Medicare Utilization and Spending Among Nurses Compared with the General United States Population

J Womens Health (Larchmt). 2018 Dec;27(12):1466-1473. doi: 10.1089/jwh.2017.6802. Epub 2018 Aug 17.

Abstract

Background: To better understand health habits in older nurses versus the general population, we sought to determine whether the demographics, health care utilization, and Medicare spending by the Nurses' Health Study (NHS) participants enrolled in Medicare and a matched sample of Medicare beneficiaries meaningfully differed. Materials and Methods: Analytic cohorts included a random 20% sample of Medicare beneficiaries continuously enrolled in fee for service (FFS) Medicare that were propensity matched to the NHS participants continuously enrolled in FFS Medicare in a single year (2012). Matching was based upon preselected demographic factors and health status, using a nearest-neighbor matching algorithm to obtain a 1:1 match without replacement. Healthcare utilization and spending were compared between the two groups; we also stratified findings by number of chronic comorbidities. Results: Similar rates of utilization of primary care and most outpatient services. However, NHS participants had slightly higher rates of cancer screening, specialist care, and inpatient surgery were observed. When stratified by comorbidity status, the largest differences in utilization and spending were found in women with no comorbidity. Conclusions: The modest differences in observed healthcare utilization and spending suggest that older healthcare professionals may access care in fairly similar ways to the general population, and that health status may be a more important determinant of utilization and spending than health profession in older age groups.

Keywords: Nurses' Health Study; administrative claims data; generalizability studies; healthcare spending; healthcare utilization; linkage studies.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Ambulatory Care / economics
  • Ambulatory Care / statistics & numerical data
  • Female
  • Geriatric Assessment / methods
  • Health Services for the Aged* / economics
  • Health Services for the Aged* / statistics & numerical data
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Insurance Claim Review
  • Medicare* / economics
  • Medicare* / statistics & numerical data
  • Nurses* / statistics & numerical data
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Primary Health Care / economics
  • Primary Health Care / statistics & numerical data
  • Reference Values
  • Risk Assessment
  • United States