Health Care Expenditure Among People With Disabilities

Abstract

Workplace health-promotion programs have the potential to reduce health care expenditures, especially among people with disabilities. Utilizing nationally representative survey data, the authors provide estimates for health care expenditures related to secondary conditions, obesity, and health behaviors among working-age people with disabilities. Furthermore, by computing the expenditures attributable to secondary conditions, obesity, and health behaviors, the authors emphasize the importance of disability-inclusive workplace health-promotion programs for employees with disabilities. Overall, the authors observed that the annual average health care expenditure among employed people with disabilities was US$4,524 (95% confidence interval [CI] = US$4,248–US$4,800) compared with US$1,325 (95% CI = US$1,299–US$1,351) for employed people without disabilities. Furthermore, obesity accounted for 27% to 41% of excess expenditures for people with various disability classifications compared with their nonobese peers with disabilities. Secondary conditions accounted for about 20% to 25% of higher health care expenditures among working people with various disability classifications, compared with their peers with disabilities who do not have secondary conditions. In addition, lack of exercise and alcohol consumption accounted for one fourth to over one third of excess health care expenditures among employed people with disabilities. The authors discuss implications of these findings for rehabilitation counselors and public health practitioners.