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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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    1. 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.
    2. Berntsen, Kjersti Norgård & Kravdal, Øystein, 2012. "The relationship between mortality and time since divorce, widowhood or remarriage in Norway," Social Science & Medicine, Elsevier, vol. 75(12), pages 2267-2274.
    3. Fu‐Min Tseng & Dennis Petrie & Shaolin Wang & Colin Macduff & Audrey I. Stephen, 2018. "The impact of spousal bereavement on hospitalisations: Evidence from the Scottish Longitudinal Study," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 120-138, February.
    4. Judith G. Chipperfield & Betty Havens, 2001. "Gender Differences in the Relationship Between Marital Status Transitions and Life Satisfaction in Later Life," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 56(3), pages 176-186.
    5. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    6. Maarse, J.A.M. (Hans) & Jeurissen, P.P. (Patrick), 2016. "The policy and politics of the 2015 long-term care reform in the Netherlands," Health Policy, Elsevier, vol. 120(3), pages 241-245.
    7. Edward Frees & Jie Gao & Marjorie Rosenberg, 2011. "Predicting the Frequency and Amount of Health Care Expenditures," North American Actuarial Journal, Taylor & Francis Journals, vol. 15(3), pages 377-392.
    8. Strohschein, Lisa & McDonough, Peggy & Monette, Georges & Shao, Qing, 2005. "Marital transitions and mental health: Are there gender differences in the short-term effects of marital status change?," Social Science & Medicine, Elsevier, vol. 61(11), pages 2293-2303, December.
    9. Tseng, Fu-Min & Petrie, Dennis & Leon-Gonzalez, Roberto, 2017. "The impact of spousal bereavement on subjective wellbeing: Evidence from the Taiwanese elderly population," Economics & Human Biology, Elsevier, vol. 26(C), pages 1-12.
    10. Kenneth Couch & Christopher Tamborini & Gayle Reznik, 2015. "The Long-Term Health Implications of Marital Disruption: Divorce, Work Limits, and Social Security Disability Benefits Among Men," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1487-1512, October.
    11. Blough, David K. & Madden, Carolyn W. & Hornbrook, Mark C., 1999. "Modeling risk using generalized linear models," Journal of Health Economics, Elsevier, vol. 18(2), pages 153-171, April.
    12. Katherine A. Ornstein & Melissa M. Garrido & Albert L. Siu & Evan Bollens-Lund & Omari-Khalid Rahman & Amy S. Kelley, 2019. "An Examination of Downstream Effects of Bereavement on Healthcare Utilization for Surviving Spouses in a National Sample of Older Adults," PharmacoEconomics, Springer, vol. 37(4), pages 585-596, April.
    13. Vivian Kraaij & Ella Arensman & Philip Spinhoven, 2002. "Negative Life Events and Depression in Elderly Persons," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 57(1), pages 87-94.
    14. Isaac Sasson & Debra J. Umberson, 2014. "Editor's choice Widowhood and Depression: New Light on Gender Differences, Selection, and Psychological Adjustment," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 69(1), pages 135-145.
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