ArticleEClinicalMedicine2021
Trends in medicare spending across strata of resource utilization among older individuals in the United States.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Implementation of a peer health navigator program for patients at risk of frequent hospitalisation.BMC geriatrics · 2026Observational
- Healthcare spending for non-fatal falls among older adults, USA.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2024Article
- Patterns of Healthcare Utilization and Spending Among Homebound Older Adults in the USA: an Observational Study.Journal of general internal medicine · 2023Observational
- Trends in and Factors Contributing to the Slowdown in Medicare Spending Growth, 2007-2018.JAMA health forum · 2022Article
- Assessing Hospital Resource Utilization with Application to Imaging for Patients Diagnosed with Prostate Cancer.Healthcare (Basel, Switzerland) · 2022Article
- Consider expenditure controls' impacts on equity.EClinicalMedicine · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth care spending is an increasing proportion of government expenditures in most Western countries. How this growth is distributed between individuals with minimal compared to high health care utilization is unknown.
methodsWe examined total and per-capita government expenditure in an observational cohort of fee-for-service U.S. Medicare enrollees aged ≥65 years from 2007 to 2018. We categorized patients into annual resource utilization strata. We examined annualized changes in adjusted spending across resource utilization strata and the distribution of spending within and across strata for a variety of health care settings.
findingsExamining 314,593,489 beneficiary-years of coverage, the top 1% of beneficiaries accounted for 14.9% of all expenditures, the top 5% for 41.5%, the top 10% for 60.0%, the top 20% for 79.1%, and the top 50% for 95.7%. Annual expenditures remained relatively stable from 2007 to 2018, with annual mean change of 0.7% (standard deviation 1.1%; median 1.1%) and mean per capita change of 0.4% (standard deviation 1·6%; median 0·3%). Changes were similar across strata with mean increases <1% in all, save for the <50th percentile strata (mean annual growth=1·9%), a significant difference (
interpretationIn the U.S. from 2007 to 2018, Medicare spending has a Pareto distribution in which 80% of the costs are attributable to 20% of beneficiaries. Despite low overall Medicare spending growth from 2007 to 2018, growth has been greatest among those in the lowest spending group.
fundingThe Commonwealth Fund (20,202,411).
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