Public Hospital Spending in England: Evidence from National Health Service Administrative Records
Public Hospital Spending in England: Evidence from National Health Service Administrative Records
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DOI：
10.1111/j.1475-5890.2016.12101
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发表时间：
2016-09-01
期刊：
影响因子：
7.3
通讯作者：
Vera-Hernandez, Marcos
中科院分区：
文献类型：
--
作者：
Kelly, Elaine;Stoye, George;Vera-Hernandez, Marcos
自1997年以来，英格兰的人均医疗支出几乎翻了一番，但人们对这些支出在人口中的分布情况知之甚少。本文使用行政国民保健服务（NHS）的医院记录，检查在英格兰公立医院支出的主要特点。我们描述了成本如何在整个生命周期中变化，以及人们和时间的支出集中度。我们发现，人均成本在50岁后开始增加，70岁后逐步上升。支出高度集中在一小部分人口中，但老年群体的集中程度较低。对于25岁及以下的人来说，所有医院支出的三分之一由25岁以下人口的1%承担，五分之一的支出由25岁以下患者的1%承担。在65岁及以上的人中，这些数字分别下降到22%和13%。随着时间的推移，支出持续存在，高支出的患者更有可能在随后的几年中有支出，而零支出的患者更有可能继续住院。
Health spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after age 70. Spending is highly concentrated in a small section of the population, but the degree of concentration is lower for older age groups. For those aged 25 and under, a third of all hospital spending is accounted for by 1 per cent of the population under 25 and a fifth of spending is accounted for by 1 per cent of patients under 25. For those aged 65 and over, these figures fall to 22 and 13 per cent, respectively. There is persistence in spending over time, with patients with high spending more likely to have spending in subsequent years and those with zero expenditures more likely to remain out of hospital.