Trends in Health Care Utilization and Expenditures in the United States Across 5 Decades: 1977-2017.
Trends in Health Care Utilization and Expenditures in the United States Across 5 Decades: 1977-2017.
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DOI：
10.1097/mlr.0000000000001557
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发表时间：
2021-08-01
期刊：
影响因子：
3
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Mortensen K;Dean EB;French MT;Wang N;Chen J
美国的医疗保健支出很高，而且还在不断增加，几十年来显着增加。由于技术创新、政策变化、患者偏好、支付机制改变、人口结构变化和其他因素，医疗保健系统的提供、组织和融资随着时间的推移而不断发展。研究美国医疗保健利用和支出的长期趋势。本分析采用描述性统计数据来检验医疗保健研究与质量机构 (AHRQ) 1977 年至 2017 年 5 年来的医疗保健利用率和支出数据。衡量标准包括住院患者、急诊科、门诊医生、门诊非医生、办公室医生、牙科和自付费用零售处方药的使用和支出（而非收费）。我们证明，虽然医疗保健支出总体上和医疗类型显着增加，但利用率趋势不太明显。 1977 年至 2017 年间，美国人口增长了 53%，而年度医疗保健总支出增长了 208%。由于人们对意外医疗费用的自付费用的关注，自付费用从 1977 年的 32% 下降到 2017 年的 12%，但金额有所增加。本文首次详细介绍了美国医疗保健利用和支出的动态。今天的医疗保健方面与过去几十年有很大不同，但住院环境仍然在支出中占主导地位。
Health care expenditures in the United States are high and rising, with significant increases over the decades. The delivery, organization, and financing of the health care system has evolved over time due to technological innovation, policy changes, patient preferences, altering payment mechanisms, shifting demographics, and other factors. To examine trends over time in health care utilization and expenditures in the United States. This analysis employs descriptive statistics to examine 5 decades of health care utilization and expenditure data from the Agency for Healthcare Research and Quality (AHRQ) for 1977–2017. Measures include utilization and expenditures (not charges) for inpatient, emergency department, outpatient physician, outpatient non-physician, office-based physician, dental, and out-of-pocket retail prescription drugs. We demonstrate that while health care expenditures have increased significantly overall and by type of care, utilization trends are less pronounced. The population of the United States grew 53 percent between 1977 and 2017, while annual total expenditures on health care increased 208 percent. Amidst attention to out-of-pocket exposure for unexpected medical care bills, out-of-pocket payments for care have declined from 32 percent in 1977 to 12 percent in 2017, but increased in amount. This article provides the first extended snapshot of the dynamics of health care utilization and expenditures in the United States. Aspects of health care are much different today than in previous decades, yet the inpatient setting still dominates the expenditures.