QUALITY-QUANTITY DECOMPOSITION OF INCOME ELASTICITY OF US HOSPITAL CARE EXPENDITURE USING STATE-LEVEL PANEL DATA
QUALITY-QUANTITY DECOMPOSITION OF INCOME ELASTICITY OF US HOSPITAL CARE EXPENDITURE USING STATE-LEVEL PANEL DATA
复制标题
DOI：
10.1002/hec.2986
复制
发表时间：
2014-11-01
期刊：
影响因子：
2.1
通讯作者：
Lubiani，Gregory G.
中科院分区：
文献类型：
--
作者：
Chen，Weiwei;Okunade，Albert;Lubiani，Gregory G.
经济理论表明，随着商品支出的变化，收入增长可能导致消费数量和质量的变化。同样，由于人口结构的变化、创新医疗技术的使用和其他因素，医疗保健消费的数量和质量可能会随着收入的增加而上升。医院医疗保健支出是美国医疗保健总支出的最大组成部分。本文的创新之处在于将医院医疗支出的收入弹性分解为数量和质量两部分。通过使用1999-2008年美国50个州的面板数据集，从看似不相关的回归模型估计的结果显示，HOCEXP的收入弹性为0.427（标准差）。误差= 0.044），约为0.391（计算的标准差.误差= 0.044）和0.035（标准差，误差= 0.050）。我们的新研究结果表明：（i）医院支出的数量部分对收入变化没有弹性;（ii）几乎所有收入引起的医院支出增长都来自医疗质量的变化;（iii）HOCEXP的收入弹性为0.427，是美国医疗保健总支出的最大组成部分，使医院护理成为一种正常的商品，并且比总体医疗保健更具有技术必要性。政策影响进行了讨论。版权所有© 2013约翰威利父子有限公司.
Economic theory suggests that income growth could lead to changes in consumption quantity and quality as the spending on a commodity changes. Similarly, the volume and quality of healthcare consumption could rise with incomes because of demographic changes, usage of innovative medical technologies, and other factors. Hospital healthcare spending is the largest component of aggregate US healthcare expenditures. The novel contribution of our paper is estimating and decomposing the income elasticity of hospital care expenditures (HOCEXP) into its quantity and quality components. By using a 1999–2008 panel dataset of the 50 US states, results from the seemingly unrelated regressions model estimation reveal the income elasticity ofHOCEXPto be 0.427 (std. error= 0.044), with about 0.391 (calculated std. error= 0.044) arising from care quality improvements and 0.035 (std. error= 0.050) emanating from the rise in usage volume. Our novel research findings suggest the following: (i) the quantity part of hospital expenditure is inelastic to income change; (ii) almost the entire income‐induced rise in hospital expenditure comes from care quality changes; and (iii) the 0.427 income elasticity ofHOCEXP, the largest component of total US healthcare expenditure, makes hospital care a normal commodity and a much stronger technical necessity than aggregate healthcare. Policy implications are discussed. Copyright © 2013 John Wiley & Sons, Ltd.