Sex differences in health care expenditures and mortality after spousal bereavement: A register-based Danish cohort study

• Published in: PloS one 2023-03, Vol.18 (3), p.e0282892-e0282892
• Main Authors: Katsiferis, Alexandros, Bhatt, Samir, Mortensen, Laust Hvas, Mishra, Swapnil, Westendorp, Rudi G J
• Format: Article
• Language: English
• Subjects: Age groups; Aged; Aged, 80 and over; Analysis; Bereavement; Biology and Life Sciences; Cohort analysis; Cohort Studies; Cost control; Denmark; Denmark - epidemiology; Expenditures; Female; Females; Forecasts and trends; Gender differences; Hazards; Health care; Health care expenditures; Health Expenditures; Humans; Male; Males; Medical care, Cost of; Medicine and Health Sciences; Mortality; Older people; People and Places; Population; Population studies; Prevention; Primary care; Psychological aspects; Retrospective Studies; Sex Characteristics; Sex differences; Sexes; Social aspects; Social Sciences; Sociodemographics; Socioeconomic factors; Survival analysis; Variables
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0282892

Spousal bereavement is a life event that affects older people differently. We investigated the impact of spousal bereavement on medical expenditures and mortality in the general population, emphasizing on age and sex. Data are from a population-based, retrospective cohort study following 924,958 Danish citizens over the age of 65 years, within 2011-2016. Changes in health care expenditures in those who suffer bereavement were compared with time matched changes among those who did not. Mortality hazards were analysed with time to event analysis. A total of 77,722 (~8.4%) individuals experienced bereavement, 65.8% being females. Among males, bereavement was associated with increase of expenditures the year after, that was 42 Euros per week (95% CI, 36 to 48) larger than the non-bereaved group. The corresponding increase for females was 35 Euros per week (95% CI, 30 to 40). The increase of mortality hazards was highest in the first year after bereavement, higher in males than females, in young old and almost absent in the oldest old. Compared with the reference, mortality the year after spousal loss was 70% higher (HR 1.70 [95% CI 1.40 to 2.08]) for males aged 65-69 years and remained elevated for a period of six years. Mortality for females aged 65-69 years was 27% higher in the first year (HR 1.27, [1.07 to 1.52]), normalizing thereafter. Bereavement affects older people differently with younger males being most frail with limited recovery potential.