The relationship between lifetime out-of-pocket medical expenditures, dementia, and socioeconomic status in the U.S

TitleThe relationship between lifetime out-of-pocket medical expenditures, dementia, and socioeconomic status in the U.S
Publication TypeJournal Article
Year of PublicationForthcoming
AuthorsHudomiet, P, Hurd, MD, Rohwedder, S
JournalThe Journal of the Economics of Ageing
ISSN Number2212828X
KeywordsCognitive Ability, Dementia, Medical Expenses, Out-of-pocket payments, Socioeconomic factors
Abstract

Dementia is one of the most expensive medical conditions. The costs are borne by families, by private insurance and by society via public programs such as Medicaid in the U.S.. There is extensive research on the relationship between dementia and annual medical spending. This paper, instead, estimates cumulative lifetime medical expenditures that can be attributed to the onset of dementia using a nationally representative longitudinal survey from the U.S., the Health and Retirement Study. The lifetime expenditures are estimated by summing any out-of-pocket medical spending reported in the panel from age 65 to death. Censored cases are imputed using a non-parametric matching algorithm called splicing. For example, survivors to the most recent wave are matched to similar individuals from older cohorts who are observed at the relevant ages all the way through death. We find that those who live with dementia for at least half a year pay, on average, $38,540 more out of pocket from age 65 to death when controlling for length of life, demographics, lifetime earnings and comorbidities. The costs of dementia are almost exclusively due to spending on nursing homes. Spending on drugs, doctor visits or hospitals, is not significantly related to dementia. The lifetime costs of dementia are significantly larger for white and rich individuals, perhaps because they use higher quality nursing homes and because they have more financial resources to spend down before becoming eligible for Medicaid support.

URLhttps://www.sciencedirect.com/science/article/pii/S2212828X18300690
DOI10.1016/j.jeoa.2018.11.006
Short TitleThe Journal of the Economics of Ageing
Citation Key9908