Analysis: Gender delineation seen in medical spending
An analysis of 2004 national healthcare spending by the Centers for Medicare & Medicaid Services reveals some gender delineations.
According to the 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.
The paper expands upon a 2008 Health Affairs article “Pronounced Gender And Age Differences Are Evident in Personal Healthcare Spending Per Person,” By Jonathan Cylus, Micah Hartman, Benjamin Washington, Kimberly Andrews and Aaron Catlin, to include spending by gender as well as by age.
The five authors involved in the analysis are affiliated with CMS' Office of the Actuary 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 healthcare spending by gender into three age groups: children (0-18), working-age adults (19-64) and the elderly (65 and older). They 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.
According to the analysis:
- Women spent approximately $1,448 more per person than men ($5,989 versus $4,541).
- 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 instance in which healthcare spending was greater for men than for women was in“other public payers,” a difference largely attributable to male enrollment in the Department of Defense and the Department of Veterans Affairs healthcare 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 healthcare 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.
- According to the Census Bureau’s Group Quarters Population data, almost three-fourths of those over 65 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 healthcare spending by gender and age and can contribute to a greater understanding of overall health patterns in the United States,” the analysis concluded. “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 healthcare reform can be adequately evaluated.”