Income, Insurance, And Technology: Why Does Health Spending Outpace Economic Growth?
Income, Insurance, And Technology: Why Does Health Spending Outpace Economic Growth?
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DOI：
10.1377/hlthaff.28.5.1276
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发表时间：
2009-09-01
期刊：
影响因子：
9.7
通讯作者：
Freeland, Mark S.
中科院分区：
文献类型：
--
作者：
Smith, Sheila;Newhouse, Joseph P.;Freeland, Mark S.
一个广泛的共识认为，提高医疗能力-技术-是卫生支出增长的主要驱动力。然而，技术的发展并不独立于历史背景;它受到收入增加和更慷慨的保险覆盖的推动。我们估计，自1960年以来，医疗技术占卫生支出增长的27%-48%，这一比例低于先前的估计。收入（国内生产总值或GDP）增长起着关键作用，主要是通过政府和雇主代表消费者群体采取的行动。保险的贡献可能会有所不同，保险范围越来越慷慨的推动作用较小，而更多的是供应商付款方式的变化。[ Health Afff（Millwood）. 2009; 28（5）：1276-84; 10.1377/hlthaff.28.5.1276]
A broad consensus holds that increased medical capability-technology-is the primary driver of health spending growth. However, technology does not expand independently of historical context; it is fueled by rising incomes and more generous insurance coverage. We estimate that medical technology explains 27-48 percent of health spending growth since 1960-a smaller percentage than earlier estimates. Income ( gross domestic product, or GDP) growth plays a critical role, primarily through the actions of governments and employers on behalf of pools of consumers. The contribution of insurance is likely to differ, with less of a push from increasing generosity of coverage and more of a push from changes in provider payment. [ Health Aff (Millwood). 2009; 28(5):1276-84; 10.1377/hlthaff.28.5.1276]