Socioeconomic Factors and Out-of-Pocket Healthcare Spending Among Adults with Hypertension and Type 2 Diabetes: National Cohort Insights

Background Type II diabetes and hypertension often co-occur significantly, adding to patients’ healthcare economic burden. Objective This study examined socioeconomic factors that predict disparities in annual total out-of-pocket (OOP) healthcare expenditures among adults 50 years and older with co-occurring hypertension and diabetes in the U.S. Design This secondary data analysis study uses a nationally representative cohort of civilian, non-institutionalized households in the U.S. from the 2018–2022 consolidated Medical Expenditure Panel Survey (MEPS) data. Participants Adults (50+) with diabetes and hypertension. Main Measures The outcome variable is the annual OOP cost for individuals with both diabetes and hypertension. Covariates include age, gender, race/ethnicity, insurance coverage (e.g., Medicare, Medicaid/Tricare, private, or multiple insurances), family income, region, employment status, education, marital status, perceived general health, and perceived mental health. We applied weighted linear regression (with logarithmic transformation) to determine the relationship between sociodemographic variables and total OOP medical expenditures. Results We included 7,445 individuals with both diabetes and hypertension. The average annual OOP cost for those with co-occurring type diabetes and hypertension, diabetes only, and hypertension only was $441.51, $368.29, and $73.22, respectively. Average OOP costs varied, with perceived health status, residence in the Northeast region, higher family income, marital status, education, insurance type, and race/ethnicity associated with OOP costs. Conclusions These findings underscore the complex interplay of health status, socioeconomic factors, and insurance coverage in driving differences in annual OOP healthcare expenditures among adults with hypertension and diabetes in the U.S.