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Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016

BACKGROUND: Disparities in health care utilization and outcomes for racial and ethnic minorities with arthritis are well-established. However, there is a paucity of research on racial and ethnic differences in healthcare expenditures and if this relationship has changed over time. Our objectives wer...

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Autores principales: Spector, Antoinette L., Nagavally, Sneha, Dawson, Aprill Z., Walker, Rebekah J., Egede, Leonard E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291726/
https://www.ncbi.nlm.nih.gov/pubmed/32532272
http://dx.doi.org/10.1186/s12913-020-05395-z
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author Spector, Antoinette L.
Nagavally, Sneha
Dawson, Aprill Z.
Walker, Rebekah J.
Egede, Leonard E.
author_facet Spector, Antoinette L.
Nagavally, Sneha
Dawson, Aprill Z.
Walker, Rebekah J.
Egede, Leonard E.
author_sort Spector, Antoinette L.
collection PubMed
description BACKGROUND: Disparities in health care utilization and outcomes for racial and ethnic minorities with arthritis are well-established. However, there is a paucity of research on racial and ethnic differences in healthcare expenditures and if this relationship has changed over time. Our objectives were to: 1) examine trends in annual healthcare expenditures for adults with arthritis by race and ethnicity, and 2) determine if racial and ethnic differences in annual healthcare expenditures were independent of other factors such as healthcare access and functional disability. METHODS: We used the Medical Expenditures Panel Survey (2008–2016) to examine trends in annual healthcare expenditures within and between racial and ethnic groups with arthritis (n = 227,663). A two-part model was used to estimate the marginal differences in expenditures by race and ethnicity after adjusting for relevant covariates, including the impact of healthcare access. RESULTS: Between 2008 and 2016, there were no significant changes in unadjusted healthcare expenditures within any of the racial and ethnic groups, but the trend among non-Hispanic whites did differ significantly from Hispanics and Other. In fully adjusted analysis, mean annual expenditures for non-Hispanic whites was $946, $939, and $1178 more than non-Hispanic blacks, Hispanics, and Other, respectively (p < .001). Healthcare access also independently explained expenditure differences in this population with adults who delayed care spending significantly more ($2629) versus those who went without care spending significantly less (−$1591). CONCLUSIONS: Race and ethnicity are independent drivers of healthcare expenditures among adults with arthritis independent of healthcare access and functional disability. This underscores the need for ongoing research on the factors that influence persistent racial and ethnic differences in this population.
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spelling pubmed-72917262020-06-12 Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016 Spector, Antoinette L. Nagavally, Sneha Dawson, Aprill Z. Walker, Rebekah J. Egede, Leonard E. BMC Health Serv Res Research Article BACKGROUND: Disparities in health care utilization and outcomes for racial and ethnic minorities with arthritis are well-established. However, there is a paucity of research on racial and ethnic differences in healthcare expenditures and if this relationship has changed over time. Our objectives were to: 1) examine trends in annual healthcare expenditures for adults with arthritis by race and ethnicity, and 2) determine if racial and ethnic differences in annual healthcare expenditures were independent of other factors such as healthcare access and functional disability. METHODS: We used the Medical Expenditures Panel Survey (2008–2016) to examine trends in annual healthcare expenditures within and between racial and ethnic groups with arthritis (n = 227,663). A two-part model was used to estimate the marginal differences in expenditures by race and ethnicity after adjusting for relevant covariates, including the impact of healthcare access. RESULTS: Between 2008 and 2016, there were no significant changes in unadjusted healthcare expenditures within any of the racial and ethnic groups, but the trend among non-Hispanic whites did differ significantly from Hispanics and Other. In fully adjusted analysis, mean annual expenditures for non-Hispanic whites was $946, $939, and $1178 more than non-Hispanic blacks, Hispanics, and Other, respectively (p < .001). Healthcare access also independently explained expenditure differences in this population with adults who delayed care spending significantly more ($2629) versus those who went without care spending significantly less (−$1591). CONCLUSIONS: Race and ethnicity are independent drivers of healthcare expenditures among adults with arthritis independent of healthcare access and functional disability. This underscores the need for ongoing research on the factors that influence persistent racial and ethnic differences in this population. BioMed Central 2020-06-12 /pmc/articles/PMC7291726/ /pubmed/32532272 http://dx.doi.org/10.1186/s12913-020-05395-z Text en © The Author(s) 2020 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/. The Creative Commons Public Domain Dedication waiver (http://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 Article
Spector, Antoinette L.
Nagavally, Sneha
Dawson, Aprill Z.
Walker, Rebekah J.
Egede, Leonard E.
Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
title Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
title_full Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
title_fullStr Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
title_full_unstemmed Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
title_short Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
title_sort examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291726/
https://www.ncbi.nlm.nih.gov/pubmed/32532272
http://dx.doi.org/10.1186/s12913-020-05395-z
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