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Area of Science:

  • Health Economics
  • Health Services Research
  • Epidemiology

Background:

  • Understanding health care spending patterns is crucial for identifying trends, inequalities, and cost-saving strategies.
  • Significant variation in health care expenditure exists across geographic locations and over time.

Purpose of the Study:

  • To estimate US health care spending across 3110 counties, 4 payers, 148 conditions, 38 age/sex groups, and 7 care types from 2010-2019.
  • To analyze variations in health care spending by condition, location, and demographic factors.

Main Methods:

  • Observational analysis of over 40 billion insurance claims and 1 billion facility records.
  • Estimation of health care spending and utilization for ambulatory, dental, emergency, home health, inpatient, nursing facility, and pharmaceutical care.
  • Analysis of data from 2010 through 2019.

Main Results:

  • Type 2 diabetes ($143.9 billion), musculoskeletal disorders ($108.6 billion), and oral disorders ($93 billion) were the costliest conditions.
  • Ambulatory care accounted for the largest share of spending (42.2%), followed by inpatient care (23.8%) and pharmaceuticals (13.7%).
  • Per capita spending ranged from $3410 in Idaho to $13,332 in New York, with utilization rates driving cross-county variation.

Conclusions:

  • Substantial variation in health care spending exists across US counties.
  • Understanding spending variations by condition, demographics, and care type is essential for addressing health care disparities and gaps.
  • Findings highlight the need for targeted strategies to manage health care costs and improve efficiency.