Examining racial and ethnic differences in health care expenditures among older adults with arthritis in the United States.

Abstract

More than 65 million Americans suffer from arthritis, which is the primary cause of disability in older adults. Arthritis is also a leading disease, with more than $600 billion in medical expenses each year. There is, however, little research on health care expenditure by race and ethnicity among older adults with arthritis. To examine the racial and ethnic differences in health care expenditures among older adults with arthritis in the United States. A retrospective multiyear cross-sectional study using the Medical Expenditure Panel Survey (MEPS) data (2018-2022) analyzed health care expenditures of adults aged 65 years and older with arthritis across different races and ethnicities. All-cause expenditures (total, office-based visits, hospital inpatient visits, prescription medicine, and outpatient visits) were compared between Hispanic patients, non-Hispanic Black (NHB) patients, and non-Hispanic White (NHW) patients, adjusting for covariates using SAS version 9.4. The study analyzed 15,345 adults (weighted frequency = 29,915,198) with arthritis. The mean total annual health care expenditure was $15,052 (95% CI = $14,435-$15,667) for all adults with arthritis. Although Hispanic patients had the lowest total expenditure ($14,159, 95% CI = $11,955-$16,363), NHB and NHW patients had similar total annual health care expenditures at $15,623 (95% CI = $12,228-$19,015) and $15,237 (95% CI = $14,599-$15,876), respectively. After adjustment for covariates, Hispanic and NHB patients spent 34% (95% CI = 24%-43%) and 31% (95% CI = 22%-39%) less than NHW patients (<i>P</i> < 0.0001). This was largely because of lower office-based expenditures, where both Hispanic and NHB patients spent approximately 52% (95% CI = 42%-60%, <i>P</i> < 0.0001) less than NHW patients. Also, Hispanic patients incurred 23% (95% CI = 1%-41%) lower hospital inpatient expenditure (<i>P</i>  =  0.0406) than NHW patients. For outpatient visits, Hispanic patients spent 71% (95% CI = 59%-80%) and NHB patients 50% (95% CI = 34%-62%) (both <i>P</i> < 0.0001) lower than NHW patients. Hispanic and NHB patients differed only in outpatient expenditures, where NHB patients significantly spent 75% more than Hispanic patients (95% CI = 16%-162%, <i>P</i>  =  0.007) after adjusting for covariates. Total health care expenditures were substantially lower for Hispanic and NHB patients with arthritis compared with NHW patients after adjusting for various covariates. Specifically, Hispanics and NHB patients had lower office-based and outpatient expenditures. Additionally, Hispanic patients incurred lower hospital inpatient expenditures than NHW patients. There is a need for further studies delving into finding reasons for these differences in expenditures, such as behavioral and belief systems that may limit the use of care among racial and ethnic minority groups.