Aug 18, 2021 - Health

U.S. disparities emerge in health spending figures

Annual healthcare spending per person
Data: Dieleman, et al., 2021, “US Health Care Spending by Race and Ethnicity, 2002-2016”; Chart: Axios Visuals

The amount of per-person health care spending is highest among white individuals compared to patients of other races, even after adjusting for age and health conditions, according to a study led by the Institute for Health Metrics and Evaluation in Seattle.

Why it matters: The study, published Tuesday in JAMA, provides evidence of inequities by race and ethnicity "from how physicians respond to patients to bias that exists in the algorithms that assess health needs and determine the appropriate intervention," the researchers write.

The details: Researchers from the set out to measure health care spending by race to understand patterns in utilization and treatments.

  • The study included data from 7.3 million health system visits, admissions or prescriptions captured in the Medical Expenditure Panel Survey from 2002 to 2016 and the Medicare Current Beneficiary Survey from 2002 to 2012.

By the numbers: Of the $2.4 trillion spent across six types of care included in this study, health care spending per person spending for white individuals averaged $8,141 and accounted for 72% of health care spending.

  • Per-person spending was the lowest, or $4,692, for Asian, Native Hawaiian, and Pacific Islander individuals.
  • The average per-person spending for Black individuals and Hispanic individuals was $7,361 and $6,025, respectively.

Zoom in: The researchers observed differences in health care usage by race. For instance, white individuals received an estimated 15% more spending on ambulatory care than the all-population mean.

  • Meanwhile, spending for Black individuals was 26% less on ambulatory care than the all-population mean but was 19% more on inpatient and 12% more spending on emergency care.
  • Hispanic individuals received about 33% less spending per person on ambulatory care than the all-population mean.
  • Spending for Asian, Native Hawaiian and Pacific Islander individuals was less than the all-population mean on all types of care, except dental care.

Big picture: The study was one of a series of studies examining racial and ethnic inequities in medicine published by the journal this week.

  • Another analysis showed that living in a more highly disadvantaged neighborhood was associated with a 32% increased risk of dying from any cause and a 57% increased risk of death from cardiovascular disease.
  • Another study found African American patients with nonmetastatic triple-negative breast cancer had a 28% increased risk of death compared with their white counterparts, even after the researchers adjusted for age, insurance status, county-level socioeconomic deprivation, and rural residency.
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