Non-Hispanic Black and Hispanic people on Medicare had higher costs to treat their dementia compared to non-Hispanic white people. In fact, costs were highest for Non-Hispanic Black individuals during every phase of care, according to a new report.
The study was published in the Journal of the American Geriatrics Society on Wednesday. It included data from the 2000–2016 Health and Retirement Study, which consisted of data from Medicare claims. The team looked at the costs for care a year before a person was diagnosed, during the first year, after the first year and then during the last year a person lived.
The average total Medicare expenditures for non-Hispanic Black people with dementia was $165,730. Hispanic people using Medicare who had dementia had $160,442 in expenses. Non-Hispanic whites had an average total Medicare spending of $136,326. The mean spending for non-Hispanic Black people was higher in the year before diagnosis and in the year after compared to whites by a few thousand dollars. During the last year a person with dementia lived, non-Hispanic Black people had $51,294 in spending while Hsipanic people had an average spending of $47,469, and non-Hispanic white individuals had $39,499 in expenditures.
What drove the differences, the authors said, was greater use of high-cost services such as visits to the emergency department, inpatient services and intensive care. This was especially true during a person’s last year living, the data showed.
In every phase of the disease the researchers examined, non-Hispanic Black people had had fewer ambulatory care visits and more emergency department visits as well as hospitalizations compared to non-Hispanic white individuals. Non-Hispanic Black people were more likely to be admitted to the intensive care unit, less likely to utilize hospice care and more likely to die in a hospital compared to non-Hispanic Whites during the last year of life.
“This pattern implies that non-Hispanic Blacks may be less likely to access care management in the lower-cost ambulatory settings and more likely to receive care in ED and inpatient facilities at higher cost,” the authors wrote.
Authors of the report say more research is needed to find out what’s behind the disparities and to find ways to enhance communication, decision making and access to care.
