Gupta N, Sheng Z. Disparities in the hospital cost of cardiometabolic diseases among lesbian, gay, and bisexual Canadians: a population-based cohort study using linked data.
CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2020;
111:417-425. [PMID:
32112310 PMCID:
PMC7351996 DOI:
10.17269/s41997-020-00296-4]
[Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/03/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES
Sexual identity has been recognized as a social determinant of health; however, evidence is limited on sexual minority status as a possible contributor to inequalities in cardiometabolic outcomes and the related hospital burden. This study aimed to investigate the association between sexual identity and hospital costs for cardiometabolic diseases among a cohort of Canadians using linked survey and administrative data.
METHODS
Data from the 2007-2011 Canadian Community Health Survey were linked to acute-care inpatient records from the 2005/2006-2012/2013 Discharge Abstract Database. Multiple linear regression was used to assess the association between self-reported sexual identity and inpatient resource use for cardiometabolic diseases.
RESULTS
Among the population ages 18-59, 2.1% (95% CI 1.9-2.2) identified as lesbian, gay, or bisexual (LGB). LGB individuals more often reported having diabetes or heart disease compared with heterosexuals. The mean inflation-adjusted cost for cardiometabolic-related hospitalizations was found to be significantly higher among LGB patients (CAD$26,702; 95% CI 26,166-60,365) than among their heterosexual counterparts ($10,137; 95% CI 8,639-11,635), in part a reflection of longer hospital stays (13.6 days versus 5.1 days). Inpatient costs remained 54% (95% CI 8-119) higher among LGB patients after controlling for socio-demographics, health status, and health behaviours.
CONCLUSION
This study revealed a disproportionate cost for potentially avoidable hospitalizations for cardiometabolic conditions among LGB patients, suggesting important unmet healthcare needs even in the Canadian context of universal coverage.
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