SEARCH · PubMed Health

Results for “Expenditures”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed1978

Expenditures for health care of children and youth in the United States.

This paper describes the expenditures for health care in the United States in fiscal year 1975. Proportionately, health expenditures for children and youth are lower than for other age groups. The average per capita expenditure for children and youth was $212.00. For children and youth public health care expenditures represented 24 per cent of the total; from public funds, Medicaid and the Department of Defense were the largest two programs; from the public sector, the federal government provided two thirds of the total health expenditures. For children and youth, two thirds of all health expenditures were for hospital care and physicians' services.

Adolescent↗

PubMed2025

BRCA genetic testing utilization and expenditures among privately insured adults in the United States, 2013 to 2022.

PURPOSE: Recent clinical guidelines have broadened the criteria for BRCA counseling and testing for women and men, including indications based on family history, personal history, and current diagnosis of breast, ovarian, pancreatic, and prostate cancer. METHODS: Using claims data from 2013 to 2022, we identified BRCA testing using procedure codes to evaluate annual utilization, median expenditures per enrollee, and the percentage of 0 out-of-pocket expenditures by sex among enrollees aged 18 to 64 years who were continuously enrolled within calendar years. We examined BRCA utilization by metropolitan status and indications. RESULTS: Annual BRCA testing utilization among women (and men) increased 10.2% (44.5%) per year during 2014 to 2015 and 1.7% (10.0%) per year during 2016 to 2019, decreased 34.4% (44.8%) in 2020, and rebounded 8.5% (22.3%) per year during 2021 to 2022, remaining below prepandemic levels in 2022. Median expenditures for comprehensive BRCA testing per enrollee decreased by 68% from 2013 to 2022, most of whom had 0 out-of-pocket expenditures. Most BRCA testing was done based on family health history of breast, ovarian, or prostate cancer and among women aged 18 to 50 years. CONCLUSION: Health care providers who are knowledgeable about evolving indications for germline BRCA testing can help ensure that eligible individuals have access to germline BRCA testing as preventive service.

Humans↗

PubMed1979

Racial differences in medical care expenditures.

Out of pocket medical expenditures made by families for physician services, dental visits, medications, hospitalizations and insurance premiums are examined in a southern rural community using household survey interview data. White families paid an average out of pocket amount for total medical services of $709 as compared with $383 for black families over a 12-month period, 1974-75. Correlates of expenditure differences between blacks and whites are explored with respect to family characteristics (race, education of household head, family income, family size and family composition), illness levels (number of family members with perceived fair or poor health status and number of family members reporting chronic conditions), and use of services (number of doctor visits and type of usual source of care). We find that whites consistently report greater expenditures than blacks, regardless of the variables controlled for. We consider that expenditure differences are in part due to a mix of three factors: variations in the cost of doctor visits to whites and blacks; a lower level of use of services by blacks; and the differential availability and use of third party payors.

Black or African American↗

PubMed1977

Social welfare expenditures, fiscal year 1976.

In 1976, for the second fiscal year in a row, public expenditures for social welfare purposes expanded at an abnormally high rate. Even after adjusting the 16-percent increase in aggregate expenditures for price and population changes, the 8-percent real growth rate proves to be the highest since 1971. The $45 billion rise in social welfare expenditures to a total of $331 billion reflects the effects of both recession and inflation. Benefits for the needy and the unemployed continued to expand at the same time that higher prices triggered cost-of-living adjustments in cash benefit programs and helped swell the cost of furnishing other social welfare services. A further reflection of this growth is the rise in the proportion of the Nation's gross national product devoted to social welfare expenditures from 19.7 percent in 1975 to 20.6 percent in 1976. The latter proportion becomes 27.5 percent when private social welfare spending is included.

Financing, Government↗

PubMed1979

Social welfare expenditures under public programs, fiscal year 1977.

