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Health expenditure growth: Looking beyond the average through decomposition of the full distribution

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  • de Meijer, Claudine
  • O’Donnell, Owen
  • Koopmanschap, Marc
  • van Doorslaer, Eddy

Abstract

Explanations of growth in health expenditures have restricted attention to the mean. We explain change throughout the distribution of expenditures, providing insight into how expenditure growth and its explanation differ along the distribution. We analyse Dutch data on actual health expenditures linked to hospital discharge and mortality registers. Full distribution decomposition delivers findings that would be overlooked by examination of changes in the mean alone. The growth rate of hospital expenditures is greatest at the middle of the distribution and is driven mainly by changes in the distributions of determinants. Pharmaceutical expenditures increase most rapidly at the top of the distribution and are mainly attributable to structural changes, including technological progress, making treatment of the highest cost cases even more expensive. Changes in hospital practice styles make the largest contribution of all determinants to increased spending not only on hospital care but also on pharmaceuticals, suggesting important spill over effects.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 32 (2013)
Issue (Month): 1 ()
Pages: 88-105

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Handle: RePEc:eee:jhecon:v:32:y:2013:i:1:p:88-105

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Web page: http://www.elsevier.com/locate/inca/505560

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Keywords: Health care expenditure; Decomposition; Ageing; Pharmaceuticals; The Netherlands;

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Cited by:
  1. Jones, A.; & Lomas, J.; & Rice, N.;, 2014. "Going Beyond the Mean in Healthcare Cost Regressions: a Comparison of Methods for Estimating the Full Conditional Distribution," Health, Econometrics and Data Group (HEDG) Working Papers, HEDG, c/o Department of Economics, University of York 14/26, HEDG, c/o Department of Economics, University of York.

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