Persistence in Health Expenditures in the Short Run
Prevalence and Consequences
Bibliographic Data
| ID | 9101844 |
|---|---|
| Authors | Alan C Monheit (0000-0002-1105-0228, Rutgers, the State University of New Jersey, corresponding author) |
| Year | 2003 |
| Volume | 41 |
| Issue | Supplement |
| Pages | III-53-III-64 |
| Publication date | 2003-07-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000076046.46152.ef |
| PMID | 12865727 |
| OpenAlex | W1993522567, W4250741066 |
| Language | EN |
| Citations received | 17 |
| References cited | 10 |
Background. Knowing whether persons in the top percentiles of the health expenditure distribution exhibit persistently high expenditure is fundamental to developing health plan payment policies, containing costs, and understanding the consequences of costly illnesses. Objectives. To determine the extent of high expenditure persistence over a 2-year period. To identify the correlates and consequences of expenditure persistence. Subjects. A national sample of the population from a longitudinal panel of the Medical Expenditure Panel Survey (MEPS). Methods. Changes in a person's position in the expenditure distribution were examined. χ2 tests were used to identify differences in characteristics between high and low spenders. Logistic regression was used to predict the likelihood of expenditure persistence. Changes in income, employment, out-of-pocket expenditure burden, and health insurance were compared for high and low spenders. Results. Of the top 5% of spenders in 1996, 30% retain this position in 1997 and 45% are in the top decile of 1997 spenders. High expenditures begin to regress to the mean over the study period. Cancer, mental disorders, diabetes, and infectious diseases and being in the top decile of 1996 spenders increase the probability of expenditure persistence (P< 0.05 for all). This probability also has a strong random component. An increased proportion of persons in the top expenditure decile for both years had out-of-pocket health spending greater than 20% of income in 1997 (P< 0.10). Persons with persistently high expenditures were less likely than low spenders to lose employment-based coverage (5.4% vs. 8.8%,P< 0.05) but no changes in income or employment status were detected. Conclusions. A sizable minority of persons exhibits persistently high expenditures, creating incentives for favorable risk selection. Few consequences of short-run expenditures persistence are observed
Decile · Economics · Environmental health · Health care · Health insurance · Medical Expenditure Panel Survey · Persistence (discontinuity) · Population · Statistics · Demography · Global Health Care Issues · Health disparities and outcomes · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine
Identifying Characteristics Associated with the Concentration and Persistence of Medical Expenses among Middle-Aged and Elderly Adults
Effects of an Integrated Care System on Quality of Care and Satisfaction for Children with Special Health Care Needs
The prevalence of persistence and related health status
Challenges in an aging society
The Capacity of the Medical Expenditure Panel Survey to Inform the Affordable Care Act
More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries
Informing the Design and Evaluation of Superuser Care Management Initiatives
Mortality, Disenrollment, and Spending Persistence in Medicaid and CHIP
Identifying Consistent High-cost Users in a Health Plan
Health Care Spending and Service Use among High-Cost Medicaid Beneficiaries, 2002–2004
Assessing Risk-Adjustment Approaches under Non-Random Selection
The Risks of an Ownership Society
Parents’ Experiences in Choosing a Health Plan for Their Children with Special Health Care Needs
Characteristics and spending patterns of high-cost child patients
The Utility of Extended Longitudinal Profiles in Predicting Future Health Care Expenditures
Using the SF-12 Health Status Measure to Improve Predictions of Medical Expenditures
The Medical Expenditure Panel Survey
Employment-Based Health Insurance and Job Mobility
Development of a Method to Identify Seniors at High Risk for High Hospital Utilization
Patterns of Expenditures Among High Utilizers of Medical Care Services
Regression Toward the Mean in Medical Care Costs
An Analysis of the Use of Medicare Services by the Continuously Enrolled Aged
The Inequality of Medical Expenditures for Several Years in a Healthy, Nonelderly Population
| Citations per year | 0.82 |
|---|---|
| Citation span | 2004 - 2024 (21) |
| Highly cited | No |