The cost of being a woman - A national study of health care utilization and expenditures for female-specific conditions
ABSTRACT An important component of women's health care is for conditions that are exclusive to women, yet little research has addressed the economic impact of health care for these conditions. The purpose of this study was to describe health care utilization for female-specific conditions, the incremental expenditures attributable to these conditions, and the overall incremental expenditures across the lifespan.
We analyzed 3 years of a nationally representative survey of the US noninstitutionalized population, the 2000-2002 National Medical Expenditure Panel Survey, which included 25,361 females aged > or =14, representing 38,170 person-years.
More than one fifth of women (21.2%) reported having a female-specific condition during a 1-year period, the most common of which were gynecologic disorders (7.4%); pregnancy-related conditions (6.4%); and menopausal symptoms (5.3%). The mean increment in annual total expenditures attributable to female-specific conditions ranged from $483 for menopausal disorders to $3,896 for female cancers. The annual total health care expenditures of women with female-specific conditions were estimated to be $108 billion, of which >40% ($43.3 billion) was attributable to female-specific conditions. Women with female-specific conditions who had no health insurance were less likely to have visited a doctor (p = .0002), filled a prescription (p = .001), and been hospitalized (p = .0001) for these conditions, but more likely to have visited an emergency department (p = .02) seeking treatment for these conditions.
In this nationally representative sample of American women aged > or =14, female-specific conditions were common and substantially increased costs of health care.
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ABSTRACT: Objective: Although adiposity has been considered to be protective against hot flashes, newer data suggest positive relationships between hot flashes and adiposity. No studies have been specifically designed to test whether weight loss reduces hot flashes. This pilot study aimed to evaluate the feasibility, acceptability, and initial efficacy of behavioral weight loss in reducing hot flashes. Methods: Forty overweight or obese women with hot flashes (>= 4 hot flashes/d) were randomized to either behavioral weight loss intervention or wait-list control. Hot flashes were assessed before and after intervention via physiologic monitoring, diary, and questionnaire. Comparisons of changes in hot flashes and anthropometrics between conditions were performed via Wilcoxon tests. Results: Study retention (83%) and intervention satisfaction (93.8%) were high. Most women (74.1%) reported that hot flash reduction was a major motivator for losing weight. Women randomized to the weight loss intervention lost more weight (-8.86 kg) than did women randomized to control (+0.23 kg; P < 0.0001). Women randomized to weight loss also showed greater reductions in questionnaire-reported hot flashes (2-wk hot flashes, -63.0) than did women in the control group (-28.0; P = 0.03) -a difference not demonstrated in other hot flash measures. Reductions in weight and hot flashes were significantly correlated (eg, r = 0.47, P = 0.006). Conclusions: This pilot study shows a behavioral weight loss program that is feasible, acceptable, and effective in producing weight loss among overweight or obese women with hot flashes. Findings indicate the importance of a larger study designed to test behavioral weight loss for hot flash reduction. Hot flash management could motivate women to engage in this health-promoting behavior.Menopause (New York, N.Y.) 06/2014; 22(1). DOI:10.1097/GME.0000000000000274 · 2.81 Impact Factor
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ABSTRACT: While recent national discussions of the Affordable Care Act (ACA) made the introduction of mandated contraceptive coverage within health insurance policies seem like a novel idea, it is not new at all. Since the late 1990s, 29 states have mandated that insurance providers include prescription contraceptive supplies and, in some instances, associated contraceptive services in their coverage. We use state-level policy variation to generate both difference-in-differences and triple difference estimates to determine if women in states with state-level contraception supply or contraception supply and services insurance mandates experienced changes in their utilization of contraception and preventive health care services. We find a positive relationship between these policies and prescription contraception use for those with low educational attainment, but the results are not robust to a variety of specifications. Our results also show an increase in the consumption of preventive health services for women with low educational attainment as a result of these health insurance mandates. We conclude by discussing the implications for the ACA.Population Research and Policy Review 12/2014; DOI:10.1007/s11113-014-9353-6 · 0.76 Impact Factor
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ABSTRACT: Gynecological care is vital to women's health but utilization of gynecological care has been seldom addressed. We applied the population-based "ecology model" to demonstrate the utilization of gynecological care of women, with examples from Taiwan. We analyzed the claims data from the cohort datasets within the National Health Insurance Research Database in Taiwan. Women's utilization of gynecological care in 2009 was computed. Of 1000 women, 319 utilized gynecological care at least once, 277 visited Western medicine clinics, 193 visited physician clinics, 118 visited hospital-based outpatient clinics, 73 visited traditional Chinese medicine clinics, eight were hospitalized, four were hospitalized in an academic medical center, and four visited emergency departments. More than 90% of young and middle-aged women who sought gynecological care visited gynecologist clinics. Elderly women were less likely to utilize gynecological care in all settings of medical care, but were more likely to be attended by non-gynecologists. Young women tended to visit emergency departments. The ecology model highlighted age disparities in women's utilization of gynecological care in various settings of medical care. Since gynecological conditions were common among women, more attention should be paid on the availability of gynecologists and continuing medical education in gynecological care for non-gynecologists to guarantee women's health.International Journal of Environmental Research and Public Health 08/2014; 11(8):7669-7677. DOI:10.3390/ijerph110807669 · 1.99 Impact Factor