Racial and Ethnic Disparities in Healthcare Expenditures Among United States Older Adults with Joint Pain
Author(s)
Paroma Arefin, M Pharm, Samuel C Ofili, BPharm, CHIJIOKE MODESTUS OKEKE, BSc, Marjan Zakeri, MD, PhD, Sujit S. Sansgiry, MS, PhD.
Pharmaceutical Health Outcomes and Policy, College of Pharmacy- University of Houston, Houston, TX, USA.
Pharmaceutical Health Outcomes and Policy, College of Pharmacy- University of Houston, Houston, TX, USA.
Presentation Documents
OBJECTIVES: Patients routinely seek medical attention for joint pain, the most prevalent chronic pain with leading causes for disability. This study examines racial/ethnic disparities in healthcare expenditures associated with joint pain among older adults in the US.
METHODS: : In this retrospective cohort study Medical Expenditure Panel Survey (MEPS) data from 2018-2022 on healthcare expenditures in adults >=65 years with joint pain were analyzed, focusing on Non-Hispanic Whites (NHWs), Non-Hispanic Blacks (NHBs), and Hispanics. Healthcare expenditures across six categories: total healthcare expenditures (THE), office-based visits, inpatient stays, outpatient visits, emergency room visits, and prescription medications were compared by racial/ethnic group, controlling for sample characteristics and other covariates. Due to zero expenditures, we added $10 to each healthcare expenditure category for every patient and calculated the natural log of the total value. After log transformation, linear regression models adjusted for all covariates were used to compare the healthcare expenditures in SAS V9.4.
RESULTS: The study identified 4,130 older adults (weighted frequency 42,328,774) with joint pain, (NHWs:82.56%, NHBs:9.07%, and Hispanics:8.36%). After adjusting for covariates, Hispanics had lower total expenditures (35% p=0.0002), office-based (49% p<0.0001), prescription medications (35% p=0.0005), and outpatient visit expenditures (58% p<0.0001), respectively than NHWs. NHBs had lower total expenditures (39% p<0.0001), office-based (59% p<0.0001), and outpatient care expenditures (43% p<0.001), respectively, than NHWs. Those with any private insurance had 28% (p<0.0001) higher total expenditures, while uninsured individuals had 21.5% (p<0.0001) lower total expenditures than those with public insurance only. Those with four and 5+ chronic conditions had 242% (p<0.0001) and 379% (p<0.0001) higher total expenditures, respectively than those without any chronic condition.
CONCLUSIONS: Racial/ethnic disparities in healthcare expenditures for US older adults with joint pain emphasize lower spending for Hispanics and NHBs, particularly in office-based and outpatient services, highlighting the need for equitable access to healthcare.
METHODS: : In this retrospective cohort study Medical Expenditure Panel Survey (MEPS) data from 2018-2022 on healthcare expenditures in adults >=65 years with joint pain were analyzed, focusing on Non-Hispanic Whites (NHWs), Non-Hispanic Blacks (NHBs), and Hispanics. Healthcare expenditures across six categories: total healthcare expenditures (THE), office-based visits, inpatient stays, outpatient visits, emergency room visits, and prescription medications were compared by racial/ethnic group, controlling for sample characteristics and other covariates. Due to zero expenditures, we added $10 to each healthcare expenditure category for every patient and calculated the natural log of the total value. After log transformation, linear regression models adjusted for all covariates were used to compare the healthcare expenditures in SAS V9.4.
RESULTS: The study identified 4,130 older adults (weighted frequency 42,328,774) with joint pain, (NHWs:82.56%, NHBs:9.07%, and Hispanics:8.36%). After adjusting for covariates, Hispanics had lower total expenditures (35% p=0.0002), office-based (49% p<0.0001), prescription medications (35% p=0.0005), and outpatient visit expenditures (58% p<0.0001), respectively than NHWs. NHBs had lower total expenditures (39% p<0.0001), office-based (59% p<0.0001), and outpatient care expenditures (43% p<0.001), respectively, than NHWs. Those with any private insurance had 28% (p<0.0001) higher total expenditures, while uninsured individuals had 21.5% (p<0.0001) lower total expenditures than those with public insurance only. Those with four and 5+ chronic conditions had 242% (p<0.0001) and 379% (p<0.0001) higher total expenditures, respectively than those without any chronic condition.
CONCLUSIONS: Racial/ethnic disparities in healthcare expenditures for US older adults with joint pain emphasize lower spending for Hispanics and NHBs, particularly in office-based and outpatient services, highlighting the need for equitable access to healthcare.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH69
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)