Table 3.
Models Examining Racial/Ethnic Differences in Total Medicare Expenditures per Capita in the Last 6 Months of Life
| Model A Race only | Model B A + Age, gender | Model C B + Cause of death + Illness Burden | Model D C + HSA Effect | Model E D + SES | Model F E + Hospice | Model G F + Medical Interventions | |
|---|---|---|---|---|---|---|---|
|
| |||||||
| Reference (Constant) | 20,166 | 14,462 | 4,901 | 6,178 | 6,243 | 6,455 | 2,488 |
| Race | |||||||
| White | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| Black | 6,538 | 5,840 | 5,395 | 2,924 | 3,068 | 3,031 | 997 |
| Hispanic | 11,536 | 10,504 | 9,524 | 3,705 | 4,282 | 4,278 | 1,902 |
| Other | 5,307 | 5,613 | 5,203 | 2,103 | 2,477 | 2,454 | 717 |
| Sex & age | |||||||
| Women | |||||||
| 66 to 74 | 12,258 | 11,427 | 11,777 | 11,640 | 11,607 | 4,156 | |
| 75 to 84 | 7,438 | 6,922 | 6,973 | 6,839 | 6,813 | 2,075 | |
| 85 or older | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | |
| Men | |||||||
| 66 to 74 | 9,690 | 9,358 | 9,865 | 9,543 | 9,478 | 2,716 | |
| 75 to 84 | 7,959 | 7,115 | 7,538 | 7,177 | 7,131 | 1,691 | |
| 85 or older | 2,783 | 1,687 | 2,022 | 1,717 | 1,695 | -231* | |
| Cause of death | |||||||
| Stroke & brain diseases | Ref. | Ref. | Ref. | Ref. | Ref. | ||
| Heart disease | 1,915 | 1,051 | 941 | 856 | 110* | ||
| Cancer, all | 5,333 | 4,790 | 4,555 | 4,797 | 4,178 | ||
| COPD | 5,586 | 5,345 | 5,294 | 5,278 | 4,135 | ||
| Pneumonia & influenza | 1,048 | 1,203 | 1,182 | 1,110 | 1,145 | ||
| Diabetes | 7,891 | 6,937 | 6,943 | 6,814 | 3,494 | ||
| Chronic liver disease & cirrhosis | 4,021 | 3,541 | 3,443 | 3,531 | 2,683 | ||
| Unintentional injuries, homicide, suicide, etc | 3,371 | 3,489 | 3,310 | 3,176 | 1,585 | ||
| Other | 7,503 | 7,292 | 7,269 | 7,213 | 4,264 | ||
| DCG Risk Score Geography (HSA) Income quartile (Residence Zip code Median Income) | 3,731 | 3,327 | 3,393 | 3,410 | 2,907 | ||
| Lowest | 1,851 | 1,831 | 772 | ||||
| Second lowest | 997 | 982 | 251* | ||||
| Third lowest | 171* | 162* | -287* | ||||
| Highest | Ref. | Ref. | Ref. | ||||
| Medicaid Buy-In | -1,963 | -1,984 | -616 | ||||
| Enrolled for hospice in last 6 months | -784 | 3,470 | |||||
| End-of-life Interventions | |||||||
| ICU | 12,094 | ||||||
| Resuscitation, cardiac conversion | -5,501 | ||||||
| Ventilation | 15,208 | ||||||
| Gastrostomy | 22,827 | ||||||
| Vascular transfusion | 11,023 | ||||||
| Dialysis | 13,072 | ||||||
| Chemotherapy | 7,039 | ||||||
| Cardiac Catheterization | 20,377 | ||||||
| Heart assist/balloon | 7,470 | ||||||
| PAP, wedge | 2,927 | ||||||
| Antibiotic | 12,360 | ||||||
All coefficients are significant at p<0.05 except those starred (*).