Health expenditures across racial and ethnic groups among childhood cancer patients/survivors

Introduction: Previous studies have found that minority childhood cancer survivors are more likely to develop worse outcomes than the majority population. In order to explore the causes for different outcomes between racial and ethnic groups, this study examines whether there are racial and ethnic disparities in health expenditures among childhood cancer survivors.

Methods: Children (younger than 20) with cancer diagnoses in the Medical Expenditure Panel Survey (MEPS; 1996 to 2004) were included in the analysis. Consumer price indices for medical care released by the Department of Labor were used to convert costs from all years to 2004 dollars. The cost categories included (1) total health care expenditures, (2) expenditures on office-based visits, (3) outpatient visits, (4) hospitalization and emergency room visits, (5) home health care, (6) prescription drugs, and (7) visual, dental, and other health care expenditures.

Results: The numbers of childhood cancer patients/survivors in the study sample across racial and ethnic groups were 322 (weighted to 3,977,468) for non-Hispanic whites, 42 (weighted to 276,742) for non-Hispanic blacks, and 76 (weighted to 352,635) for Hispanic whites. Hispanic blacks were excluded from further analysis because of small sample size (2, weighted to 20,072). The annual total health expenditures for treating each childhood cancer patient or survivor were $3253.29. Of this amount, expenditures on inpatient and emergency room visits accounted for the largest proportion (29.14%) and office-based visits accounted for the second largest proportion (28.92%). The next category that accounted for large proportion of total health expenditures was dental, vision, and other health expenditures. Other categories of health expenditures accounted for 9.19%, 2.72%, and 7.26% for outpatient department visits, home health care, and prescription drugs, respectively. The total health expenditures were higher among Hispanic whites ($3782.92) than non-Hispanic whites ($3250.32) and non-Hispanic blacks ($2505.61). The comparisons between racial and ethnic groups for different categories of health expenditures did not follow a consistent pattern. For example, the expenditures on inpatient and emergency room visits were higher among non-Hispanic whites than non-Hispanic blacks and Hispanic whites. Despite these numerical differences in health expenditures across racial and ethnic groups, the differences in total health expenditures and all categories of health expenditures were generally not significant.

Conclusions: There does not seem to be racial and ethnic disparities in health expenditures among childhood cancer patients/survivors. Racial and ethnic disparities in adverse outcomes among these individuals might be due to long term effects of cancer, socioeconomic characteristics, etc.