Methods: The 2005 Medical Expenditure Panel Survey (MEPS) linked to the 2004 National Health Interview Survey (NHIS) was analyzed guided by the Andersen model. OLS models were tested for four dependent variables: total and OOP medical expenditures, and the percentage of total expenditure and income spent for OOP medical payments. Immigrant status (IV) had three categories (N=3,454; ages 65+): 1) late-life immigrants with less than 15 years of residence in US (recent immigrants; n=77); 2) longer-term immigrants (n=392); and 3) the U.S.-born (n=2,985). The SAS survey procedures were used to account for the complex sampling design.
Results: The findings indicate no differences in the total and OOP medical expenditures, and the proportion of expenditures paid out-of-pocket across the three groups, after controlling for predisposing (e.g., age, gender, ethnicity), enabling (e.g., insurance status), and need factors (e.g., 12 medical conditions). However, recent immigrants spent a higher proportion of their income for OOP medical payments compared to the U.S.-born (p=.020) and longer-term immigrants (p=.009). In 2005, OOP medical payments accounted for 18% of recent immigrants' income (median), while it was only 4.6% and 3.9% among the U.S.-born and longer-term immigrants, respectively.
Implications: Many studies on older immigrants' health care utilization focused on access to health care in relation to their insurance status, whereas few studies have examined the OOP financial burdens of health care among this population. Considering the higher OOP financial burden of healthcare among recent immigrants, further studies are necessary to understand the consequences and appropriate policies should be considered (e.g., providing affordable health insurance options).