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The Concentration of Hospital‐Based Medical Spending: Evidence from Canada

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Listed:
  • Eric French
  • Elaine Kelly
  • Aurélie Côté‐Sergent
  • Damien Échevin
  • Pierre‐Carl Michaud

Abstract

In this paper, we present evidence on the concentration of hospital-based medical spending in Canada. We use longitudinal administrative data from the province of Quebec to document how medical spending is concentrated cross-sectionally, over time and finally near the end-of-life when death occurs at the hospital. Average expenditures rise rapidly with age, starting around the age of 50, and are concentrated in a small fraction of high-cost users. For example, the top 1% of men and women in terms of hospital spending account for 55.5% and 54.8% of total spending respectively. Persistence among high-users is rather low. Fewer than 3% of those in the top quintile of hospital spending stay in the same quintile the following year, fewer than 5% have any spending the following year. Finally, hospital spending among those in their last year of life and who die at the hospital can account for 11.1% of total hospital spending in the population. Most of that end-of-life spending, more than 80%, occurs in the last month of life.
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Suggested Citation

  • Eric French & Elaine Kelly & Aurélie Côté‐Sergent & Damien Échevin & Pierre‐Carl Michaud, 2016. "The Concentration of Hospital‐Based Medical Spending: Evidence from Canada," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 627-651, September.
    • Handle: RePEc:ifs:fistud:v:37:y:2016:i::p:627-651
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    References listed on IDEAS

    as
    1. Ha Dao & Luc Godbout & Pierre Fortin, 2014. "On the Importance of Taking End-of-Life Expenditures into Account when Projecting Health-Care Spending," Canadian Public Policy, University of Toronto Press, vol. 40(1), pages 45-56, March.
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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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