Social welfare expenditures under public programs reached $362.3 billion in fiscal year 1977, which covered the 12-month period from October 1, 1976, to September 30, 1977. This figure was about $30 billion higher than the $331.9 billion spent in fiscal year 1976 (July 1, 1975, through June 30, 1976) and represented a 9-percent increase. When adjusted for price and population changes, real per capita expenditures rose from $1,623 in fiscal year 1976 to $1,646 in 1977, reflecting a 1-percent real increase in per capita spending under these programs. Social welfare expenditures as a proportion of the Nation's gross national product dropped slightly from 20.4 percent in fiscal year 1976 to 19.7 percent in 1977. The decline resulted from lower rates of growth during 1977 in most of the major social welfare categories and a higher rate of growth in the gross national product.

Financing, Government↗

PubMed1979

Comparing the medical utilization and expenditures of low income health plan enrollees with Medicaid recipients and with low income enrollees having Medicaid eligibility.

The study examines the medical care (hospital, physician, drug, diagnostic) utilization and expenditures of low income persons enrolled in a prepaid health plan with a matched group of Medicaid recipients. The study also examines the medical care utilization of low income persons enrolled in a prepaid health plan with a similar group of low income persons enrolled in the health plan but also eligible for Medicaid benefits. Utilization and population-at-risk data were obtained from the Kaiser-Permanente Medical Care Program of Portland, Oregon and from the State of Oregon Welfare Division. A hypothesis of lower hospital utilization by low income enrollees compared with Medicaid recipients was accepted. A hypothesis of higher ambulatory care utilization was accepted for diagnostic procedures and prescription use, but rejected for office visit utilization. An analysis of the findings appeared to implicate the Medicaid program for differences observed. The hypotheses of no significant differences in inpatient and ambulatory medical care utilization of low income health plan enrollees with and without Medicaid eligibility were generally rejected. Low income enrollees with concurrent Medicaid had consistently higher utilization rates for all services resulting in substantially higher medical care expenditures per person. The findings appear to contribute some useful information to planning or establishing policy for Medicaid Prepayment programs or other programs enrolling low income persons in prepaid health plans or HMOs.

Adolescent↗

PubMed1979

Health expenditure under multiple-priority pressures. A case study of Israel.

Since Israel's inception, it has faced many problems that have a high priority in the national consciousness. Problems of defense and national security are outstanding among these, and problems such as absorption of immigrants, education, land reclamation and water supply are next. This creates heavy pressure on scarce resources, and is reflected in the share of specific items in Government and national expenditures. An analysis of developments since the early 1950s shows how health expenditure has been given a high priority in the evaluation of the nation's needs on one hand, and has been influenced by defense needs and other pressing requests on the other hand. It may be concluded that health receives a fair share of the nation's resources, but, in view of the strained economic situation in the country, careful planning for future health services in coordination, cooperation and integration with other welfare services is essential.

Budgets↗

PubMed1979

Perinatal care and cost effectiveness: changes in health expenditures and birth outcome following the establishment of a nurse-midwife program.

Estimates of infant health status and expenditures for perinatal care are presented for periods of time before and after implementation of a nurse-midwife program in rural Georgia. As the program developed, the infant mortality rate of the four counties served by the program showed a decrease. Similarly, the target population (pregnant women of low to moderate income who had no private physician) experienced decreases in the rate of neonatal mortality, low birthweight, and short gestational age. Estimated expenditures for perinatal care in the four counties decreased as well. These results are examined from the perspective of the National Health Planning and Resources Development Act of 1974 and the utility of using an epidemiologic approach for estimating the output of health services in terms of health status is emphasized.

Cost-Benefit Analysis↗

PubMed1976

Rates and correlates of expenditure increases for personal health services: pre- and post-medicare and medicaid.

