Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, SC 29425, USA.
J Natl Med Assoc. 2019 Feb;111(1):28-36. doi: 10.1016/j.jnma.2018.04.004. Epub 2018 May 24.
Racial and ethnic minority groups have a higher prevalence of diabetes, increased risk for adverse complications, and worse health outcomes compared to Non-Hispanic Whites. Evidence suggests they also have higher healthcare expenses associated with diabetes care. Therefore, the objective of this study was to assess racial and ethnic differences in out-of-pocket (OOP) costs among a nationally representative sample of adults with diabetes.
Cross-sectional study of 17,702 adults (aged ≥18 years) with diabetes from years 2002-2011 in the Medical Expenditure Panel Survey Household Component. The outcome was OOP expenditures, and the primary predictor was race/ethnicity. Descriptive statistics summarized the sample population. Unadjusted mean values were computed to compare OOP expenses over time. A two-part model was used to estimate adjusted incremental OOP expenses.
For the overall sample, OOP expenditures decreased significantly over time. In addition, compared to NHWs, racial and ethnic minority groups had significantly lower OOP costs per year when adjusted for sociodemographic characteristics, comorbid conditions, and time. NHBs paid $481 less than NHWs; Hispanics paid $591 less than NHWs; and individuals in the 'Other' racial/ethnic category paid nearly $645 less compared to NHWs (p < 0.001).
Racial/ethnic minority patients with diabetes had significantly less OOP expenses compared to NHWs, possibly due to differences in healthcare utilization. OOP expenses decreased significantly over time for all racial and ethnic groups. Additional research is needed to understand the factors associated with differences in OOP expenditures among racial groups.
与非西班牙裔白人相比，少数族裔群体的糖尿病患病率更高，发生不良并发症的风险更高，健康状况更差。有证据表明，他们在糖尿病护理方面的医疗保健支出也更高。因此，本研究的目的是评估具有全国代表性的糖尿病成年患者样本中种族和民族差异的自付费用。
这是一项横断面研究，纳入了 2002 年至 2011 年医疗支出调查家庭部分中 17702 名年龄≥18 岁的糖尿病患者。结果是自付支出，主要预测指标是种族/民族。描述性统计总结了样本人群。计算未调整的平均值以比较随时间推移的自付费用。使用两部分模型估计调整后的增量自付费用。
对于整个样本，自付支出随时间显著下降。此外，与非西班牙裔白人相比，调整了社会人口统计学特征、合并症和时间后，少数族裔群体的年自付费用明显较低。非西班牙裔黑人比非西班牙裔白人少支付 481 美元；西班牙裔比非西班牙裔白人少支付 591 美元；与非西班牙裔白人相比，其他种族/民族类别的个体支付的费用少了近 645 美元（p<0.001）。
与非西班牙裔白人相比，患有糖尿病的少数族裔患者的自付费用明显较低，这可能是由于医疗保健利用的差异所致。所有种族和民族群体的自付费用随时间显著下降。需要进一步研究以了解与种族群体自付支出差异相关的因素。
