Differences in Medical Expenditures for Men and Women with Diabetes in the Medical Expenditure Panel Survey, 2008–2016

Background: Evidence suggests that women have increased health care costs; however, little is known about expenditures for women with diabetes compared with men with diabetes. The objective of this study was to calculate expenditures for men and women and to identify factors associated with increased costs in women. Materials and Methods: Adults with diabetes (n = 2,078) from the 2011 Medical Expenditure Panel Survey (MEPS) were identified. A generalized linear model with gamma distribution and log link was used to estimate incremental expenditure in women compared with men and to identify reasons for this difference. Sequential models were analyzed by entering variables in blocks (demographics, medical comorbidities, mental comorbidity and disability, and functional limitation). IRB approval was waived for this secondary data analysis. Results: Unadjusted mean total expenditures were $12,485 for women with diabetes compared with $10,828 for men (p = 0.04). In the model with demographic variables and medical comorbidities, expenditures for women increased to $1,720 (p = 0.03) (95% confidence interval [CI] 164–3,266) compared with men. With a comorbid mental health disorder, expenditures for women decreased slightly, but they remained significantly higher than for men at $1,668 (p = 0.04) (95% CI 104–3,222). In the final analysis with all variables, incremental expenditures increased by $1,314 for women compared with men and were no longer statistically significantly higher than for men (p = 0.10; 95% CI −257 to 2,933). Conclusions: Our findings show that women with diabetes have increased expenditures for health care compared with men with diabetes. Increased functional limitation and disability in women account for incremental increases in costs, which suggest a need for more efforts to manage disability burden in women with diabetes.