Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Expenditures”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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

At least 469 records · Page 26Linked to original sources
PubMed2004

Out-of-pocket expenditures for oral contraceptives and number of packs per purchase.

OBJECTIVE: Two potential barriers to use of oral contraceptives (OCPs) are out-of-pocket expenditures and the inconvenience of monthly pharmacy visits. This study used nationally representative data to examine the out-of-pocket costs of OCPs and whether women obtain more than 1 pack per purchase. METHODS: We used data from the 1996 Medical Expenditure Panel Survey. Dependent variables were out-of-pocket expenditures per pack and the number of packs obtained per purchase. Chi2 tests were used to examine the bivariate relationships between the dependent variables and covariates. Regression analyses were used to examine the predictors of OCP expenditures and the number of packs obtained per purchase. RESULTS: Women paid an average of 14 dollars per pack of OCPs, and 73% obtained only 1 pack per purchase. On average, privately insured women paid 60% of the total expenditures for OCPs. Women who had no prescription drug coverage, who were uninsured, or who were privately insured but not in managed care plans had higher out-of-pocket expenditures. Women who were without prescription drug coverage or who were in managed care plans were more likely to obtain only 1 pack per purchase. CONCLUSION: Out-of-pocket costs and dispensing restrictions may be barriers to consistent use of OCPs. Women's health care providers should consider options to overcome these barriers, such as the use of mail order prescription services.

Adolescent↗
PubMed1992

Comparison of dietary self-reports with energy expenditure measured using a whole-room indirect calorimeter.

In this study we used a whole-room indirect calorimeter to evaluate the accuracy of self-reported food intake. Daily measured energy expenditure was compared with 2 weeks of self-reported food intake. Additionally, oxidation of each macronutrient was compared with its self-reported intake to assess the accuracy of self-reported dietary composition. Participants (23 through 60 years old) were eight dietitians, eight subjects who were trained in keeping dietary records, and eight subjects who were not trained. Physical activity in the calorimeter was matched to usual daily physical activity. Overall, measured energy expenditure was approximately 200 kcal/day higher than reported metabolizable energy intake. However, this was the result primarily of a few subjects whose self-reported food intake was considerably below measured energy expenditure. Subjects who were trained in record keeping did not differ from untrained subjects. Dietitians had the lowest difference between intake and expenditure; none of them had the large discrepancies between intake and expenditure seen in the other groups. In all groups, there was a much greater discrepancy between self-reported intake and oxidation of each macronutrient than between self-reported total energy intake and expenditure.

Adult↗
PubMed1992

Amount of exercise per day and weeks of training: effects on body weight and daily energy expenditure.

The effects of 16 wk of 1 or 3 h of daily swim-training on the body weight and 24-h postexercise energy expenditure of adult male Sprague-Dawley rats were examined. Daily energy expenditure (kcal.d-1.kg-0.75) of sedentary rats displayed the usual age-associated decline in daily energy expenditure (kcal.d-1.kg-0.75) over this 16-wk period. Daily swimming forestalled this decline, leading to differences in daily energy expenditure between exercised and sedentary rats, which grew progressively larger. One and 3 h of daily swimming led to similar declines in weight, but 3 h of daily swimming elevated daily (postexercise) expenditure after fewer weeks of training and to a greater extent than did 1 h of daily swimming. Exercise-induced elevations in daily (nonexercise) expenditure thus appear to be a joint function of how long the daily exercise program has been in effect and the amount of daily exercise.

Animals↗
PubMed1991

[Analysis of economic and socio-economic expenditures in relation to clinico-psychopathological characteristics of schizophrenia].

