A Hurdle and Negative Binomial Model Approach to Analyzing the Gender Differences in Diagnostic Imaging Utilization Under High-Deductible Health Plans

Qingyu Hu ¹ Sarah Zheng ^2*

• ¹ Chongqing University, Chongqing, China
• ² University of Victoria, Victoria, British Columbia, Canada

This study aims to analyze the impact of High-Deductible Health Plans (HDHPs) on the utilization of diagnostic imaging services among patients of different genders and to examine gender differences in the use of various types of imaging modalities. Using data from the 2010 Thomson-Reuters MarketScan Commercial Database, this study employs Negative Binomial Regression and the Hurdle model to investigate the relationship between HDHPs enrollment and diagnostic imaging utilization, with a particular focus on gender disparities. The results indicate that, males utilize diagnostic imaging services less frequently than females. Following HDHPs enrollment, the overall utilization rate of diagnostic imaging decreased by 7%, with a more significant reduction among males. Notably, the likelihood of initial ultrasound (US) utilization among male HDHPs enrollees declined by 8.2% more than that of female enrollees. However, after undergoing at least one imaging procedure, the gender disparity in utilization among HDHPs enrollees disappears. The findings suggest that HDHPs exert differential effects on diagnostic imaging utilization across genders, with males experiencing a more significant reduction, particularly in ultrasound utilization. Therefore, in designing health insurance policies, gender differences should be carefully considered, alongside targeted patient education strategies for different demographic groups, to ensure the effective implementation of HDHPs and the optimal allocation of medical resources.