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Decomposing Medical-Care Expenditure Growth

Abe Dunn, Eli B. Liebman, Adam Shapiro

NBER Working Paper No. 23117
Issued in February 2017
NBER Program(s):Health Care, Health Economics

Medical-care expenditures have been rising rapidly, accounting for over 17 percent of GDP in 2012. In this study, we assess the sources of the rising medical-care expenditures in the commercial sector. We employ a novel framework for decomposing expenditure growth into four components at the disease level: service price growth, service utilization growth, treated disease prevalence growth, and demographic shift. The decomposition shows that growth in prices and treated prevalence are the primary drivers of medical-care expenditure growth over the 2003 to 2007 period. There was no growth in service utilization at the aggregate level over this period. Price and utilization growth were especially large for the treatment of malignant neoplasms. For many conditions, treated prevalence has shifted towards preventive treatment and away from treatment for late-stage illnesses.

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Document Object Identifier (DOI): 10.3386/w23117

Published: Decomposing Medical Care Expenditure Growth, Abe Dunn, Eli Liebman, Adam Hale Shapiro. in Measuring and Modeling Health Care Costs, Aizcorbe, Baker, Berndt, and Cutler. 2018

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