The paper is a fragment of the studies into estimation of expenditures in a representative group (386 patients) with schizophrenia. The authors describe the results of an analysis of "direct" and "indirect" expenditures incurred for the treatment of schizophrenic patients depending on the sex, age, disease pattern, prevailing positive syndrome, and the level of negative symptomatology. The values of these expenditures turned out fairly variable. It could be demonstrated that there are definite, significant correlations between the magnitude of these expenditures and ++clinico-psychopathological factors. The highest expenditures were recorded in patients fit for work, they are largely determined by expenditures for inpatient treatment and disability payments. It should be emphasized that in male patients, they appear much higher, particularly in the group of patients with simple schizophrenia. It means that using economic estimates indirectly reflecting the gravity and characteristic features of schizophrenia, one can assess different manifestations of the disease in terms of universal units of cost.

Adult↗
PubMed1991

[Increase of energy expenditure in Parkinson's disease].

Energy expenditure was determined in 18 patients with Parkinson's disease, 6 healthy volunteers and 6 patients with essential tremor, age-matched, using the indirect calorimetric method which measures the gas exchange rate. The results showed a significant increase in the relative energy expenditure, i.e. the difference between absolute and predictable values from the Harris and Benedict equation, among the parkinsonian patients (+21 +/- 4.1 p. 100; mean +/- S.E.M.) as compared to the 2 control groups (-8.6 +/- 7 p. 100 and -2.1 +/- 4.1 p. 100 respectively; p less than 0.001). There was no correlation between the rate of energy expenditure and the duration or degree of severity of the disease, and particularly the occurrence and magnitude of weight loss, which is frequently observed during the course of the disease. The relative energy expenditure was not significantly different between untreated and treated parkinsonian patients (18.8 +/- 3 p. 100 and 24.5 +/- 6.2 p. 100 respectively). Further investigations were designed to determine whether the increased energy expenditure could reflect a functional impairment of the automatic nervous system. The integrity of the vagus nerve was tested by plotting vs time the plasma Pancreatic Polypeptide levels in response to insulin-induced hypoglycaemia. A physiological stimulation was obtained in the 8 parkinsonian patients studied. This is not the case in chronic autonomic failure. On the contrary, the relative energy expenditure was significantly decreased in the 6 patients that were given a beta-blocking drug, pindolol, 15 mg daily for 3 weeks (+30.7 +/- 4.3 p. 100 before and +21 +/- 4.2 p. 100 after treatment; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Energy expenditure of dockers performing heavy loading/discharging works and of other occupational groups in ports.

The examinations conducted in 1986-1990 comprised 1123 harbour workers in ports of Gdańsk and Gdynia. The mean age of all persons examined was 42.38 +/- 11.27, the mean period of the employment at port was 19.38 +/- 7.20 years. In the group stevedore-trimmers the corresponding values were 38.13 +/- 10.81 and 14.27 +/- 5.76 years, respectively. Average body height in the whole group of men investigated was 173.46 +/- 6.43 cm. The lowest body mass found in stevedores and trimmers was 76.36 +/- 11.43 kg, the highest in supervisors and controllers was 82.32 +/- 10.76 kg. The energy expenditure of the occupational work in the groups examined fell within a wide range from 493.25 +/- 45.09 kcal (2064.19 +/- 177.05 kJ) to 2335.79 +/- 326.02 kcal (9778.62 +/- 1234.34 kJ). The energy expenditure of stacking-yard tenders, shipping clerks, tallymen, foremen, hoistmen and cranemen fluctuated within the range of 493.25 +/- 45.09 kcal (2064.19 +/- 177.05 kJ) and 614.08 +/- 67.23 kcal (2567.06 +/- 254.74 kJ). In the group of maintenance workers of mechanical equipment: from 886.98 +/- 144.09 kcal (3722.85 +/- 378.03 kJ) to 1268.65 +/- 231.45 kcal (5309.11 +/- 824.00 kJ). In the largest group of mechanical equipment operators it was 1142.06 +/- 102.45 kcal (4646.45 +/- 386.05 kJ) on the average. The energy expenditures of stevedores and trimmers in all loading operations fell in the range from 1714.5 kcal (7176.9 kJ) to 2678.5 kcal (11213.9 kJ) and per eight hour shift they averaged 2047.03 +/- 257.25 kcal (8568.90 +/- 1076.85 kJ). Such results of the energy expenditures of stevedores and trimmers occupational jobs qualify it as heavy and in several loading operations as very heavy, the remaining groups perform work counted light and mean, periodically moderate. Out of all the occupational groups of the harbour workers examined, the labour of stevedores and trimmers was characterized by the highest energy expenditure, statistically higher than in other groups of dockers. It was found that the lower was the energy expenditure at work in a given group, the higher was the average body mass and the incidence of overweight and obesity in the groups of workers examined.

