Health Affairs

How Does U.S. Medical Spending Vary By Age And Gender?

New analysis of 2004 national health care spending by five researchers from the Centers for Medicare and Medicaid (CMS) reveal some clear gender delineations. According to the authors’ analysis, female per capita expenditures were 32 percent higher than those of males, per capita differences were most pronounced among the population of child-bearing age, and the gender difference in total spending levels was highest for the elderly, due to women’s longer life expectancy. This paper expands the research reported in a 2008 Health Affairs paper to include spending by gender as well as by age.

Pronounced Gender And Age Differences Are Evident in Personal Health Care Spending Per Person
By Jonathan Cylus, Micah Hartman, Benjamin Washington, Kimberly Andrews, and Aaron Catlin
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0216

 

Hartman, Washington, Andrews, and Catlin are affiliated with the Office of the Actuary, Centers for Medicare and Medicaid Services (CMS), in Baltimore. Cylus, previously affiliated with CMS, is currently a research fellow at the World Health Organization’s European Observatory on Health Systems and Policies, in London.

The authors divided personal health care spending by gender into three age groups: children (0-18), working-age adults (19-64) and the elderly (65 and older). No single source of comprehensive health care spending data by gender and age exists. Therefore, the authors used several sources and methods to estimate the proportion of spending by gender and age group and applied those estimates to the historical data in the National Health Expenditure Accounts.

Here are some key findings:

• Women spent approximately $1,448 more per person than men ($5,989 versus $4,541).


• In the aggregate, hospital spending showed the smallest gender difference: women spent about 18 percent more than men. The greatest imbalance was in nursing home care, where women spent almost twice as much as men.


• The one payer where total health care spending was greater for men than for women was the category of “other public payers,” a difference largely attributable to male enrollment in the Department of Defense and the Department of Veterans Affairs health care programs.


• For children, per capita spending for boys was $2,736–4 percent higher than the spending of $2,620 for girls.


• Among the elderly, 61 percent of all health care spending was for women. Out-of-pocket per capita spending was 50 percent higher for women than for men–and 39 percent of women’s spending in this category went to nursing home care, compared to 27 percent for men. This is not surprising: According to the Census Bureau’s Group Quarters Population data, almost three-fourths of those over sixty-five who live in skilled nursing facilities are female. Elderly women also spent more per capita on retail prescription drugs ($1,703 versus $1,364 for men).

“The estimates presented in this paper can shed light on some of the variation in health care spending by gender and age and can contribute to a greater understanding of overall health patterns in the United States,” conclude the authors. “It is our hope that the work described here will help give researchers, policy makers, and others a baseline set of estimates and a more comprehensive understanding of how gender and age influence health spending, so that the future effects of health care reform can be adequately evaluated.”

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at www.healthaffairs.org. You can also find the journal on Facebook and Twitter and download Narrative Matters on iTunes. Address inquiries to Sue Ducat at (301) 841-9962 or sducat@projecthope.org