美国医疗保健支出按支付者和健康状况,1996-2016年
Joseph L Dieleman1, Jackie Cao1, Abby Chapin1
1Institute for Health Metrics and Evaluation, Seattle, Washington.
JAMA
|March 4, 2020
概括
美国医疗保健支出从1996年至2016年大幅增长,其中公共保险增长最快. 背部疼痛,肌肉骨疾病和糖尿病造成的成本最高,
科学领域:
- 健康经济学
- 公共卫生
- 医疗保健政策
背景情况:
- 美国医疗保健支出占国民经济的18%,
- 了解医疗保健支出趋势对于政策制定和资源分配至关重要.
研究的目的:
- 从1996年到2016年,根据付款人类型 (公共,私人,自付) 和健康状况,估计美国的医疗保健支出.
- 分析20多年来不同条件,人口和护理类型的支出率的变化.
主要方法:
- 使用政府预算,保险索赔,设施记录和154个健康状况的调查 (1996-2016).
- 根据人口和年龄,每个付款人和条件计算出支出增长率.
- 包括门诊,住院,护理,急诊,牙科和处方药费用.
主要成果:
- 美国医疗保健总支出在2016年上升至3.1万亿美元 (占GDP的17.9%).
- 2016年私人保险占支出总额的48.0%,公共保险占支出总额的42.6%,自付费用占支出总额的9.4%.
- 背部/部疼痛 (1345亿美元),肌肉骨疾病 (129.8亿美元) 和糖尿病 (111.2亿美元) 是最昂贵的疾病. 公共保险支出增长最快 (每年增长2.9%).
结论:
- 美国医疗保健支出在1996年至2016年间大幅增加,公共保险支出显著增长.
- 虽然背部疼痛和糖尿病等特定疾病造成了巨大的成本,但支付者组合和支出增长动态却有很大差异.
- 调查结果强调需要针对不同条件和保险类型管理成本的有针对性的策略.
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