Adult↗
PubMed1990

[Effect of physical exercise and heat on energy expenditure in obesity].

The effect of exercise and thermal stress on energy expenditure was studied in obese and lean subjects. The group of obese subjects comprised 20 women with body weight 81-159 kg, and the control group included 12 lean women weighing 51-58 kg. The energy expenditure was assessed by the method of indirect calorimetry with a Spirolyt II apparatus. The heart rate, the systolic and diastolic pressure were measured. The tested subjects were subjected to a 60 W (60 J/s) exercise on a cycle ergometer during 10 minutes, and immediately after it they were exposed to hot air in a chamber at about 60 degrees for 30 min. On the following day this sequence was reversed, with exercise following heat exposure. In the obese women the energy expenditure at rest was 93.4 +/- 17.5 W, and during exposure to heat after exercise it was 124.0 +/- 21.3 W. During exercise preceded by heat exposure it was 436.3 +/- 51.6 W. In lean subjects the corresponding values were lower: 77.5 +/- 6.5 W, 104.0 +/- 14.8 W, 376.8 +/- 36.1 W. After calculation of energy expenditure per 1 m2 of body area this expenditure was, however, lower in the group of obese subjects. The exposure to physical exercise before thermal stress increased significantly the energy expenditure in relation to that caused by each of these exposures separately. The heart rate and the systolic and diastolic blood pressures were higher in obese subjects. In both groups thermal stress increased the heart rate and systolic pressure but decreased the diastolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Comparison of energy expenditure estimated in healthy infants using the doubly labelled water and energy balance methods.

The doubly labelled water method was used to estimate energy expenditure in 20 formula-fed infants (10 aged 1 month and 10 aged 4 months). We then compared the energy expenditure values with energy balance values calculated from energy intake and energy cost of growth. Our purpose was to compare various published equations for calculating CO2 expiration rates (and thus energy expenditure values) from the isotopic data. Those equations in which we used measured values for 18O and 2H isotope dilution spaces and estimated or measured values for insensible water losses yielded energy expenditure values (69.7 +/- 8.4 kcal/kg/d) that agreed most closely with energy balance data (70.3 +/- 11.9 kcal/kg/d). Equations in which we used a constant ratio of 1.03 between the 2H and 18O isotope dilution spaces resulted in energy expenditure values (66.3 +/- 10.2 kcal/kg/d) lower than those predicted by the energy balance data. Data analysis by nonlinear curve fitting compared to logarithmic transformation did not alter the estimates of energy expenditure obtained in these infants.

Child Development↗
PubMed1989

Assessment of energy expenditure by recording heart rate and body acceleration.

The feasibility of a portable accelerometer equipped with a three-directional sensor for the assessment of physical activity and the consequences for energy expenditure was examined under laboratory conditions and during normal daily life. Heart rate monitoring was also conducted to allow comparison of both techniques. In the laboratory study 16 healthy subjects performed a number of specified exercises within a range of activity levels that may be expected in normal life. Accelerometer output was compared with energy expenditure measured by continuous respirometry. A linear relationship was found between accelerometer output and energy expenditure for the pooled data. The standard error of estimate is 79.1 J.min-1.kg-1. In the field study four subjects were observed during a week under free living conditions. Energy expenditure was calculated from food intake registered over the whole period. Energy expenditure calculated from accelerometer output and heart rate exceeded the energy intake figures by 30% and 33%, respectively. Possible explanations for this discrepancy are discussed. Despite this discrepancy, accelerometer output appeared to correlate highly with energy intake (r = 0.99, P less than 0.025), which suggests accurate performance of the accelerometer under free living conditions. The heart rate method gave much poorer results in estimating individual energy expenditure.

