Healthcare use among US women aged 45 and older: Total costs and costs forselected postmenopausal health risks

The purpose of this study is to estimate the level of healthcare use and co sts incurred by postmenopausal women overall and for these selected conditi ons: cardiovascular disease, osteoporosis, breast cancer, and gynecological cancers. National healthcare survey and discharge data were used to estima te healthcare use by women aged 45 and older. Clinical Classification for H ealth Policy Research (CCHPR) codes were used to identify patients whose pr imary diagnosis or procedure corresponded with the selected conditions. Nat ional weights were used to estimate resource use. Treatment costs were esti mated using cost/charge ratios or the Medicare fee schedule to calculate co sts for each individual procedure. Estimated total annual medical care trea tment costs for women 45 and older were about $186 billion in 1997 dollars, including about $60.4 billion for cardiovascular disease, $12.9 billion fo r osteoporosis, and $5.0 billion for breast and gynecological cancers. For each condition, estimated resource use and costs are reported for hospitali zation, outpatient, nursing home, and home healthcare services. Resource us e and costs are also reported by age and expected source of payment. The ec onomic burden of disease for conditions commonly affecting postmenopausal w omen is substantial. Prior research establishes that hormone replacement th erapy (HRT) may be effective in reducing the burden of disease among women who continue preventive therapy for many years, but few at-risk women do so . New alternatives for prevention, such as selective estrogen receptor modu lators (SERMs), may be effective in reducing the burden of disease among po stmenopausal women.