An Examination of Downstream Effects of Bereavement on Healthcare Utilization for Surviving Spouses in a National Sample of Older Adults

Katherine A. Ornstein (), Melissa Garrido, Albert L. Siu (), Evan Bollens-Lund (), Omari-Khalid Rahman () and Amy S. Kelley ()
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Katherine A. Ornstein: Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai
Albert L. Siu: Icahn School of Medicine at Mount Sinai
Evan Bollens-Lund: Icahn School of Medicine at Mount Sinai
Omari-Khalid Rahman: Icahn School of Medicine at Mount Sinai
Amy S. Kelley: Icahn School of Medicine at Mount Sinai

PharmacoEconomics, 2019, vol. 37, issue 4, No 13, 585-596

Abstract: Abstract Background While bereavement is associated with increased mortality, it is unclear how bereaved families utilize the healthcare system after the death of their loved ones. Objective The aim of this study was to examine the association between bereavement and healthcare expenditures for surviving spouses. Methods We used data from the Health and Retirement Study, a nationally representative cohort study of older adults linked to Medicare claims. We determined a spouse’s total Medicare expenditures 2 years before and after their partner’s death across six biennial interview waves. Using coarsened exact matching, we created a comparison group of non-bereaved dyads. Costs were wage index- and inflation-adjusted to 2017 dollars. We used generalized linear models and difference-in-differences (DID) analysis to calculate the average marginal effects of bereavement on Medicare spending by gender. We also examined subgroup differences based on caregiver status, cause of death, and length of terminal illness. Results Our sample consisted of 941 bereaved dyads and a comparison group of 8899 matched dyads. Surviving female spouses (68% of the sample) had a $3500 increase in spending 2 years after death (p

Date: 2019
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DOI: 10.1007/s40273-019-00787-4

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