Health disparities in cost of care in patients with Alzheimer's disease: an analysis across 4 state Medicaid populations

Am J Alzheimers Dis Other Demen. 2013 Feb;28(1):84-92. doi: 10.1177/1533317512467679. Epub 2012 Nov 29.


Objectives: To investigate health disparities with respect to cost of care across 4 state Medicaid populations.

Methods: Data were obtained from Centers for Medicare and Medicaid Services (CMS) for this retrospective study. Patients were enrolled in a California, Florida, New Jersey, or New York Medicaid programs during 2004, with a diagnosis of Alzheimer's disease (International Classification of Diseases, Ninth Revision 331.0). Outcome of interest was cost of care. Decomposition of cost to calculate disparities was estimated using the Oaxaca-Blinder model. An a priori α level of .01 was used.

Results: Approximately 158 974 individuals qualified for this study. Disparities were found to exist between blacks and whites (with blacks having higher costs; P < .0001), whites and others (with whites having higher costs; P < .0001), blacks and Hispanics (with blacks having higher costs; P < .0001), blacks and others (with blacks having higher costs; P < .0001), and Hispanics and others (with Hispanics having higher costs; P < .0001).

Conclusions: Disparities in cost among minority-to-minority populations were just as prevalent, if not higher, than minority-white disparities.

Publication types

  • Comparative Study

MeSH terms

  • Alzheimer Disease / economics*
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / ethnology
  • Black or African American
  • California / epidemiology
  • California / ethnology
  • Costs and Cost Analysis / economics
  • Florida / epidemiology
  • Florida / ethnology
  • Healthcare Disparities / economics*
  • Hispanic or Latino
  • Humans
  • Medicaid / economics*
  • Minority Groups
  • New Jersey / epidemiology
  • New Jersey / ethnology
  • New York / epidemiology
  • New York / ethnology
  • Retrospective Studies
  • United States / epidemiology
  • United States / ethnology
  • White People