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Does widowhood explain gender differences in out-of-pocket medical spending among the elderly?

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  • Goda, Gopi Shah
  • Shoven, John B.
  • Slavov, Sita Nataraj

Abstract

Despite the presence of Medicare, out-of-pocket medical spending is a large expenditure risk facing the elderly. While women live longer than men, elderly women incur higher out-of-pocket medical spending than men at each age. In this paper, we examine whether differences in marital status and living arrangements can explain this difference. We find that out-of-pocket medical spending is approximately 24 percent higher when an individual becomes widowed, a large portion of which is spending on nursing homes. Our results suggest a substantial role of living arrangements in out-of-pocket medical spending. Our estimates combined with differences in rates of widowhood across gender suggest that marital status can explain about one third of the gender difference in total out-of-pocket medical spending, leaving a large portion unexplained. On the other hand, gender differences in widowhood more than explain the observed gender difference in out-of-pocket spending on nursing homes.

Suggested Citation

  • Goda, Gopi Shah & Shoven, John B. & Slavov, Sita Nataraj, 2013. "Does widowhood explain gender differences in out-of-pocket medical spending among the elderly?," Journal of Health Economics, Elsevier, vol. 32(3), pages 647-658.
  • Handle: RePEc:eee:jhecon:v:32:y:2013:i:3:p:647-658
    DOI: 10.1016/j.jhealeco.2012.10.011
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    2. Zhao, Yuejun & Inder, Brett & Kim, Jun Sung, 2021. "Spousal bereavement and the cognitive health of older adults in the US: New insights on channels, single items, and subjective evidence," Economics & Human Biology, Elsevier, vol. 43(C).
    3. Jessamyn Schaller & Chase Eck, 2019. "Adverse Life Events and Intergenerational Transfers," Upjohn Working Papers 19-309, W.E. Upjohn Institute for Employment Research.
    4. Bergeot, Julien & Tenand, Marianne, 2021. "Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data," CEPREMAP Working Papers (Docweb) 2105, CEPREMAP.
    5. Herberholz, Chantal & Phuntsho, Sonam, 2021. "Medical, transportation and spiritual out-of-pocket health expenditure on outpatient and inpatient visits in Bhutan," Social Science & Medicine, Elsevier, vol. 273(C).
    6. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    7. Margherita Borella & Mariacristina De Nardi & Fang Yang, 2017. "Marriage-related Policies in an Estimated Life-cycle Model of Households’ Labor Supply and Savings for Two Cohorts," Working Papers wp371, University of Michigan, Michigan Retirement Research Center.
    8. Margherita Borella & Fang Yang & Mariacristina De Nardi, 2019. "The changing opportunities and outcomes of non-college educated Americans," 2019 Meeting Papers 206, Society for Economic Dynamics.
    9. Peña-Longobardo, L.M. & Rodríguez-Sánchez, B. & Oliva-Moreno, J., 2021. "The impact of widowhood on wellbeing, health, and care use: A longitudinal analysis across Europe," Economics & Human Biology, Elsevier, vol. 43(C).
    10. Kim Peijnenburg & Theo Nijman & Bas J.M. Werker, 2017. "Health Cost Risk: A Potential Solution to the Annuity Puzzle," Economic Journal, Royal Economic Society, vol. 127(603), pages 1598-1625, August.
    11. 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.
    12. Yinan Liu & Emma Zai, 2023. "The unintended effect of Medicaid aging waivers on informal caregiving," MPIDR Working Papers WP-2023-006, Max Planck Institute for Demographic Research, Rostock, Germany.
    13. Li, Qin & Smith, James P. & Zhao, Yaohui, 2023. "Understanding the effects of widowhood on health in China: Mechanisms and heterogeneity," The Journal of the Economics of Ageing, Elsevier, vol. 25(C).
    14. Margherita Borella & Mariacristina De Nardi & Fang Yang, 2017. "The Effects of Marriage-Related Taxes and Social Security Benefits," NBER Working Papers 23972, National Bureau of Economic Research, Inc.
    15. Fang Yang & Mariacristina De Nardi, 2016. "The Insurance Role of Marriage," 2016 Meeting Papers 427, Society for Economic Dynamics.

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    More about this item

    Keywords

    Medical spending; Out-of-pocket; Widowhood; Nursing home; Marital status;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J12 - Labor and Demographic Economics - - Demographic Economics - - - Marriage; Marital Dissolution; Family Structure
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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