Title: Comparisons of changes over time in per capita health expenditures across racial and ethnic groups

Authors: Junling Wang, C. Daniel Mullins, Cyril F. Chang, Dick R. Gourley, Ya-Chen Tina Shih, William C. Cushman, Samuel Dagogo-Jack, Shelley I. White-Means

Addresses: Department of Pharmaceutical Sciences and Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 847 Monroe Avenue, Room 205R, Memphis, TN 38163, USA. ' 220 Arch Street, Baltimore, MD 21201, USA. ' 312 Fogelman Clsrm Bldg., 3675 Central Avenue, Memphis, TN 38152, USA. ' 847 Monroe Ave., Suite 226, Memphis, TN 38163, USA. ' 1515 Holcombe Boulevard, Houston, TX 77030, USA. ' CW508 Veterans Affairs Medical Center, Memphis, TN 38104, USA. ' 920 Madison Avenue, Suite 816, Memphis, TN 38163, USA. ' 847 Monroe Ave., Room 205N, Memphis, TN 38163, USA

Abstract: The study compared changes over time in health expenditures across race and ethnicity, using data from the Medical Expenditure Panel Survey. Changes from 1996-1997 to 2004-2005 were compared between non-Hispanic Whites (NHW) and non-Hispanic Blacks (NHB) and between NHW and Hispanic Whites (HW). Three expenditure measures were used: annual expenditures per capita, annual out-of-pocket expenditures per capita (OOPE), and OOPE as a proportion of family income per capita. A linear regression-based difference-in-difference model was analysed by including interaction terms between the latter time period and dummy variables for NHB and HW. NHW had higher increases in annual expenditures per capita than HW ($1657.31 vs. $435.49, p < 0.0001); NHW had similar increases to NHB ($1657.31 vs. $1300.77, p = 0.293). The former comparison was significant in the multivariate analysis (p < 0.001) but the latter was not (p = 0.686). The findings on OOPE were similar to those on expenditures. There were no significant racial or ethnic differences in the changes in OOPE as a proportion of family income per capita. Compared to NHW, HB and HW had lower expenditures throughout the study period, but their increases in financial burden were not higher.

Keywords: race; ethnicity; disparities; health expenditures; public policy; changes; time; per capita; ethnic groups; racial groups; USA; United States; family income; annual expenditure; out-of-pocket expenditure; healthcare expenditure.

DOI: 10.1504/IJPP.2010.035123

International Journal of Public Policy, 2010 Vol.6 No.3/4, pp.172 - 189

Published online: 05 Sep 2010 *

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