The 130th Annual Meeting of APHA

Abstract #45591

Jose L. Calderon, MD¹, Deyu Pan, MS¹, and Richard S. Baker, MD². (1) Biomedical Research Center-RCMI, Charles R. Drew University of Medicine and Science, 1731 E. 120th Street, MP-30, Los Angeles, CA 90059, 323-563-4966, jocalder@cdrewu.edu, (2) Biomedical Research Center-RCMI, Charles R. Drew Universityof Medicine and Science, 1731 E. 120th Street, MP 30, Los Angeles, CA 90059

Background: Diabetes outcomes for African American (AA) and Hispanic elderly are poorer than for non-Hispanic whites (NHW). Having Medicare may not be as important as expenditures when seeking to explain this disparity. We compared expenditures for AA, Hispanic and NHW elderly diabetics across six healthcare events. Methods: Data from the MEPS household component for 1996-1998 were used to identify AA , Hispanic and NHW diabetics > 65 years old. Hospital stays (IP), medical provider visits (OB), outpatient (OP), emergency room (ER), home healthcare (HH) and prescription (RX) data were analyzed using ANOVA. Outcome Measures: Average annual cost per person and cost per event. Results: Average cost per person was greater for AA in 1996 (p=.01) and for Hispanics in 1997 (p=.01) when compared to NHW. Average cost per event was greater for AA in 1996 when compared to Hispanics and NHW (p=.01), and greater for Hispanics in 1997 compared to NHW (p=.01). There was decreased HH and OP expenditures for AA and increased HH, IP and RX expenditures for Hispanics during those years. There was an overall decrease in expenditures for AA and Hispanics with no significant inter-group differences detected by 1998. Conclusions: An overall decrease in Medicare expenditures for AA and Hispanics between 1996-1998 resulted in expenditure parity with NHW elderly diabetics in 1998. Greater expenditures did not solve the problem of disparate outcomes but less Medicare expenditure may mean that elderly AA and Hispanic diabetics will have less access to care despite their continued poorer outcomes from diabetes.

Learning Objectives: At the end of this session participants will be able to

• Discuss differences in cost for health services for elderly diabetic African American, Hispanic and non-Hispanic white Medicare receipients.
• Discuss access and utilization issues that may arise from changes in Medicare expenditures for diabetes care.

Keywords: Cost Issues, Elderly

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.