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Healthcare cost and race: analysis of young women with stroke
BACKGROUND: Over the last decade, the prevalence of young stroke has increased 40% particularly among vulnerable populations. These strokes are often more severe with worse outcomes. However, few studies have examined the impact on annual healthcare costs. METHODS: Data from the 2008 to 2018 Medical...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122319/ https://www.ncbi.nlm.nih.gov/pubmed/37085848 http://dx.doi.org/10.1186/s12939-023-01886-7 |
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author | Jacobs, Molly Ellis, Charles |
author_facet | Jacobs, Molly Ellis, Charles |
author_sort | Jacobs, Molly |
collection | PubMed |
description | BACKGROUND: Over the last decade, the prevalence of young stroke has increased 40% particularly among vulnerable populations. These strokes are often more severe with worse outcomes. However, few studies have examined the impact on annual healthcare costs. METHODS: Data from the 2008 to 2018 Medical Expenditure Panel Survey (MEPS) was used to identify a sample of female stroke survivors aged 18 and 60. MEPS includes demographics, health status, healthcare use, and expenditures for all participants providing the largest nationally representative data source of healthcare costs in the US. First, differences in racial and ethnic healthcare expenditure among young women with stroke were evaluated controlling for insurance type and demographic characteristics. Second, the relationship between healthcare expenditure and 1) time post stroke, 2) comorbidities, 3) healthcare utilization, and 4) post-stroke functional status was assessed. Finally, differential healthcare quality was tested as a potential mitigating differential. RESULTS: Young Black women with stroke spend roughly 20% more on healthcare than White women after controlling for insurance, time post-stroke, healthcare utilization, and demographic differences. Costs remain 17% higher after controlling for comorbidities. Differences in expenditure are larger if survivors have diabetes, high blood pressure, or high cholesterol (78%, 24%, and 28%, respectively). Higher expenditure could not be explained by higher healthcare utilization, but lower quality of healthcare may explain part of the differential. CONCLUSION: Young Black women with stroke have 20% greater healthcare expenditure than other groups. Cost differentials cannot be explained by differentials in comorbidities, utilization, time post stroke, or functionality. Additional research is needed to explain these differences. |
format | Online Article Text |
id | pubmed-10122319 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101223192023-04-23 Healthcare cost and race: analysis of young women with stroke Jacobs, Molly Ellis, Charles Int J Equity Health Research BACKGROUND: Over the last decade, the prevalence of young stroke has increased 40% particularly among vulnerable populations. These strokes are often more severe with worse outcomes. However, few studies have examined the impact on annual healthcare costs. METHODS: Data from the 2008 to 2018 Medical Expenditure Panel Survey (MEPS) was used to identify a sample of female stroke survivors aged 18 and 60. MEPS includes demographics, health status, healthcare use, and expenditures for all participants providing the largest nationally representative data source of healthcare costs in the US. First, differences in racial and ethnic healthcare expenditure among young women with stroke were evaluated controlling for insurance type and demographic characteristics. Second, the relationship between healthcare expenditure and 1) time post stroke, 2) comorbidities, 3) healthcare utilization, and 4) post-stroke functional status was assessed. Finally, differential healthcare quality was tested as a potential mitigating differential. RESULTS: Young Black women with stroke spend roughly 20% more on healthcare than White women after controlling for insurance, time post-stroke, healthcare utilization, and demographic differences. Costs remain 17% higher after controlling for comorbidities. Differences in expenditure are larger if survivors have diabetes, high blood pressure, or high cholesterol (78%, 24%, and 28%, respectively). Higher expenditure could not be explained by higher healthcare utilization, but lower quality of healthcare may explain part of the differential. CONCLUSION: Young Black women with stroke have 20% greater healthcare expenditure than other groups. Cost differentials cannot be explained by differentials in comorbidities, utilization, time post stroke, or functionality. Additional research is needed to explain these differences. BioMed Central 2023-04-21 /pmc/articles/PMC10122319/ /pubmed/37085848 http://dx.doi.org/10.1186/s12939-023-01886-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Jacobs, Molly Ellis, Charles Healthcare cost and race: analysis of young women with stroke |
title | Healthcare cost and race: analysis of young women with stroke |
title_full | Healthcare cost and race: analysis of young women with stroke |
title_fullStr | Healthcare cost and race: analysis of young women with stroke |
title_full_unstemmed | Healthcare cost and race: analysis of young women with stroke |
title_short | Healthcare cost and race: analysis of young women with stroke |
title_sort | healthcare cost and race: analysis of young women with stroke |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122319/ https://www.ncbi.nlm.nih.gov/pubmed/37085848 http://dx.doi.org/10.1186/s12939-023-01886-7 |
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