Full Citation

Title: Determinants of Healthcare Expenditures among People with Aphasia: Importance of Race, Sex, Residence, and Aphasia Type

Citation Type: Journal Article

Forthcoming?: Yes

ISBN:

ISSN: 0268-7038

DOI: 10.1080/02687038.2023.2216921

NSFID:

PMCID:

PMID:

Abstract: Introduction Roughly 30% of stroke survivors suffer from aphasia—a communication disorder that affects the ability to communicate effectively—but little is known about their healthcare expenditure or how it varies between aphasia subtypes. This study evaluates the relative differential in healthcare expenditure of anomic, Broca’s, Wernicke’s and Conduction aphasia and assesses expenditure between demographic cohorts Methods Individual level data from the 2010 Moss Aphasia Psycholinguistic Project Database was matched with the 2010 Medical Expenditure Panel Survey using a propensity score algorithm based on functional, health, and demographic characteristics. Multilevel, generalized, nonlinear regression models were applied to the resulting data set to assess the correlation between annual healthcare expenditure, time post onset (tpo), sex, race, family size, marital status, income, education, aphasia type, and region of residence. Results were used to predict expenditure by aphasia subtype, race, and sex. Multiple distributional specifications tested the sensitivity and ensured the robustness of estimates. Results Regression results indicate that individuals with Broca’s aphasia had statistically higher healthcare expenditures paying an average of $10,896.45 annually when compared to anomic ($7,927.60), Wernicke’s ($7,096.22), and Conduction ($9,447.19) aphasias. Additionally, healthcare expenditure increased with each year of age (β=0.004, SE=0.005), but decreased with each year after stroke (β=-0.002, SE=0.001). Females (β=0.358, SE=0.131) and Blacks (β=0.103, SE=0.200) paid significantly more annually compared to males and Whites, respectively. Neither region of residence, income, nor level of education were significantly correlated with healthcare expenditure. Conclusion This study showed that, while individuals with Broca’s aphasia had higher average healthcare expenditure than other subtypes, the differential was not statistically significant. Sex and race cohorts did, however, show statistically significant differences in healthcare expenditures. While causality is outside the scope of this analysis, additional work is needed to determine the best strategy to mitigate these disparities.

Url: https://www.tandfonline.com/doi/abs/10.1080/02687038.2023.2216921

User Submitted?: No

Authors: Jacobs, Molly; Evans, Elizabeth; Ellis, Charles

Periodical (Full): Aphasiology

Issue:

Volume:

Pages: 1-16

Data Collections: IPUMS Health Surveys - MEPS

Topics: Gender, Health, Poverty and Welfare, Race and Ethnicity

Countries: