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Estimating healthcare expenditures after becoming divorced or widowed using propensity score matching

Author

Listed:
  • Iris Meulman

    (National Institute for Public Health and the Environment
    Tilburg University)

  • Bette Loef

    (National Institute for Public Health and the Environment)

  • Niek Stadhouders

    (Radboud University Medical Center)

  • Tron Anders Moger

    (University of Oslo)

  • Albert Wong

    (National Institute for Public Health and the Environment)

  • Johan J. Polder

    (National Institute for Public Health and the Environment
    Tilburg University)

  • Ellen Uiters

    (National Institute for Public Health and the Environment)

Abstract

Becoming divorced or widowed are stressful life events experienced by a substantial part of the population. While marital status is a significant predictor in many studies on healthcare expenditures, effects of a change in marital status, specifically becoming divorced or widowed, are less investigated. This study combines individual health claims data and registered sociodemographic characteristics from all Dutch inhabitants (about 17 million) to estimate the differences in healthcare expenditure for individuals whose marital status changed (n = 469,901) compared to individuals who remained married, using propensity score matching and generalized linear models. We found that individuals who were (long-term) divorced or widowed had 12–27% higher healthcare expenditures (RR = 1.12, 95% CI 1.11–1.14; RR = 1.27, 95% CI 1.26–1.29) than individuals who remained married. Foremost, this could be attributed to higher spending on mental healthcare and home care. Higher healthcare expenditures are observed for both divorced and widowed individuals, both recently and long-term divorced/widowed individuals, and across all age groups, income levels and educational levels.

Suggested Citation

  • Iris Meulman & Bette Loef & Niek Stadhouders & Tron Anders Moger & Albert Wong & Johan J. Polder & Ellen Uiters, 2023. "Estimating healthcare expenditures after becoming divorced or widowed using propensity score matching," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(7), pages 1047-1060, September.
    • Handle: RePEc:spr:eujhec:v:24:y:2023:i:7:d:10.1007_s10198-022-01532-z
    DOI: 10.1007/s10198-022-01532-z
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