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Health Expenditure Growth: Looking beyond the Average through Decomposition of the Full Distribution

Author

Listed:
  • Claudine de Meijer

    (Erasmus University Rotterdam)

  • Marc Koopmanschap

    (Erasmus University Rotterdam)

  • Owen O'Donnell

    (Erasmus University Rotterdam)

  • Eddy van Doorslaer

    (Erasmus University Rotterdam)

Abstract

This discussion paper resulted in an article in the Journal of Health Economics (2013). Volume 32, pages 88-105. Explanations of growth in health expenditures have restricted attention to the mean. We explain change throughout the distribution of expenditures, providing insight into how 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 in expenditures on hospital care is strongest at the middle of the distribution and is driven mainly by changes in the distributions of determinants. Pharmaceutical expenditures increase most 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.

Suggested Citation

  • Claudine de Meijer & Marc Koopmanschap & Owen O'Donnell & Eddy van Doorslaer, 2012. "Health Expenditure Growth: Looking beyond the Average through Decomposition of the Full Distribution," Tinbergen Institute Discussion Papers 12-051/3, Tinbergen Institute.
  • Handle: RePEc:tin:wpaper:20120051
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    Cited by:

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    2. Andrew M. Jones & James Lomas & Nigel Rice, 2015. "Healthcare Cost Regressions: Going Beyond the Mean to Estimate the Full Distribution," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1192-1212, September.
    3. 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 14/26, HEDG, c/o Department of Economics, University of York.
    4. José Villaverde & Adolfo Maza & María Hierro, 2014. "Health care expenditure disparities in the European Union and underlying factors: a distribution dynamics approach," International Journal of Health Economics and Management, Springer, vol. 14(3), pages 251-268, September.
    5. Decker, Simon & Schmitz, Hendrik, 2016. "Health shocks and risk aversion," Journal of Health Economics, Elsevier, vol. 50(C), pages 156-170.
    6. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    7. Jonas Krämer & Jonas Schreyögg, 2019. "Demand-side determinants of rising hospital admissions in Germany: the role of ageing," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 715-728, July.
    8. Eric French & Elaine Kelly & Pieter Bakx & Owen O'Donnell & Eddy Doorslaer, 2016. "Spending on Health Care in the Netherlands: Not Going So Dutch," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 593-625, September.
    9. Kolodziej, Ingo W.K. & García-Gómez, Pilar, 2017. "The causal effects of retirement on mental health: Looking beyond the mean effects," Ruhr Economic Papers 668, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    10. Anurag Sharma & Fabrice Etilé & Kompal Sinha, 2016. "The Effect of Introducing a Minimum Price on the Distribution of Alcohol Purchase: A Counterfactual Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1182-1200, September.
    11. Michael Stucki, 2021. "Factors related to the change in Swiss inpatient costs by disease: a 6-factor decomposition," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 195-221, March.
    12. Sungchul Park & Anirban Basu, 2018. "Alternative evaluation metrics for risk adjustment methods," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 984-1010, June.
    13. Anne Mason & Idaira Rodriguez Santana & María José Aragón & Nigel Rice & Martin Chalkley & Raphael Wittenberg & Jose-Luis Fernandez, 2019. "Drivers of health care expenditure: Final report," Working Papers 169cherp, Centre for Health Economics, University of York.
    14. Kokot, Johanna, 2017. "Does a spouse's health shock influence the partner's risk attitudes?," Ruhr Economic Papers 707, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

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    More about this item

    Keywords

    Health care expenditure; decomposition; aging; pharmaceuticals; the Netherlands;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

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