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Regional variations in medical spending and utilization: a longitudinal analysis of US Medicare population

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  • Andrew J. Rettenmaier
  • Zijun Wang

Abstract

One of the perceived symptoms of US Medicare inefficiency is the existence of the dramatic variation in spending and utilization in different areas of the country. This study uses the Continuous Medicare History Sample, a large longitudinal 5% sample of all Medicare beneficiaries from 1974 to 2003, to study the issue. We show that the spending and utilization disparities are significant at the aggregate state level. More importantly, the variation shows signs of narrowing over time, particularly in the earlier years of the sample period and in some cases following major reforms. However, it remains significant even after an array of demographic, demand and supply side factors are controlled for. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Andrew J. Rettenmaier & Zijun Wang, 2012. "Regional variations in medical spending and utilization: a longitudinal analysis of US Medicare population," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 67-82, February.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:2:p:67-82
    DOI: 10.1002/hec.1700
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    References listed on IDEAS

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    2. Carine Milcent & Saad Zbiri, 2020. "Use of telehealth: evidence from French teleconsultation for women's healthcare, prior and during COVID-19 pandemic," PSE-Ecole d'économie de Paris (Postprint) halshs-03163281, HAL.
    3. Katharina Schley, 2018. "Health care service provision in Europe and regional diversity: a stochastic metafrontier approach," Health Economics Review, Springer, vol. 8(1), pages 1-11, December.
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    5. Svetlana N. Beilfuss & James A. Thornton, 2016. "Pathways and Hidden Benefits of Healthcare Spending Growth in the U.S," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 44(3), pages 363-375, September.
    6. Dirk Göpffarth & Thomas Kopetsch & Hendrik Schmitz, 2016. "Determinants of Regional Variation in Health Expenditures in Germany," Health Economics, John Wiley & Sons, Ltd., vol. 25(7), pages 801-815, July.
    7. Herwartz, Helmut & Schley, Katharina, 2018. "Improving health care service provision by adapting to regional diversity: An efficiency analysis for the case of Germany," Health Policy, Elsevier, vol. 122(3), pages 293-300.
    8. José‐Luis Fernandez & Julien Forder, 2015. "Local Variability in Long‐Term Care Services: Local Autonomy, Exogenous Influences and Policy Spillovers," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 146-157, March.
    9. Boris Augurzky & Thomas Kopetsch & Hendrik Schmitz, 2013. "What accounts for the regional differences in the utilisation of hospitals in Germany?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 615-627, August.
    10. Rouven Edgar Haschka & Katharina Schley & Helmut Herwartz, 2020. "Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 55-71, February.

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