title: Does widowhood explain gender differences in out-of-pocket medical spending among the elderly?
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.
authors.affiliation: Stanford University, Stanford Institute for Economic Policy Research, 366 Galvez Street, Stanford, CA 94305, USA. gopi@stanford.edu
authors.forename: Gopi Shah
authors.initials: GS
authors.lastname: Goda
authors.forename: John B
authors.initials: JB
authors.lastname: Shoven
authors.forename: Sita Nataraj
authors.initials: SN
authors.lastname: Slavov
mesh_terms: D000368:Aged; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics; D009735:Nursing Homes / Q000191:economics; D012737:Sex Factors; D014481:United States; D017805:Widowhood / Q000706:statistics & numerical data*