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Am J Alzheimers Dis Other Demen. 2013 Feb;28(1):84-92. doi: 10.1177/1533317512467679. Epub 2012 Nov 29.

Health disparities in cost of care in patients with Alzheimer's disease: an analysis across 4 state Medicaid populations.

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College of Pharmacy-Pulido Center, Tucson AZ 85721, USA.



To investigate health disparities with respect to cost of care across 4 state Medicaid populations.


Data were obtained from Centers for Medicare and Medicaid Services (CMS) for this retrospective study. Patients were enrolled in a California, Florida, New Jersey, or New York Medicaid programs during 2004, with a diagnosis of Alzheimer's disease (International Classification of Diseases, Ninth Revision 331.0). Outcome of interest was cost of care. Decomposition of cost to calculate disparities was estimated using the Oaxaca-Blinder model. An a priori α level of .01 was used.


Approximately 158 974 individuals qualified for this study. Disparities were found to exist between blacks and whites (with blacks having higher costs; P < .0001), whites and others (with whites having higher costs; P < .0001), blacks and Hispanics (with blacks having higher costs; P < .0001), blacks and others (with blacks having higher costs; P < .0001), and Hispanics and others (with Hispanics having higher costs; P < .0001).


Disparities in cost among minority-to-minority populations were just as prevalent, if not higher, than minority-white disparities.

[Indexed for MEDLINE]

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