This investigation of the increases in expenditures for medical care of the noninstitutionalized population of the United States in two recent periods suggests the following: Price increases contributed substantially more to overall expenditure increases in both periods than did use increases. Hospital price increases contributed most to overall price increases in both periods. Drug use in the first period and hospital use in the second period contributed most to overall use increases. The so-called "free services" made a substantial contribution to increases in use between 1963 and 1970, while apparently making no contribution in the earlier period. In the pre-Medicare/Medicaid period, use increase were greatest among the working-age and male population. However, increases in use also seemed to be relatively high among the low-income group. In the most recent period, use increases shifted not only to the elderly and the very young, but also to the group 55-64. The relatively high rate of use increase for males and the low-income group continued. These findings, then, suggest that institution of the Medicare and Medicaid programs was accompanied by acceleration of some trends that were already taking place, i.e., relatively high rates of increase in the use of health services for the low-income population and the aged. Some groups not considered to be target populations for the programs, such as those 35-54, showed a reduction in their use rates; others those 55-64, increased their use. Finally, the non-white population showed no greater rate of increase in use of health services than the white population, even though the former would presumably be considered a target group.

Adolescent↗

PubMed1977

National health expenditures, fiscal year 1976.

The Nation's spending for health in fiscal year 1976 reached $139.3 billion, or $638 per person, according to preliminary figures. This total was 14 percent higher than the $122.2 billion spent for health in 1975. In the 2 years since price controls on the health industry were lifted, expenditures have risen $33.0 billion (31 percent). During this period, the economy has grown at a relatively slow pace with the gross national product increasing 18 percent. Thus, the percentage of the GNP attributed to health care reached 8.6 percent in 1976. Public and private spending rose 16 percent and 13 percent, respectively, in 1976, with the rise in public expenditures appreciably below the 22-percent increase of 1975. Third-party financing affected slightly more than two-thirds of all personal health care--the private insurance share at 26 percent and that of government 40 percent.

Education, Medical↗

PubMedDate not supplied

Financial expenditures for the care of cerebrovascular disease patients in an urban setting.

A study was undertaken to determine the magnitude of the charges and costs and the sources of reimbursements for the care of cerebrovascular disease (CVD) patients in an urban setting, Orleans Parish (County), Louisiana, in 1971. The study helps to put national data on the cost-burden of cerebrovascular disease into perspective at the community level. It is thought that such data may prove useful in planning and evaluation of intervention programs and more coordinated approaches to care. All hospitals, nursing homes, extended care facilities, and noninstitutional sources of care (home health and rehabilitation agencies) that were identified as providing services to CVD patients were invited to participate in the study, and a sample of such cases was selected from each participating facility. The billing records for these cases were then reviewed and analyzed to determine charges by category of service and sources of reimbursement. At government institutions, per diem rates were used to determine costs. Total charges for care of the CVD patients amounted to $6,070,000. Hospital care generated the major charge, amounting to $5,159,000 (85 percent of the total charges) during the study year. Nursing home care charges totaled $391,000 (6.5 percent), extended care services $373,000 (6.1 percent), and home health care and noninstitutional rehabilitation services $147,000 (2.4 percent). Analysis of the data according to type of service revealed that only a small percentage of the care dollar was spent for rehabilitation services. The greatest amounts were spent for room and board in institutional facilities and for drugs, diagnostic services, and miscellaneous other services in hospitals. Average expenditures per CVD case for rehabilitation services in institutions were highest in extended care facilities, being much lower in hospitals and negligible in nursing homes. Average expenditures for care by noninstitutional health service agencies were highest for home aide services, followed by nursing and rehabilitation services.

Cerebrovascular Disorders↗

PubMed2026

Deletion of neurosecretory proteins GL and GM drives dual anti-obesity effects via appetite suppression and enhanced energy expenditure.

