Abstract

Key components of preventive health care for middleaged and older women include evaluating the risk for osteoporosis and coronary artery disease, considering hormone replacement therapy (HRT), and cancer screening. HRT is effective for treating the symptoms of acute menopause, and it may prevent some chronic health problems associated with growing older. However, HRT may increase the risks for other diseases. OBJECTIVE: The purpose of this study was to estimate the level of health care use and costs incurred by post-menopausal women for conditions that have been associated with HRT. METHODS: National health care survey and discharge data were used to estimate health care use by women age 45 and older for cardiovascular disease, osteoporosis, breast cancer, uterine cancer, and deep-vein thrombosis/ pulmonary embolism. The databases used were the Healthcare Utilization Project-3, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, National Nursing Home Survey, and National Home and Hospice Care Survey. Clinical Classification for Health Policy Research codes were used to identify patients whose primary diagnosis or procedure corresponded with the above conditions. National weights were used to estimate resource use. Treatment costs were estimated using cost-to-charge ratios or Medicare Fee Schedule to calculate costs of individual procedures. RESULTS: For each of the five conditions, resource use and costs are reported for hospitalization, outpatient, nursing home, and home health care services. Resource use and costs are also reported by age and race/ethnicity. CONCLUSION: Results of the study may be used to estimate the burden of disease for conditions commonly affecting postmenopausal women and to provide data for cost-effectiveness models comparing newly developed drugs to existing HRTs.

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