Trends in Medical Expenditures by Race/Ethnicity in Adults with Type 2 Diabetes 2002-2011

Objective: The objective of the study was to examine racial/ethnic differences in medical expenditures (prescription, office-based, in-patient, out-patient, emergency room, total) over time, overall and by type of expenditure, in a nationally representative sample of adults with diabetes. Methods: A weighted sample of 17,820,243 adults aged ≥18 with diabetes from the Medical Expenditure Panel Survey (MEPS) dataset from 2002 to 2011 were analyzed for this study. Multiple comparison testing and general linear model (GLM) were used to test for differences in expenditures by race. Total unadjusted expenditures by racial/ethnic category stratified by different insurance categories (privately insured, publicly insured, uninsured and overall) were also estimated. Results: Non-Hispanic Whites (NHW) had more than $4000 higher expenditures than Hispanics and Other races (p < 0.0001). Prescription costs were about $410 less for Non-Hispanic Blacks (NHB) (p < 0.0001), and more than $600 less for Hispanics (p < 0.0001) and Others (p < 0.0001) compared to NHW. Conclusion: Minority groups with type 2 diabetes were found to have significantly less total expenditures, with the exception of total expenditures for NHB compared to NHW. These findings indicate minorities with type 2 diabetes may be receiving less care than NHW, which has implications for the known disparities in health outcomes and complications in individuals with diabetes.