Identifying Gender Minority Patients' Health And Health Care Needs In Administrative Claims Data

Health Aff (Millwood). 2018 Mar;37(3):413-420. doi: 10.1377/hlthaff.2017.1295.


Health care utilization patterns for gender minority Medicare beneficiaries (those who are transgender or gender nonbinary people) are largely unknown. We identified gender minority beneficiaries using a diagnosis-code algorithm and compared them to a 5 percent random sample of non-gender minority beneficiaries from the period 2009-14 in terms of mental health and chronic diseases, use of preventive and mental health care, hospitalizations, and emergency department (ED) visits. Gender minority beneficiaries experienced more disability and mental illness. When we adjusted for age and mental health, we found that they used more mental health care. And when we adjusted for age and chronic conditions, we found that they were more likely to be hospitalized and to visit the ED. There were several small but significant differences in preventive care use. Findings were similar for disabled and older cohorts. These findings underscore the need to capture gender identity in health data to better address this population's health needs.

Keywords: Disparities; Gender Minority; Medicare; Mental Health/Substance Abuse; Minority Health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administrative Claims, Healthcare / statistics & numerical data*
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / therapy
  • Disabled Persons / statistics & numerical data
  • Emergency Service, Hospital
  • Hospitalization
  • Humans
  • Medicare
  • Mental Disorders / therapy
  • Middle Aged
  • Needs Assessment*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Sexual and Gender Minorities / statistics & numerical data*
  • United States