Sex differences in healthcare expenditures among adults with diabetes: evidence from the medical expenditure panel survey, 2002-2011. BMC Health Serv Res 2017 Apr 11;17(1):259
Date
04/13/2017Pubmed ID
28399859Pubmed Central ID
PMC5387347DOI
10.1186/s12913-017-2178-3Scopus ID
2-s2.0-85018510803 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
BACKGROUND: The evidence assessing differences in medical costs between men and women with diabetes living in the United States is sparse; however, evidence suggests women generally have higher healthcare expenditures compared to men. Since little is known about these differences, the aim of this study was to assess differences in out-of-pocket (OOP) and total healthcare expenditures among adults with diabetes.
METHODS: Data were used from 20,442 adults (≥18 years of age) with diabetes from the 2002-2011 Medical Expenditure Panel Survey. Dependent variables were OOP and total direct expenditures for multiple health services (prescription, office-based, inpatient, outpatient, emergency, dental, home healthcare, and other services). The independent variable was sex. Covariates included sociodemographic characteristics, comorbid conditions, and time. Sample demographics were summarized. Mean OOP and total direct expenditures for health services by sex status were analyzed. Regression models were performed to assess incremental costs of healthcare expenditures by sex among adults with diabetes.
RESULTS: Fifty-six percent of the sample was composed of women. Unadjusted mean OOP costs were higher for women for prescriptions ($1177; 95% CI $1117-$1237 vs. $959; 95% CI $918-$1000; p < 0.001) compared to men. Unadjusted mean total direct expenditures were also higher for women for prescriptions ($3797; 95% CI $3660-$3934 vs. $3334; 95% CI $3208-$3460; p < 0.001) and home healthcare ($752; 95% CI $646-$858 vs. $397; 95% CI $332-$462; p < 0.001). When adjusting for covariates, higher OOP and total direct costs persisted for women for prescription services (OOP: $156; 95% CI $87-$225; p < 0.001 and total: $184; 95% CI $50-$318; p = 0.007). Women also paid > $50 OOP for office-based visits (p < 0.001) and > $55 total expenditures for home healthcare (p = 0.041) compared to men after adjustments.
CONCLUSIONS: Our findings show women with diabetes have higher OOP and total direct expenditures compared to men. Additional research is needed to investigate this disparity between men and women and to understand the associated drivers and clinical implications. Policy recommendations are warranted to minimize the higher burden of costs for women with diabetes.
Author List
Williams JS, Bishu K, Dismuke CE, Egede LEAuthors
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinJoni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Delivery of Health Care
Demography
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Female
Health Expenditures
Humans
Male
Middle Aged
Office Visits
Retrospective Studies
Sex Distribution
Surveys and Questionnaires
United States
Young Adult
