Understanding racial disparities in health care expenditures for cervical cancer.

Jerusha Daggolu, Marjan Zakeri, Sujit Sansgiry
Author Information
  1. Jerusha Daggolu: University of Houston College of Pharmacy, Pharmaceutical Health Outcomes and Policy, Houston, TX.
  2. Marjan Zakeri: University of Houston College of Pharmacy, Pharmaceutical Health Outcomes and Policy, Houston, TX.
  3. Sujit Sansgiry: University of Houston College of Pharmacy, Pharmaceutical Health Outcomes and Policy, Houston, TX.

Abstract

BACKGROUND: Cervical cancer demonstrates a notable efficacy in treatment, evidenced by a 92% 5-year survival rate among cases diagnosed at a localized stage. In 2020, the estimated annual national expenditure for cervical cancer care amounted to $2.3 billion in the United States. Limited real-world data are available for racial disparities in health care expenditures for cervical cancer.
OBJECTIVE: To evaluate racial disparities associated with annual health care expenditures among patients diagnosed with cervical cancer in the United States.
METHODS: A retrospective observational cohort study of annual health care expenditures in patients with cervical cancer diagnosed during 2014-2019 was performed using the Medical Expenditure Panel Survey data. In addition to the descriptive weighted analysis, an unadjusted analysis of the annual health care expenditure was conducted. An adjusted linear regression model with log transformation of the outcome variable was used to evaluate the total annual health care expenditure as well as expenditures by category across the racial groups.
RESULTS: Overall, 826 patients with cervical cancer were identified from the Medical Expenditure Panel Survey during 2014-2019. The majority were classified as White patients (81.2%) and in the age group of 45-64 years (44.65%). On average, the total annual health care expenditure was $11,537 (95% CI = $9,887-$13,186) among the White cohort, $10,659 (95% CI = $6,704-$14,614) among the African American cohort, and $8,726 (95% CI = $6,113-$11,340) among the Hispanic cohort. After adjusting for covariates, the average total annual health care expenditure for the Hispanic cohort was 35% of the total health care expenditure of the White cohort ( < 0.001) and 46% of the African American cohort's health care expenditure ( = 0.02). Specifically, adjusted costs of office-based and outpatient visits for the Hispanic cohort were 47% ( = 0.009) and 57% ( = 0.005) lower than for the White cohort, respectively. The total annual home health care expenditure for the African American cohort was 49% lower than White patients ( = ), and the Hispanic cohort's total expenditure, excluding prescription medicines, was 57% lower than African American patients ( = 0.02).
CONCLUSIONS: This study provides valuable information regarding the health care disparities that need to be addressed among certain minority races. Reducing the disparities in health care spending across racial groups should be included as a crucial element in tackling well-established health care inequities.

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MeSH Term

Adult
Aged
Female
Humans
Middle Aged
Young Adult
Black or African American
Cohort Studies
Health Expenditures
Healthcare Disparities
Retrospective Studies
United States
Uterine Cervical Neoplasms
White

Word Cloud

Created with Highcharts 10.0.0carehealthexpenditurecohortannual=canceramongcervicalpatientstotalracialdisparitiesexpendituresWhite0AfricanAmericanHispanicdiagnosed95%CIlowerUnitedStatesdataevaluatestudy2014-2019MedicalExpenditurePanelSurveyanalysisadjustedacrossgroupsaverage$6cohort's0257%BACKGROUND:Cervicaldemonstratesnotableefficacytreatmentevidenced92%5-yearsurvivalratecaseslocalizedstage2020estimatednationalamounted$23billionLimitedreal-worldavailableOBJECTIVE:associatedMETHODS:retrospectiveobservationalperformedusingadditiondescriptiveweightedunadjustedconductedlinearregressionmodellogtransformationoutcomevariableusedwellcategoryRESULTS:Overall826identifiedmajorityclassified812%agegroup45-64years4465%$11537$9887-$13186$10659704-$14614$8726113-$11340adjustingcovariates35%<00146%Specificallycostsoffice-basedoutpatientvisits47%009005respectivelyhome49%excludingprescriptionmedicinesCONCLUSIONS:providesvaluableinformationregardingneedaddressedcertainminorityracesReducingspendingincludedcrucialelementtacklingwell-establishedinequitiesUnderstanding

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