Out-of-Pocket Medical Expenditures in the United States: Evidence from the Health and Retirement Study
Out-of-Pocket Medical Expenditures in the United States: Evidence from the Health and Retirement Study
复制标题
DOI：
10.1111/j.1475-5890.2016.12126
复制
发表时间：
2016-09-01
期刊：
影响因子：
7.3
通讯作者：
Skinner, Jonathan
中科院分区：
文献类型：
--
作者：
Fahle, Sean;McGarry, Kathleen;Skinner, Jonathan
我们使用健康与退休研究（HRS）的数据来记录美国55岁及以上人群的自付医疗支出分布。HRS的数据使我们能够检查接近生命结束时的自付支出，并比以前的研究更详细地分析支出的组成部分。我们发现，随着年龄的增长和生命的结束，消费风险急剧上升。虽然中位数个人在生命的最后一年花费了6，328美元，但据报道，5%的人花费了超过62，040美元。我们的研究结果还表明，自付支出高度集中，前10%的支出者占所有支出的42%，并且即使在多年的时间内也持续存在。最后，虽然某些类别的支出对收入和财富非常敏感，但我们并没有发现整体支出沿着这些维度高度集中。从国际背景来看，我们的研究结果表明，美国面临非常高的自付支出的家庭比例远高于其他发达国家。
We use data from the Health and Retirement Study (HRS) to document the distribution of out-of-pocket medical spending among individuals aged 55 and over in the US. The HRS data permit us to examine out-of-pocket spending close to the end of life and to analyse the components of spending in more detail than has been done in previous studies. We find that spending risk rises sharply at older ages and near the end of life. While the median individual spent $6,328 out-of-pocket in the last year of life, 5 per cent were reported to have spent over $62,040. Our results also indicate that out-of-pocket spending is highly concentrated, with the top 10 per cent of spenders accounting for 42 per cent of all spending, and persistent, even over periods spanning many years. Finally, while certain categories of spending are very responsive to income and wealth, we do not find overall spending to be highly concentrated along these dimensions. Viewed within the international context, our results suggest that the fraction of households facing very high out-of-pocket spending is substantially greater in the US than in other developed countries.