Acceleration↗
PubMed1980

Excessive caloric expenditure as a cause of malnutrition in patients with cancer.

The resting metabolic expenditure of 65 patients with advanced cancer was measured by indirect calorimetry. Resting metabolic expenditure was found to be abnormally high in about 60 per cent of the patients, and there was a strong correlation between resting metabolic expenditure and weight loss and between resting metabolic expenditure and variation in serum transferrin. No relation was observed between resting metabolic expenditure and serum albumin or between resting metabolic expenditure and creatinine-height index. We suggest that these high values of resting metabolic rate, despite the weight loss and starvation, could play a role in the genesis of malnutrition in patients with cancer. The importance of these findings for an adequate planning of nutritional rehabilitation of patients with cancer is emphasized.

Body Height↗
PubMed1993

Industrial hygienic study on nursing activities comparison of energy expenditure between pedometer and Holter electrocardiograph.

Few objective and quantitative studies have been made on energy expenditure during hospital nursing activities. The pedometer is a light handy instrument, which gives highly accurate results, and is a minimal burden for subjects. To ascertain daily energy expenditures, we used a pedometer. Twelve day-shift nurses served as subjects, in whom the number of steps token in 16 hours, from getting up until going to bed, was measured. We used the data obtained to calculate energy expenditures for 24 hours. In addition, eight nurses were chosen from among these subjects to undergo simultaneous pedometry and Holter electrocardiography. These data were also used to calculate energy expenditures. The following results were obtained. 1) The maximum total number of steps was 13897, the minimum 9899 and the mean +/- standard deviation was 11478.4 +/- 1285.8. 2) As to the energy expenditure of the eight nurses who were both pedometer and Holter electrocardiograph, the highest energy expenditure calculated from pedometry results was 2648 kcal. the lowest 2455 kcal, and the mean +/- standard deviation was 2514.1 +/- 55.5. The highest energy calculated from Holter electrocardiographic data was 3040 kcal, the lowest 2683 kcal, and the mean +/- standard deviation was 2868.1 +/- 108.0. The correlation coefficient was r = 0.59, (P < 0.05).

Adult↗
PubMed1995

[Energy expenditure of patients with Crohn's disease. Course study during hospitalization].

Weight loss and protein energy malnutrition are frequent in Crohn's disease. The increase of resting energy expenditure has been pointed out as the cause of these findings. In this study we report eleven patients with Crohn's disease, six women and five men hospitalized with active Crohn's disease. In three patients the disease involved the small bowel, in five the large bowel and three shared large and small bowel involvement. At the beginning of the hospitalization the activity disease index of Van Hees was 196 +/- 52, range: 132-265. The resting energy expenditure was eleven percent higher than that, of a healthy population (p: n.s). During hospitalization the energy expenditure decreased weekly with statistically significant difference. No relation has been observed between the activity index of Van Hees, and any of the energy parameters studied. Patients with body weight lower 90% of ideal weight, had an increased resting energy expenditure when that was expressed in kcal/kg of weight (p = 0.003). Fever was the sole parameter analyzed with statistically significant relation with consumption of oxygen: with the index of oxygen consumption (p = 0.03) and with the percentage of resting energy expenditure (p = 0.006). In summary, the REE in active Crohn's disease is higher than that of healthy population, although without statistically significance. The REE tends to normalization coinciding with the decreasing of inflammatory activity. Increased energy expenditure has been detected in weight loss patients.

Adolescent↗
PubMed1996

Energy expenditure in overweight and obese adults in affluent societies: an analysis of 319 doubly-labelled water measurements.

