-Hispanic White (%) | 79.7 | 79.0 | 73.0 | 66.4 |
Non-Hispanic Black (%) | 11.6 | 10.0 | 15.2 | 11.2 |
Hispanic (%) | 7.4 | 8.0 | 7.8 | 14.8 |
Other (%) | 1.3 | 3.0 | 4.0 | 7.6 |
Male (%) | 48.7 | 15.8 | 49.1 | 48.5 |
BMI [kg/m (squared)] | 28.3 | 26.7 | 26.9 | 27.1 |
Poverty Statusd
| ||||
Poor (%) | 9.3 | 10.9 | 19.5 | 12.1 |
Near Poor (%) | 2.6 | 7.0 | 7.3 | 4.4 |
Low Income (%) | 17.2 | 15.4 | 19.0 | 13.6 |
Middle Income (%) | 32.8 | 30.6 | 30.4 | 30.3 |
High Income (%) | 38.1 | 36.1 | 23.8 | 39.7 |
Health Insurance | ||||
Public (%) | 26.8 | 32.9 | 46.5 | 17.0 |
Private (%) | 65.2 | 65.1 | 50.3 | 67.7 |
None (%) | 8.1 | 2.0 | 3.2 | 15.4 |
Perceived Physical Health | ||||
Excellent (%) | 6.0 | 13.0 | 4.2 | 24.7 |
Very Good (%) | 12.8 | 26.7 | 20.8 | 34.1 |
Good (%) | 33.0 | 29.0 | 29.3 | 28.3 |
Fair (%) | 35.3 | 16.8 | 25.6 | 9.6 |
Poor (%) | 10.3 | 11.7 | 17.6 | 2.9 |
Comorbidity | CKDa
| Cancerb
| Stroke | No CKD, cancer or strokec
|
---|---|---|---|---|
Angina (%) | 10.3 | 5.9 | 12.6 | 2.3 |
Arthritis (%) | 63.7 | 55.2 | 61.2 | 25.8 |
Asthma (%) | 11.8 | 14.7 | 11.8 | 9.3 |
Coronary Heart Disease (%) | 20.8 | 12.7 | 26.6 | 5.3 |
High Cholesterol (%) | 85.0 | 56.2 | 66.8 | 31.5 |
Diabetes (%) | 49.6 | 19.3 | 31.2 | 9.3 |
Emphysema (%) | 1.2 | 10.7 | 7.8 | 2.0 |
High Blood Pressure (%) | 87.8 | 60.9 | 78.2 | 33.8 |
Heart Attack (%) | 4.9 | 8.9 | 22.6 | 3.5 |
Other Heart Disease (%) | 41.5 | 24.3 | 34.4 | 10.7 |
Total direct expenditures ($) | Out-of-pocket expenditures ($) | |
---|---|---|
Median (IQR) | Median (IQR) | |
CKDa
| 12,877 (5031 – 19,710) | 1439 (688 – 2732) |
Cancerb
| 7428 (3460 – 18,323) | 770 (349– 1703) |
Stroke | 8150 (3966– 19,375) | 748 (242 – 1599) |
Population without CKD, cancer or strokec
| $1189 (196 – 4388) | 226 (20 – 764) |
dDifferences in total direct healthcare expenditures ($) |
dDifferences in out-of-pocket expenditures ($) | |||||
---|---|---|---|---|---|---|
No CKD, cancer or strokec
| Referent | 95% CI |
P-value
| Referent | 95% CI |
P-value
|
CKDa
| $4746 | $1775–$7718 | 0.002 | $760 | 0–1745 | 0.130 |
Cancerb
| $8608 | $6167–$11,049 | <0.001 | $419 | $158–$679 | 0.002 |
Stroke | $5992 | $4208–$7775 | <0.001 | $246 | $87–$406 | 0.002 |