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Area Differences in Utilization of Medical Care and Mortality Among U.S. Elderly

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Author Info
Victor R. Fuchs
Mark McClellan
Jonathan Skinner

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Abstract

This paper examines 313 U.S. areas for differences in medical care utilization and mortality of whites ages 65-84 in 1990. The variables included in the analysis are education, real income, cigarette sales, obesity, air pollution, percent black, and dummy variables for seven regions and five population size categories from MSAs over 500,000 to not in MSA. Utilization, especially inpatient care, is strongly positively related to mortality. Mortality is positively related to cigarette sales, obesity, air pollution and percent black. Utilization (especially outpatient) is significantly higher in MSAs with populations greater than 500,000. Mortality does not vary with population size, with or without controls. Florida is an outlier for both utilization (very high) and mortality (by far the lowest of any region). The puzzles of Floridian exceptionalism and the positive relation between white mortality and percent black are discussed but not resolved.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 8628.

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Date of creation: Dec 2001
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Publication status: published as Victor R. Fuchs, Mark B. McClellan, Jonathan S. Skinner. "Area Differences in Utilization of Medical Care and Mortality among U.S. Elderly ," in David A. Wise, editor, "Perspectives on the Economics of Aging" University of Chicago Press (2004)
Handle: RePEc:nbr:nberwo:8628

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I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. David M. Cutler & Louise Sheiner, 1999. "The Geography of Medicare," American Economic Review, American Economic Association, vol. 89(2), pages 228-233, May. [Downloadable!] (restricted)
    Other versions:
  2. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1996. "Are Medical Prices Declining?," NBER Working Papers 5750, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December. [Downloadable!] (restricted)
  4. Jonathan Skinner & Elliott Fisher & John E. Wennberg, 2001. "The Efficiency of Medicare," NBER Working Papers 8395, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
    • Jonathan S. Skinner & Elliott S. Fisher & John Wennberg, 2005. "The Efficiency of Medicare," NBER Chapters, in: Analyses in the Economics of Aging, pages 129-160 National Bureau of Economic Research, Inc. [Downloadable!]
  5. Chappie, Mike & Lave, Lester, 1982. "The health effects of air pollution: A reanalysis," Journal of Urban Economics, Elsevier, vol. 12(3), pages 346-376, November. [Downloadable!] (restricted)
  6. Daniel P. Kessler & Mark B. McClellan, 1999. "Is Hospital Competition Socially Wasteful?," NBER Working Papers 7266, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. Victor R. Fuchs, 1972. "An Econometric Analysis of Spatial Variations in Mortality Rates by Race and Sex," NBER Chapters, in: Essays in the Economics of Health and Medical Care, pages 159-227 National Bureau of Economic Research, Inc. [Downloadable!]
  8. Victor R. Fuchs, 1978. "The Supply of Surgeons and the Demand for Operations," NBER Working Papers 0236, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Jennifer M. Mellor & Jeffrey Milyo, 2002. "Individual Health Status and Minority Racial Concentration in U.S. States and Counties," Working Papers 0201, Harris School of Public Policy Studies, University of Chicago. [Downloadable!]
  2. Gautam Gowrisankaran & Robert J. Town, 2004. "Managed Care, Drug Benefits and Mortality: An Analysis of the Elderly," NBER Working Papers 10204, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Jeffrey Milyo & Jennifer M. Mellor, 2002. "On the Importance of Full versus Partial Age-Adjustment in Ecological Studies of Social Determinants of Mortality," Working Papers 0207, Harris School of Public Policy Studies, University of Chicago. [Downloadable!]
  4. Marc Saez & Carme Saurina & Germà Coenders & Sònia González-Raya, 2006. "Use of primary health care services according to the different degrees of obesity in the Girona Health Region, Spain," Health Economics, John Wiley & Sons, Ltd., vol. 15(2), pages 173-193. [Downloadable!]
  5. Arrieta, Alejandro, 2007. "A Structural Misclassifcation Model to Estimate the Impact of Physician Incentives on Healthcare Utilization," MPRA Paper 6718, University Library of Munich, Germany. [Downloadable!]
  6. Jonathan Skinner & Elliott Fisher & John E. Wennberg, 2001. "The Efficiency of Medicare," NBER Working Papers 8395, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
    • Jonathan S. Skinner & Elliott S. Fisher & John Wennberg, 2005. "The Efficiency of Medicare," NBER Chapters, in: Analyses in the Economics of Aging, pages 129-160 National Bureau of Economic Research, Inc. [Downloadable!]
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