Private Enterprise Research Center, Texas A&M University, College Station, TX 77843-4231, USA.
Health Econ. 2012 Feb;21(2):67-82. doi: 10.1002/hec.1700. Epub 2010 Dec 15.
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.
美国医疗保险效率低下的一个公认症状是，该国不同地区的支出和使用存在显著差异。本研究使用了连续医疗保险历史样本，这是一个从 1974 年到 2003 年所有医疗保险受益人的大型纵向 5%样本，以研究这一问题。我们发现，在总州一级，支出和使用的差距是显著的。更重要的是，随着时间的推移，这种差异呈现出缩小的迹象，特别是在样本期间的早期，在某些情况下，在重大改革之后也是如此。然而，即使在控制了一系列人口、需求和供给方面的因素后，这种差异仍然显著。