Obesity results from an imbalance between energy intake and expenditure and is regulated by hypothalamic neuropeptide systems. The neurosecretory proteins GL (NPGL) and GM (NPGM) are expressed in the hypothalamus and promote feeding in gain-of-function studies; however, their endogenous physiological roles remain unclear. Here, we show that mice lacking both NPGL and NPGM display a lean phenotype driven by reduced food intake and increased energy expenditure. This anti-obesity phenotype is associated with increased expression of anorexigenic pro-opiomelanocortin in the hypothalamus and enhanced thermogenic activity in brown adipose tissue, marked by elevated uncoupling protein 1. Consistent with these findings, suppression of NPGL/NPGM signaling reduces feeding and alters sympathetic nerve activity. In addition, genome-wide association analysis identifies an obesity-associated variant near the human NPGM locus, suggesting relevance to human energy balance. Together, these findings identify NPGL and NPGM as endogenous regulators of energy homeostasis with potential relevance to obesity.

Animals↗

PubMed1976

[Modification of the caloric intake as a function of energy expenditure in patients with diarrhea].

UNLABELLED: We have compared, using non protein RQ method, energy expenditures of diarrheic patients with intraperitoneal or intraluminal suppuration and feed enterally (group II) or intravenously (group III). Five non suppurative diarrheic patients feed enterally were studied as control (group I). Carbohydrate, protein and fat intakes were not significantly different in the 3 groups of patients. Patients of group II metabolized significantly less of carbohydrate (p less than 0.01) and more of fat (P less than 0.01) than groups I and III patients. Carbohydrate and fat expenditures of patients of groups I and III were not significantly different. CONCLUSION: 1) There is a possible trouble of carbohydrate absorption in suppurative diarrheic patients. 2) Therefore caloric intake must be preferably parenteral in these patients.

Adolescent↗

PubMed1979

Reducing Medicaid expenditures through family responsibility: critique of a recent proposal.

The Massachusetts Department of Public Welfare recently proposed a "Family Responsibility Plan" which would impose a financial obligation upon adult children in the state for the nursing-home care of their parents who receive Medicaid. By examining the Massachusetts plan, this Note seeks to evaluate the viability of a concept of family responsibility, under which adult children contribute to the state Medicaid expenses of their medically indigent parents in nursing homes, as a means of combating the increase in state Medicaid expenditures. The Note examines the legal and policy issues raised by the Massachusetts welfare department's plan in particular, and by the concept of family responsibility in general. The author concludes that alternative methods of cost containment, such as positive financial incentives, would be more appropriate mechanisms for reducing state Medicaid expenditures than family--that is, adult child--responsibility plans.

Civil Rights↗

PubMed2026

Associations Between Health-Related Physical Fitness and Accelerometry-Based Energy Expenditure in Physiotherapy Workers.

BACKGROUND AND PURPOSE: Although it has been assumed that higher physical activity (PA) levels will contribute to better physical fitness (PF) performance, the interplay between these two has yet to be investigated. Moreover, the majority of studies have been presented in children and adolescents, and older adults, while little is known about the correlation in the adult working population of physiotherapists. Therefore, the main purpose of the study was to examine associations between objectively measured PA and health-related PF. METHODS: We recruited 50 physiotherapists (72.6% women) from several public and private settings in the city of Zagreb. The SenseWearArmbandPro3 (SWA), a triaxial accelerometer placed on the nondominant hand for 7 consecutive days, was used to capture total energy expenditure (TEE) and active EE (AEE). Cardiorespiratory fitness included the Harvard step test, and muscular fitness was composed of sit-ups in 60 sec and the Handgrip strength. Flexibility was evaluated using the Toe-touch test. RESULTS: TEE and AEE were moderately and positively correlated with the Harvard step test (r = 0.65 and 0.62, p < 0.001), sit-ups (r = 0.70 and 0.59, p < 0.001), and the Handgrip strength test (r = 0.74 and 0.64, p < 0.001). No significant correlation with the Toe-touch test was observed (r = -0.25 and -0.19, p > 0.05). When models were adjusted for age, weaker, but significant positive correlations remained. DISCUSSION: The findings suggest that both cardiorespiratory and muscular fitness are positively associated with PA, whereas no statistically significant association with flexibility was detected. Thus, it is not surprising that we obtained moderate to almost strong correlations between TEE and AEE with cardiorespiratory and muscular fitness. CONCLUSIONS: In physiotherapists, TEE and AEE yield moderate correlations with health-related PF, especially for cardiorespiratory and muscular fitness.

