Differences in spending for diabetes and multiple chronic conditions in Michigan Medicare beneficiaries.
Am J Manag Care
; 26(11): e362-e368, 2020 11 01.
Article
em En
| MEDLINE
| ID: mdl-33196287
ABSTRACT
OBJECTIVES:
To determine which combinations of type 2 diabetes (T2D) and multiple chronic conditions (MCC) contribute to total spending and differences in spending between groups based on sex, race/ethnicity, and rural residency. STUDYDESIGN:
Retrospective cohort study using 2012 Medicare claims data from beneficiaries in Michigan with T2D.METHODS:
Zero-inflated Poisson regression models to estimate relationships of demographic characteristics and MCC combinations on hospital outpatient, acute inpatient, skilled nursing, hospice, and Part D drug spending.RESULTS:
Across most MCC combinations, there are lower odds of no spending, with a concurrent increase in the expected mean of actual spending when payments are made, except for hospital outpatient costs. For hospital outpatient services, we observed lower spending across all MCC combinations. When controlling for MCC, we generally found that compared with White beneficiaries, Black, Asian/Pacific Islander, and Hispanic beneficiaries experience increased odds of no spending, but when payments were made, payments generally increased. American Indian/Alaska Native beneficiaries are the exception; they experience decreased odds of no payments for hospital outpatient and acute inpatient services, with a concurrent decrease in mean expected payments.CONCLUSIONS:
When considering a range of MCC combinations, we observed differences in total payments between racial/ethnic minority groups and White beneficiaries. Our results highlight the ongoing need to make changes in the health care system to make the system more accessible to racial/ethnic minority groups.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus Tipo 2
/
Múltiplas Afecções Crônicas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2020
Tipo de documento:
Article