Dataset Information

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

ABSTRACT:

Background and objectives

This study examines high medical spending among younger, midlife, and older households.

Research design and methods

We investigate high medical spending using data from the 2010 through March 2018 Consumer Expenditures Surveys (n = 92,951). We classify and describe high medical spenders relative to others within three age groups (household heads age 25-44, 45-64, and 65+) using finite mixture models and multinomial logistic regression, respectively. We then use hierarchical linear models to estimate the effects of high medical spending on nonmedical spending.

Results

Among younger households, high medical spending is positively associated with higher education and increased spending on housing and food. Among older households, high medical spending is associated with lower education and decreased nonmedical spending.

Discussion and implications

Earlier in the life course, high medical spending is more likely to indicate an investment in future household well-being, while at older ages, high medical spending is likely to indicate medical consumption.

SUBMITTER: Mueller CW

PROVIDER: S-EPMC7491440 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

Mueller Collin W CW Charron-Chénier Raphaël R Bartlett Bryce J BJ Brown Tyson H TH

The Gerontologist 20200901 7

<h4>Background and objectives</h4>This study examines high medical spending among younger, midlife, and older households.<h4>Research design and methods</h4>We investigate high medical spending using data from the 2010 through March 2018 Consumer Expenditures Surveys (n = 92,951). We classify and describe high medical spenders relative to others within three age groups (household heads age 25-44, 45-64, and 65+) using finite mixture models and multinomial logistic regression, respectively. We th ...[more]

PMID: 31925949

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Project description:BackgroundLong-term care insurance (LTCI) was implemented in China to solve the elderly care problems caused by the aging population. It is crucial to evaluate the effectiveness of LTCI implementation from the perspective of value-based healthcare.ObjectiveThis study aimed to investigate the impact of LTCI on medical care expenditure and health status in China.MethodsWe used staggered difference-in-differences (DID) analysis to analyze the effect of LTCI policy on medical expenditure and health status based on China Health and Retirement Longitudinal Study data from 2011 to 2018.ResultsOur findings confirmed the positive contribution of LTCI policies to medical expenditures and health status. We found that the implementation of LTCI significantly reduced inpatient and outpatient expenditure, scores of self-report of health, and CESD scores by 26.3%, 12.3%, 0.103, and 0.538, respectively. It also decreased ADL scores, but the decrease was not significant. The impact of LTCI on reducing inpatient expenditure was greater for individuals aged between 65 and 80 and those residing in urban areas and eastern cities. In terms of outpatient costs, the effect of LTCI was more pronounced among median and high-income people and people living in central and eastern cities. The impact of LTCI on self-report of health is stronger for rural populations, individuals under 80, and those in central and eastern cities. For ADL scores, LTCI affected those aged 65-80 the most. About the CESD scores, LTCI had a greater impact on rural populations, people aged 45-65, median income groups, and those in eastern cities.ConclusionsOur study underscored LTCI's effectiveness in curbing medical expenditures and enhancing health status, offering valuable insights for future LTCI development in China and beyond. Accelerating the development of LTCI is conducive to improving the quality of life of the disabled elderly, enhancing the well-being of people's livelihoods, and realizing the goal of value-based healthcare.

Project description:ObjectivesTo investigate the consequences of endogeneity bias on the estimated effect of having health insurance on health at age 63 or 64, just before most people qualify for Medicare, and to simulate the implications for total and public insurance (Medicare and Medicaid) spending on newly enrolled beneficiaries in their first years of Medicare coverage.DataThe longitudinal Health and Retirement Survey of people who were 55-61 years old in 1992, followed through biannual surveys to age 63-64 or until 2000 (whichever came first), and those who were 66-70 years olds from the Medicare Current Beneficiary Surveys, 1992-1998.Study designInstrumental variable (IV) estimation of a simultaneous equation model of insurance choice and health at age 63-64 as a function of baseline health and sociodemographic characteristics in 1992 and endogenous insurance coverage over the observation period.FindingsContinuous insurance coverage is associated with significantly fewer deaths prior to age 65 and, among those who survive, a significant upward shift in the distribution of health states from fair and poor health with disabilities to good to excellent health. Treating insurance coverage as endogenous increases the magnitude of the estimated effect of having insurance on improved health prior to age 65. The medical spending simulations suggest that if the near-elderly had continuous insurance coverage, average annual medical spending per capita for new Medicare beneficiaries in their first few years of coverage would be slightly lower because of the improvement in health status. In addition, total Medicare and Medicaid spending for new beneficiaries over their first few years of coverage would be about the same or slightly lower, even though more people survive to age 65.ConclusionsExtending insurance coverage to all Americans between the ages of 55 and 64 would improve health (increase survival and shift people from good-fair-poor health to excellent-very good health) at age 65, and possibly reduce total short-term spending by Medicare and Medicaid for newly eligible Medicare beneficiaries, even though more people would enter the program because of increased survival.

Dataset Information

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

Background and objectives

Research design and methods

Results

Discussion and implications

Publications

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

Similar Datasets

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