Evidence map›Paper›PMID 29512154›Full record

ArticleHealth services research2018

Understanding Trends in Medicare Spending, 2007-2014.

Laura M Keohane, Robert J Gambrel, Salama S Freed, David Stevenson, Melinda B Buntin

Abstract read
In one paragraph

Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Laura M KeohaneDepartment of Health Policy, Vanderbilt University School of Medicine, Nashville, TN.ORCID 0000-0002-9400-0575
Robert J GambrelDepartment of Health Policy, Vanderbilt University School of Medicine, Nashville, TN.
Salama S FreedDepartment of Health Policy, Vanderbilt University School of Medicine, Nashville, TN.
David StevensonDepartment of Health Policy, Vanderbilt University School of Medicine, Nashville, TN.
Melinda B BuntinDepartment of Health Policy, Vanderbilt University School of Medicine, Nashville, TN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo analyze the sources of per-beneficiary Medicare spending growth between 2007 and 2014, including the role of demographic characteristics, attributes of Medicare coverage, and chronic conditions. DATA SOURCES: Individual-level Medicare spending and enrollment data. STUDY

designUsing an Oaxaca-Blinder decomposition model, we analyzed whether changes in price-standardized, per-beneficiary Medicare Part A and B spending reflected changes in the composition of the Medicare population or changes in relative spending levels per person. DATA EXTRACTION

methodsWe identified a 5 percent sample of fee-for-service Medicare beneficiaries age 65 and above from years 2007 to 2014.

resultsMean payment-adjusted Medicare per-beneficiary spending decreased by $180 between the 2007-2010 and 2011-2014 time periods. This decline was almost entirely attributable to lower spending levels for beneficiaries. Notably, declines in marginal spending levels for beneficiaries with chronic conditions were associated with a $175 reduction in per-beneficiary spending. The decline was partially offset by the increasing prevalence of certain chronic diseases. Still, we are unable to attribute a large share of the decline in spending levels to observable beneficiary characteristics or chronic conditions.

conclusionsDeclines in spending levels for Medicare beneficiaries with chronic conditions suggest that changing patterns of care use may be moderating spending growth.

Indexed as

AgedFemaleHealth ExpendituresHumansMaleMedicare Part AMedicare Part BModels, EconomicUnited Stateschronic conditionsMedicarespending growth

Identifiers

PMID29512154
PMCPMC6153172

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.