The influence of race, gender and mental disorder on health care service utilization and costs among the medicare elderly

This research investigates how race, gender, and psychiatric morbidity influence health care service utilization and costs among the Medicare elderly. Multivariate ANOVA means are estimated on a 5 percent sample of Medicare beneficiaries in Tennessee (n = 33,680) to compare healthcare service utilization and costs by race, gender, and psychiatric morbidity. Psychiatric diagnoses dramatically increase health service utilization and healthcare costs for all of the race and gender groups. African American men have significantly higher costs than Caucasians and African American women. Findings suggest that race and gender interact to influence health service utilization and costs of care, and that psychiatric diagnoses dramatically influence healthcare service utilization and costs. Increased attention to psychiatric illness, preventive health, and the management of chronic illness for African Americans could dramatically lower healthcare costs.