Why the US spends more treating high-need high-cost patients
A comparative study of pricing and utilization of care in six high-income countries
Bibliographic Data
| ID | 21467570 |
|---|---|
| Authors | Luca Lorenzoni (0000-0001-5449-2985, Organisation de Coopération et de Développement Economiques), Alberto Marino (0000-0003-1588-8746, London School of Economics and Political Science), Zeynep Or (0000-0002-6860-3735, Institut de Recherche et de Documentation en Économie de la Santé), Carl Rudolf Blankart (0000-0001-6719-0038, University of Bern), Kosta Shatrov (0000-0002-6421-6754, University of Bern), Walter P Wodchis (0000-0003-2494-7031, University of Toronto), Walter Wodchis, Nils Janlöv, Jose F Figueroa (0000-0003-3811-257X, Harvard University), Bowden N (0000-0003-4589-9956, University of Otago), Enrique Bernal‐Delgado (0000-0002-0961-3298), Irene Papanicolas (0000-0002-8000-3185, Harvard University, corresponding author) |
| Year | 2023 |
| Volume | 128 |
| Pages | 55-61 |
| Publication date | 2023-02-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy (JOURNAL) |
| Journal identifiers | ISSN: 0168-8510 • E-ISSN: 1872-6054 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.healthpol.2022.12.004 |
| PMID | 36529552 |
| OpenAlex | W4311927292 |
| Language | EN |
| References cited | 13 |
One of the most pressing challenges facing most health care systems is rising costs. As the population ages and the demand for health care services grows, there is a growing need to understand the drivers of these costs across systems. This paper attempts to address this gap by examining utilization and spending of the course of a year for two specific high-need high-cost patient types: a frail older person with a hip fracture and an older person with congestive heart failure and diabetes. Data on utilization and expenditure is collected across five health care settings (hospital, post-acute rehabilitation, primary care, outpatient specialty and drugs), in six countries (Canada (Ontario), France, Germany, Spain (Aragon), Sweden and the United States (fee for service Medicare) and used to construct treatment episode Purchasing Power Parities (PPPs) that compare prices using baskets of goods from the different care settings. The treatment episode PPPs suggest other countries have more similar volumes of care to the US as compared to other standardization approaches, suggesting that US prices account for more of the differential in US health care expenditures. The US also differs with regards to the share of expenditures across care settings, with post-acute rehab and outpatient speciality expenditures accounting for a larger share of the total relative to comparators
Ambulatory care · Business · Economic growth · Economics · Environmental health · Family medicine · Health care · Inpatient care · Population · Purchasing power · Specialty · Global Health Care Issues · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Medicine
| Highly cited | No |
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