Age and gender differences in Medicare expenditures at the end of life for colorectal cancer decedents.
Age and gender differences in Medicare expenditures at the end of life for colorectal cancer decedents.
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结直肠癌死者临终时医疗保险支出的年龄和性别差异。
DOI：
10.1089/jwh.2006.0012
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
Lynn,Joanne
中科院分区：
文献类型：
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作者：
Shugarman,LisaR;Bird,ChloeE;Schuster,CynthiaR;Lynn,Joanne
目的和方法：我们通过对医疗保险管理和索赔数据的横断面研究，研究了结直肠癌死亡者生命最后一年（LYOL）医疗保险支出的年龄和性别差异。参与者是患有结直肠癌的老年医疗保险受益人（68岁以上），他们在死亡前36个月（1996-1999，n= 6657）被A部分和B部分覆盖。我们估计的差异，平均医疗保险的利用和支出在整个LYOL和服务类型（住院，门诊，医生，熟练的护理设施[SNF]，家庭健康，临终关怀hospiceherein.Results：女性比男性更有可能使用住院服务，SNF服务，家庭健康，临终关怀在LYOL。妇女的平均支出比男子高出1 600美元，这是由于家庭保健和临终关怀服务的平均支出较高。在68-74岁使用住院治疗的死者中，妇女的住院费用高于男子。年龄较大的队列不太可能使用住院和门诊服务，更有可能使用SNF服务。平均医疗保险支出显着降低，在老年cohols.Conclusions：平均医疗保险支出的性别差异大部分是由性别差异的年龄和较低的平均支出老年结直肠癌死者的解释。其余的性别差异因年龄组而异，在68-74岁年龄组中最大。妇女在每一项社会支助服务（家庭保健、家庭保健和临终关怀）上的支出较高，甚至在那些使用特定类型服务的妇女中也是如此，这可能反映出与男子相比，老年妇女缺乏非正式支助。
Purpose and Methods: We examined age and gender differences in Medicare expenditures for colorectal cancer decedents in the last year of life (LYOL) through a cross-sectional study of Medicare administrative and claims data. Participants were aged Medicare beneficiaries (68+ years) with colorectal cancer, who were covered by Parts A and B for 36 months before death (1996–1999,n= 6657). We estimated differences in mean Medicare utilization and expenditures in the LYOL overall and by type of service (inpatient, outpatient, physician, skilled nursing facility [SNF], home health, and hospice).Results: Women were more likely than men to use inpatient services, SNF services, home health, and hospice in the LYOL. Average expenditures for women were $1600 higher than for men, which were attributed to higher average expenditures on home health and hospice services. Among decedents aged 68–74 who used inpatient care, inpatient expenditures were higher for women than men. Older cohorts were less likely to use inpatient and outpatient services and more likely to use SNF services. Average Medicare expenditures were significantly lower in older cohorts.Conclusions: Most of the gender differences in average Medicare expenditures were explained by gender differences in age and the lower average expenditures on older decedents with colorectal cancer. Remaining gender differences varied across age cohorts and were largest among those aged 68–74. Higher expenditures for women on each of the social supportive services (SNF, home health, and hospice), even among those who used a particular type of service, may reflect a lack of informal supports for older women compared with men.