Multiple Chronic Conditions Among People with Disabilities: What we know from the MEPS Amanda Reichard, PhD

Research question: What are the rates of and predictors for co-occurring chronic diseases among those with disability? Data Source: Medical Expenditures Panel Survey (MEPS) Key Findings: – All disability groups (physical, cognitive, visual, hearing, multiple) had a greater rate of MCC than working age adults with no disability – People with multiple disabilities or physical disability alone were most likely to have a greater number of MCC – Regardless of the combination of chronic diseases, those with multiple disabilities had the highest rates of MCC, by a substantial margin – People with disabilities with MCC were more likely than those without disability to report fair/poor health status (vs. good/very good/excellent.

Key Implications for Policy With each added health condition there is an increased risk for: – An individual’s negative health outcomes (preventable hospitalizations, duplicative tests, impaired function, adverse drug events, conflicting medical advice and death) – Threats to quality of life and independent living. – Greater need for health and social support costs This has clear implications for policies that support and address the social determinants of health, especially those affecting people with physical disabilities – improved access to services, in both health care settings and communities at large Within any population, a subset of people typically drives most of the expenditures – HHS Strategic Initiative offers goals that show promise for aligning more targeted interventions

Key Implications for Service Providers and Clinicians All groups had very high rates of usual sources of care, indicating that provider education regarding MCC should play a role – Prevalence and distribution across disability subgroups – Understanding that functionality as reflected by disability influences health access and outcomes – Understanding barriers faced by disability subgroups – How to best meet the unique needs of each disability subgroup

Key Implications for Consumers/Advocates/Families Consumer/Family education could also improve quality of life outcomes and cost reduction: – How to overcome access barriers – How to better manage chronic conditions to prevent unnecessary hospitalizations – Increased vulnerability based on functionality

Key Questions to Audience What types of information and in what format do you find most useful in meeting your needs for change (policy, professional, personal, otherwise)? Do you have any specific questions about multiple chronic conditions that were not addressed in this presentation?