The Elderly with Disabilities: At Risk for High Health Care Costs

According to the 1987 National Medical Expenditure Survey, elderly persons with severe disabilities (defined as needing assistance with one or more activities of daily living) had out-of-pocket health care expenses nearly four times greater than persons without disabilities. Approximately 9% of the elderly population was categorized as having a severe disability. Much of the difference in out-of-pocket expenditures is due to greater home health spending among those without disabilities, who also have far greater hospital and physician expenses. Older people with disabilities also spend a greater proportion of family income on health care than do older people with disabilities — 12% versus 3%. However, these are substantial variation in expenditures among persons with substantial disability. For instance, over 70% of the severely disabled elderly do not have any out-of-pocket expenditures for home health care. Elderly persons with severe disabilities who were enrolled in Medicaid for only part of the year had highest out-of-pocket expenditures (nearly 20% of family income). (ASPE Research Notes, Volume 8) [5 PDF pages]