Humans↗

PubMed2026

Hepatic ketogenic insufficiency blunts exercise-induced energy expenditure and alters mitochondrial proteins in skeletal muscle.

Ketone body (KB) utilization increases during fasting and exercise due to enhanced hepatic fatty acid oxidation and KB production via the rate-limiting mitochondrial enzyme hydroxymethylglutaryl-CoA synthase (HMGCS2). Since KB metabolism intersects with multiple metabolic pathways and skeletal muscle KB catabolism rises during exercise, we tested the hypothesis that liver-specific HMGCS2 knockouts (KO) would have reduced energy expenditure (EE) and changes in the mitochondrial proteome of skeletal muscle with chronic exercise through voluntary wheel running (VWR), time-restricted feeding (TRF), or both combined to boost hepatic KB production and utilization. Control (CON) and HMGCS2 knockout (KO) mice (n = 6-8 per group) underwent sedentary ad libitum feeding (SED + AL), SED + TRF, VWR + AL, and VWR + TRF for 16 wk, with whole body EE measured using indirect calorimetry. In CON mice, VWR increased total EE by 19.5% and nonresting EE by 50% under AL conditions, and total EE by 16% and nonresting EE by 47.9% under TRF conditions. However, the EE increases seen with VWR did not occur in KO mice. Proteomic analysis revealed that the loss of liver HMGCS2 significantly impacted proteins involved in metabolic processes within skeletal muscle, including reduced oxidative phosphorylation (OXPHOS) protein expression in SED KO mice compared with sedentary CON. Notably, VWR restored OXPHOS protein expression in the muscle of the liver HMGCS2 KO but did not alter it in the CON. Furthermore, muscle from liver HMGCS2 KO mice had elevated expression of glycolytic pathways in sedentary and VWR conditions. These results indicate that hepatic ketogenic deficiency (HMGCS2 KO) diminishes exercise-induced increases in EE and uniquely impacts baseline and exercise-related adaptations in the metabolic and mitochondrial proteome of skeletal muscle.

Hydroxymethylglutaryl-CoA Synthase↗

PubMed1977

Expenditures for the dental care of indigent children in the Chattanooga project, 1971-1975.

This paper is part of a continuing study of the cost of children's dental care in a publicly funded model program. The Program--the Chattanooga Project--was designed to provide information and experience necessary for the development of similar programs elsewhere in the United States. From 1970 to 1975 comprehensive dental care was provided, at no charge, to an average of 5,500 indigent children per year. Children were treated in private practices (39%), public fixed clinics (20%), and public mobile clinics (41%). Costs were defined as public expenditures for purchasing care from private practitioners or producing care in public practices. As a framework for the analysis, program activities and their respective costs were divided into direct and indirect components. The former relate to the provision of care and the latter to noncare-oriented activities. Direct (indirect) costs per patient were $46.56 ($16.31) in private practices, $40.17 ($16.11) in fixed clinics, and $35.49 ($13.41) in mobile clinics. These results substantiate previous findings from a shorter period. A priori reasons for differences among the three modes in terms of patients' health status or the type of care provided have been specified and are currently under investigation.

Adolescent↗

PubMedDate not supplied

[Energy expenditures, nutritional regimen and the individual indices of the metabolic status of the students at physical education institutes].

Data of a study on the factual nutrition, energy expenditures and individual indices of the nitrogen and lipids metabolism rates in students of a Physical Culture Institute of different sport specialties (heavy athletics, light athletics, wrestling, skying, cycling and rowing) are presented. Shortcomings and organization of the students' nutrition are considered and suggestions for its improvement are given.

Adolescent↗