Age differences in the influence of race, SES, and psychiatric morbidity on healthcare utilization and expenditures

We examined how race, socio-economic status (SES), and psychiatric morbidity impact healthcare service utilization and how the impact of these predictors varies for respondents 65 years of age and over compared to those under age 65. We analyze the Household Component of the 1996 Medical Expenditure Panel Survey (MEPS), focusing on 12,303 African American and white adults in the sample. Rates of service utilization and type of service utilization are compared by race, gender, and mental disorder status. Race and psychiatric morbidity differences in costs by type of service utilization are investigated. Negative binomial and OLS regression models are examined by age and gender to discern the impact of face and psychiatric morbidity net of SES. Among respondents under the age of 65, African Americans and respondents with low SES have particular patterns of service utilization - avoiding outpatient care and physician visits. This pattern of utilization yields low costs early in life, however low SES and race are predictive of higher healthcare costs among respondents over age 65. Psychiatric impairment had a strong impact on patterns of service utilization, and its impact on healthcare costs increased with age, particularly for men. Our findings suggest that patterns of health service utilization early in the life course may have a substantial impact on future health care costs, and that alleviation of mental health problems could substantially decrease health expenditures.