OBJECTIVES: To describe the relationship between graded levels of obesity and free-living energy expenditure in men and women in affluent societies. DESIGN: Analysis of 319 measurements of energy expenditure in adults aged 18-64 years. The variables analysed were: total energy expenditure (TEE, assessed by the doubly-labelled water method); measured basal metabolic rate (BMR); activity energy expenditure (AEE, derived as TEE-BMR); and physical activity level (PAL, derived as TEE/BMR). Results were analysed according to four categories of body mass index (BMI): < 25.0, 25.0-29.9, 30.0-35.0 and > 35.0 kg/m2. RESULTS: TEE increased steadily with increasing BMI (9.5 to 13.5 MJ/d in women, 12.9 to 17.5 MJ/d in men, ANOVA, P < 0.0001 for both sexes). BMR also increased (5.7 to 8.2 MJ/d in women, 7.2 to 11.6 MJ/d in men, P < 0.0001 for both). AEE increased steadily in women (3.8 to 5.3 MJ/d, P < 0.0003), but in men increased up to the third BMI category (5.7 to 7.5 MJ/d, n.s.) and then declined in the most obese group (5.9 MJ/d, n.s.). The increases in energy expenditure were not in direct proportion to body weight since, when expressed per kg, both TEE and AEE declined significantly with increasing BMI. PAL remained quite constant across the three lowest BMI groups, indicating similar levels of physical activity. There was a non-significant decrease in PAL in the most obese men and women. CONCLUSIONS: This analysis confirms that habitual energy expenditure is substantially and progressively raised in obesity. It contradicts the claim, based on self-reported food intake, that obesity develops and is maintained in spite of very low levels of energy intake. The analysis suggests that, except in massive obesity, patterns of physical activity are quite similar at different levels of BMI. This does not exclude the possibility that an inactive lifestyle may be an important general risk factor for the development of obesity.

Adolescent↗
PubMed1998

Traversing the menopause: changes in energy expenditure and body composition.

The menopause transition is associated with several physiological changes that may impact women's health outcome. Among the changes associated with the loss of ovarian function is an increased risk of metabolic and cardiovascular disease. The present review focuses on changes in energy expenditure, body composition and body fat distribution during the postmenopausal transition. Previous work indicates that the most important component of total daily expenditure, resting metabolic rate, may be reduced by the menopause, independently of the effects of the normal aging process. This effect is mainly attributable to a decrease in fat-free mass. The energy expenditure associated with physical activity is the most variable component of total daily energy expenditure. However, small changes in this component may have a substantial impact on body composition. Longitudinal data from our laboratory indicate that the menopause transition also leads to significant decreases in physical activity energy expenditure. The changes in body composition that accompany the menopause transition have been studied by several groups and, although some studies suggested increases in body mass index or total body fat mass with the menopause, currently available cross-sectional data preclude a firm conclusion. Nevertheless, results from our longitudinal study showed significant increases in fat mass with the menopause. The accumulation of abdominal fat, which may be a better correlate of the comorbidities associated with obesity, has also been shown to be accelerated by the menopause transition. In this regard, it has been shown that treatment with hormone replacement therapy prevents the increase in the rate of abdominal adipose tissue accumulation that was noted with the menopause. Thus, it appears that the loss of ovarian function induces a reduction in resting metabolic rate, physical activity energy expenditure, fat-free mass, and an increase in fat mass and abdominal adipose tissue accumulation. These modifications probably contribute to the increased risk of cardiovascular disease of postmenopausal women.

Adipose Tissue↗
PubMed2000

Mental health care utilization and expenditures by children in foster care.

