Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA.
Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Int J Environ Res Public Health. 2022 Jul 25;19(15):9014. doi: 10.3390/ijerph19159014.
The purpose of this study was to determine if there were racial/ethnic differences and patterns for individual office-based visit expenditures by gender among a nationally representative sample of adults with arthritis. We retrospectively analyzed pooled data from the 2011 to 2019 Medical Expenditure Panel Survey of adults who self-reported an arthritis diagnosis, stratified by gender (men = 13,378; women = 33,261). Our dependent variable was office-based visit expenditures. Our independent variables were survey year (categorized as 2011-2013, 2014-2016, 2017-2019) and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, non-Hispanic other/multiracial). We conducted trends analysis to assess for changes in expenditures over time. We utilized a two-part model to assess differences in office-based expenditures among participants who had any office-based expenditure and then calculated the average marginal effects. The unadjusted office-based visit expenditures increased significantly across the study period for both men and women with arthritis, as well as for some racial and ethnic groups depending on gender. Differing racial and ethnic patterns of expenditures by gender remained after accounting for socio-demographic, healthcare access, and health status factors. Delaying care was an independent driver of higher office-based expenditures for women with arthritis but not men. Our findings reinforce the escalating burden of healthcare costs among U.S. adults with arthritis across genders and certain racial and ethnic groups.
本研究旨在确定在一个具有代表性的关节炎成年人群体中，是否存在按性别划分的种族/民族差异和个人门诊就诊支出模式。我们回顾性地分析了 2011 年至 2019 年医疗支出面板调查中自我报告关节炎诊断的成年人的汇总数据，按性别分层（男性=13378；女性=33261）。我们的因变量是门诊就诊支出。我们的自变量是调查年份（分为 2011-2013 年、2014-2016 年、2017-2019 年）和种族/民族（非西班牙裔白人、非西班牙裔黑人、西班牙裔、非西班牙裔亚裔、非西班牙裔其他/多种族）。我们进行了趋势分析，以评估随时间变化的支出变化。我们利用两部分模型来评估有任何门诊支出的参与者之间门诊支出的差异，然后计算平均边际效应。在关节炎患者中，无论性别如何，非西班牙裔白人、非西班牙裔黑人、西班牙裔、非西班牙裔亚裔和非西班牙裔其他/多种族群体的门诊就诊支出在整个研究期间都显著增加。在考虑了社会人口统计学、医疗保健获得情况和健康状况因素后，性别差异和种族/民族差异仍然存在。对于关节炎女性患者而言，延迟治疗是门诊就诊支出增加的一个独立驱动因素，但对于男性患者则不然。我们的研究结果强调了美国关节炎成年人群体中不同性别和某些种族/民族群体的医疗保健成本不断上升的负担。
