与美国医疗保健支出增加相关的因素,1996-2013年
Joseph L Dieleman1, Ellen Squires1, Anthony L Bui2
1Institute for Health Metrics and Evaluation, Seattle, Washington.
JAMA
|November 9, 2017
概括
由于服务价格和服务强度的增加以及人口增长和老龄化,美国的医疗保健支出大幅增加. 疾病发病率下降有助于减少支出,突出了政策干预的关键因素.
科学领域:
- 健康经济学
- 公共卫生政策
- 医疗保健管理
背景情况:
- 美国的医疗保健支出大幅增长,到2015年达到经济的17.8%.
- 了解医疗支出驱动因素对于有效的政策制定至关重要.
研究的目的:
- 量化五个关键因素对美国医疗保健支出变化的影响.
- 分析的因素:人口规模,年龄结构,疾病患病率,服务利用率和服务价格/强度.
主要方法:
- 利用2015年全球疾病负担研究和2013年美国疾病支出项目的数据.
- 使用分解分析将因素变化与医疗保健支出转移联系起来.
- 分析了155种健康状况和6种护理类型的数据.
主要成果:
- 医疗保健总支出增加了9335亿美元 (1996年至2013年).
- 服务价格和服务强度增加占支出增长的50.0%.
- 人口增长 (23.1%) 和老龄化 (11.6%) 也为此做出了重大贡献;疾病患病率的变化导致2.4%的下降.
结论:
- 医疗保健支出增长主要与服务价格和服务强度有关.
- 人口动态与支出有正相关性,而疾病流行率的降低则产生负面影响.
- 医疗条件和护理类型的变化需要量身定制的政策方法.
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