Ginsburg Paul B
Center for Studying Health System Change.
Synth Proj Res Synth Rep. 2008 Oct(16). Epub 2008 Oct 1.
The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.
美国在医疗保健方面的支出占国内生产总值（GDP）的比例越来越大，超过了其他工业化国家。本综述探讨了美国医疗成本较高的原因以及推动成本增长的因素。主要发现包括：医疗保健效率低下、医疗技术和健康状况（尤其是肥胖）是美国医疗保健成本上升的主要驱动因素。奖励低效率和阻碍竞争的医疗支付系统阻碍了医疗保健部门的生产率提高。最有力的证据表明，医疗技术占支出增长的二分之一至三分之二。虽然医疗事故保险和防御性医疗会增加医疗成本，但它们并非导致支出显著增加的足够大的因素。研究一致表明，尽管婴儿潮一代人口老龄化，但人口统计学因素不会成为推动支出的重要因素。
