Abstract 127: Disparities in Total Health Care Expenditure, and Payment Type Related to Hypertension Between Non Hispanics and Hispanics in the USA: Results From the Medical Expenditure Panel Survey (2013 - 2014)

Background: Each year in the USA, more than 75 million adults are diagnosed with hypertension (HTN), but less than 54% have this condition under control. Due to poor management, mortality due to HTN or related complications was 410,000 in 2014 and resulted in close to $50 billion spent. We sought to examine disparities in the proportion of events and related expenditure due to HTN between 54 million Hispanics, representing 17% in the USA population and non Hispanics. Methods and Population: We used data from the Medical Expenditure Panel Survey (MEPS), the most complete source of data on the cost and use of health care and health insurance coverage for 2013 and 2014. Cost was grouped as related to ambulatory, emergency room, inpatient, home visits and medications. By source, payments were grouped as paid by family, MEDICARE, MEDICAID, private insurance, VA, Tricare and other. Results: Overall, there were 61.2 and 61.9 million total events associated with HTN in 2013 and 2014 respectively; Hispanics accounted for 5.8 (9.5%) and 5.4 (8.7%) million events each year. On an average, HTN events involving Hispanics were costlier up to $90 - $300 more than non Hispanics ($1053 vs. $ 746 in 2013; and $890 vs. $804 in 2014). For Hispanics, payments were mainly covered by MEDICAID (42.1%) and MEDICARE (27.5%), compared to MEDICARE (39.3%) and private insurance (23.7%) for non-Hispanic population. Hispanics HTN expenditures were $6.1 billion (12.9%) in 2013 and 5.3 billion (10.3%) in 2014 and Hispanics had disproportionately fewer number of events than expected 17%, and the structure of their costs for those events was not different from non-Hispanics. In regression model, accounting for demographics and type of insurance, being Hispanic was a significant predictor of the total, ambulatory and inpatient cost, but not emergency room or medication cost. Conclusion and Discussion: Hispanics participate disproportionately less in HTN events and costs compared to their proportion in population, even when age, demographic and socioeconomic factors are accounted for. They also have on average higher and more complex events compared with non Hispanics. Almost 70% of HTN expenditure for Hispanics in 2013-2014 was covered by MEDICAID and MEDICARE indicating socioeconomic disparities.