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Sex differences in health care expenditures and mortality after spousal bereavement: A register-based Danish cohort study

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  • Alexandros Katsiferis
  • Samir Bhatt
  • Laust Hvas Mortensen
  • Swapnil Mishra
  • Rudi G J Westendorp

Abstract

Background: Spousal bereavement is a life event that affects older people differently. We investigated the impact of spousal bereavement on medical expenditures and mortality in the general population, emphasizing on age and sex. Methods: Data are from a population-based, retrospective cohort study following 924,958 Danish citizens over the age of 65 years, within 2011–2016. Changes in health care expenditures in those who suffer bereavement were compared with time matched changes among those who did not. Mortality hazards were analysed with time to event analysis. Results: A total of 77,722 (~8.4%) individuals experienced bereavement, 65.8% being females. Among males, bereavement was associated with increase of expenditures the year after, that was 42 Euros per week (95% CI, 36 to 48) larger than the non-bereaved group. The corresponding increase for females was 35 Euros per week (95% CI, 30 to 40). The increase of mortality hazards was highest in the first year after bereavement, higher in males than females, in young old and almost absent in the oldest old. Compared with the reference, mortality the year after spousal loss was 70% higher (HR 1.70 [95% CI 1.40 to 2.08]) for males aged 65–69 years and remained elevated for a period of six years. Mortality for females aged 65–69 years was 27% higher in the first year (HR 1.27, [1.07 to 1.52]), normalizing thereafter. Conclusion: Bereavement affects older people differently with younger males being most frail with limited recovery potential.

Suggested Citation

  • Alexandros Katsiferis & Samir Bhatt & Laust Hvas Mortensen & Swapnil Mishra & Rudi G J Westendorp, 2023. "Sex differences in health care expenditures and mortality after spousal bereavement: A register-based Danish cohort study," PLOS ONE, Public Library of Science, vol. 18(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0282892
    DOI: 10.1371/journal.pone.0282892
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    References listed on IDEAS

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    1. Manor, Orly & Eisenbach, Zvi, 2003. "Mortality after spousal loss: are there socio-demographic differences?," Social Science & Medicine, Elsevier, vol. 56(2), pages 405-413, January.
    2. Hamparsum Bozdogan, 1987. "Model selection and Akaike's Information Criterion (AIC): The general theory and its analytical extensions," Psychometrika, Springer;The Psychometric Society, vol. 52(3), pages 345-370, September.
    3. Ho, Daniel E. & Imai, Kosuke & King, Gary & Stuart, Elizabeth A., 2007. "Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference," Political Analysis, Cambridge University Press, vol. 15(3), pages 199-236, July.
    4. Anne Lise Holm & Elisabeth Severinsson & Astrid Karin Berland, 2019. "The Meaning of Bereavement Following Spousal Loss: A Qualitative Study of the Experiences of Older Adults," SAGE Open, , vol. 9(4), pages 21582440198, December.
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    1. Alexandros Katsiferis & Samir Bhatt & Laust Hvas Mortensen & Swapnil Mishra & Majken Karoline Jensen & Rudi G J Westendorp, 2023. "Machine learning models of healthcare expenditures predicting mortality: A cohort study of spousal bereaved Danish individuals," PLOS ONE, Public Library of Science, vol. 18(8), pages 1-16, August.

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