Out-Of-Pocket Health Care Spending: Effects Of Partner Spending On Own Spending

Abstract

Background. Delayed or foregone medical care because of cost is an ever-present possibility for most households and a current concern for many households in the United States. A small body of literature exists concerning the relationship between household out-of-pocket spending and household-member delayed or foregone health care and none of this literature focuses primarily on older adults. This research seeks to answer the following question: Among older adults, how does the existence of a pre-existing medical condition(s) in one’s partner effect one’s own out-of-pocket health care spending in the period following a recent medical condition diagnosis? Methods. This research used data from the Health and Retirement Study (HRS). The HRS surveys United States non-institutionalized residents at least 50 years of age and their partners every two years. The analytic sample was comprised of 2,325 observations for 524 households from the 2002 to 2012 survey waves. This research utilized a 2-part fixed-effects difference-in-differences model. The outcomes of interest were individual total and prescription out-of-pocket health care spending. Results. In contrast to unadjusted models, after adjusting for a number of individual and household characteristics, there was no significant difference in the change in total and prescription out-of-pocket spending behavior after a medical condition diagnosis when comparing individuals with and without a partner with a pre-existing medical condition. Conclusion. While most of the difference-in-differences results were not significant in the unadjusted, adjusted, and sensitivity analyses for both total and prescription out-of-pocket spending, all but a handful of these results were positive. Positive effect values are counter to the result that was expected. The positive sign indicates a tendency for individuals who have partners with a pre-existing condition to have a greater change in out-of-pocket spending than individuals without a partner with a pre-existing condition. A possible explanation for this finding could relate to increased health care literacy in households that have a partner with a pre-existing condition.