Explaining The Slowdown In Medical Spending Growth Among The Elderly, 1999-2012
Explaining The Slowdown In Medical Spending Growth Among The Elderly, 1999-2012
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DOI：
10.1377/hlthaff.2018.05372
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发表时间：
2019-02-01
期刊：
影响因子：
9.7
通讯作者：
Rosen, Allison B.
中科院分区：
文献类型：
--
作者：
Cutler, David M.;Ghosh, Kaushik;Rosen, Allison B.
我们研究了1999-2012年期间美国65岁及以上医疗保险受益人的人均支出趋势，以确定自2005年以来支出增长一直在下降的原因。通过按疾病分解支出，我们发现支出放缓的一半可归因于心血管疾病支出的增长放缓。用于痴呆症、肾脏和泌尿生殖系统疾病以及急性疾病患者的善后护理的支出增长也有所放缓。使用药物对急性疾病影响的医学文献估计，我们发现主要心血管事件的减少约有一半可归因于控制心血管风险因素的药物。尽管在心血管健康方面取得了重大的成本节约改善，但仍有更多的机会通过疾病预防和控制来降低支出。
We examined trends in per capita spending for Medicare beneficiaries ages sixty-five and older in the United States in the period 1999-2012 to determine why spending growth has been declining since around 2005. Decomposing spending by condition, we found that half of the spending slowdown was attributable to slower growth in spending for cardiovascular diseases. Spending growth also slowed for dementia, renal and genitourinary diseases, and aftercare for people with acute illnesses. Using estimates from the medical literature of the impact of pharmaceuticals on acute disease, we found that roughly half of the reduction in major cardiovascular events was attributable to medications controlling cardiovascular risk factors. Despite this substantial cost-saving improvement in cardiovascular health, additional opportunities remain to lower spending through disease prevention and control.