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Decomposing Medical-Care Expenditure Growth

Listed author(s):
  • Abe Dunn
  • Eli B. Liebman
  • Adam Shapiro

Medical-care expenditures have been rising rapidly, accounting for over 17 percent of GDP in 2012. In this study, we assess the sources of the rising medical-care expenditures in the commercial sector. We employ a novel framework for decomposing expenditure growth into four components at the disease level: service price growth, service utilization growth, treated disease prevalence growth, and demographic shift. The decomposition shows that growth in prices and treated prevalence are the primary drivers of medical-care expenditure growth over the 2003 to 2007 period. There was no growth in service utilization at the aggregate level over this period. Price and utilization growth were especially large for the treatment of malignant neoplasms. For many conditions, treated prevalence has shifted towards preventive treatment and away from treatment for late-stage illnesses.

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File URL: http://www.nber.org/papers/w23117.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 23117.

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Date of creation: Feb 2017
Publication status: Forthcoming: Decomposing Medical-Care Expenditure Growth , Abe Dunn, Eli Liebman, Adam Hale Shapiro. in Measuring and Modeling Health Care Costs , Aizcorbe, Baker, Berndt, and Cutler. 2016
Handle: RePEc:nbr:nberwo:23117
Note: HC HE
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  1. Ana Aizcorbe & Nicole Nestoriak, 2010. "Changing Mix of Medical Care Services: Stylized Facts and Implications for Price Indexes," BEA Working Papers 0064, Bureau of Economic Analysis.
  2. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2012. "Decomposing Medical-Care Expenditure Growth," BEA Working Papers 0088, Bureau of Economic Analysis.
  3. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2015. "Implications of Utilization Shifts on Medical‐care Price Measurement," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 539-557, 05.
  4. Abe Dunn & Eli Liebman & Adam Hale Shapiro, 2014. "Developing a Framework for Decomposing Medical-Care Expenditure Growth: Exploring Issues of Representativeness," NBER Chapters, in: Measuring Economic Sustainability and Progress, pages 545-574 National Bureau of Economic Research, Inc.
  5. Abe Dunn & Eli Liebman & Lindsey Rittmueller & Adam Shapiro, 2014. "Defining Disease Episodes and the Effects on the Components of Expenditure Growth," BEA Working Papers 0108, Bureau of Economic Analysis.
  6. Amitabh Chandra & Jonathan S. Skinner, 2011. "Technology Growth and Expenditure Growth in Health Care," NBER Working Papers 16953, National Bureau of Economic Research, Inc.
  7. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1998. "Are Medical Prices Declining? Evidence from Heart Attack Treatments," The Quarterly Journal of Economics, Oxford University Press, vol. 113(4), pages 991-1024.
  8. Abe C. Dunn & Adam Shapiro & Eli Liebman, 2011. "Geographic Variation in Commercial Medical Care Expenditures: A Decomposition Between Price and Utilization," BEA Working Papers 0075, Bureau of Economic Analysis.
  9. Dunn, Abe & Shapiro, Adam Hale & Liebman, Eli, 2013. "Geographic variation in commercial medical-care expenditures: A framework for decomposing price and utilization," Journal of Health Economics, Elsevier, vol. 32(6), pages 1153-1165.
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