OBJECTIVE: To determine the percentage of children with mental health diagnoses and utilization and expenditures of mental health services among children in foster care compared with other children receiving Medicaid, including those with disabilities. DESIGN: Analysis of Medicaid claim and eligibility records in southwestern Pennsylvania for fiscal year 1995. POPULATION: A total of 39,500 children between ages 5 and 17 years continuously eligible for Medicaid in southwestern Pennsylvania were included in the analysis. MAIN OUTCOME MEASURES: Percentage of children with mental health diagnoses and mental and general health care utilization and expenditures classified by participation in foster care and Medicaid eligibility. RESULTS: Children in foster care were 3 to 10 times more likely to receive a mental health diagnosis, had 6.5 times more mental health claims, were 7.5 times more likely to be hospitalized for a mental health condition, and had mental health expenditures that were 11.5 times greater ($2082 vs $181) than children in the Aid to Families With Dependent Children (AFDC) program. Overall, utilization rates, expenditures, and prevalence of psychiatric conditions for children in foster care were comparable with those of children with disabilities. CONCLUSIONS: Children in foster care are significantly more likely to suffer from mental health conditions and use more mental health and general health services than AFDC children. Service use and expenditures are comparable with those of disabled children, suggesting that reimbursement rates and care management for children in foster care need to be reexamined.

Adolescent↗
PubMed2002

Health care use and costs for children with attention-deficit/hyperactivity disorder: national estimates from the medical expenditure panel survey.

CONTEXT: Although attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent chronic condition of childhood, little is known about patterns of health care use and associated expenditures. OBJECTIVE: To compare health care use and costs among children with ADHD, children with asthma, and the general pediatric population. DESIGN AND SETTING: The 1996 Medical Expenditure Panel Survey, a nationally representative household survey. PARTICIPANTS: All 5439 children aged 5 to 20 years from the 1996 Medical Expenditure Panel Survey were included in this analysis. Children who had ADHD, asthma, or neither (general population) were identified from International Classification of Diseases, Ninth Revision, Clinical Modification codes and prescription records. MAIN OUTCOME MEASURES: Mean health care use (outpatient visits, emergency department visits, hospital stays, home health visit days, and prescriptions) and associated expenditures. RESULTS: We identified 165 children with ADHD, 322 with asthma, and 4952 with neither diagnosis. Children with ADHD had significantly higher mean total health care costs ($1151) compared with children with asthma ($1091; P<.05) and the general population ($712; P<.001). After adjusting for age, sex, race, household income, access to care, parent education, and marital status, excess total costs were $479 for children with ADHD (P<.001) and $437 for children with asthma (P<.01). CONCLUSIONS: Overall costs of care for children with ADHD are comparable to costs for children with asthma and significantly greater than for the general pediatric population. Specific types of health care use and the sources of expenditures differ between children with ADHD and children with asthma. Because much ADHD-related care occurs within school and mental health settings, these figures likely underestimate the true costs of caring for children with this condition.

Adolescent↗
PubMed1998

Financing health services in Poland: new evidence on private expenditures.

This paper estimates total expenditure on health care in Poland in 1994 and provides new evidence on high levels of private spending on health care. The analysis shows that health care expenditures in Poland are higher than has usually been maintained, and are comparable with the prevailing levels in many other European countries. Private expenditure on health is a significant proportion of total expenditure on health, and in particular on financing outpatient care. Available evidence indicates that informal payments made by patients to physicians contribute as much as double of the physician's salary, and thus form an important source of earnings for physicians. This situation of high private expenditures on health care and informal payments to physicians is likely to be true of other transitional economies of Central and Eastern Europe as well. One policy implication that emerges is these transitional economies face a big challenge in managing existing resources, as opposed to finding new resources, in the health sector more effectively to meet the health care needs of their population. The paper highlights the need for better understanding of the current availability and distribution of resources in the health sector and their directions of flow, in both public and private sectors, and suggests using tools such as National Health Accounts to track and monitor changes in the financing of the health care system.

Adolescent↗
PubMed2001

Living with osteoarthritis: patient expenditures, health status, and social impact.

OBJECTIVE: To determine "out-of-pocket" expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. METHODS: A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded. RESULTS: Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. CONCLUSION: Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.

Aged↗