Northwestern University, Chicago, IL, USA.
Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Inquiry. 2021 Jan-Dec;58:469580211010433. doi: 10.1177/00469580211010433.
Given increased focus on health spending, this investigation aims to compare trends in pediatric Medicaid and private insurance spending on type of service from 2002 to 2014 in order to inform policy and research. A repeated cross-sectional analysis of 2002 to 2014 National Health Expenditure Accounts data was conducted. Total spending, per capita spending, and compounded annual growth rates for type of service were determined for children ages 0 to 18 at the national level. Per capita spending growth was higher for private insurance than for Medicaid, and the areas of high per capita spending growth differed for private insurance and Medicaid. While Medicaid spent more per capita on hospital care than private insurance, private insurance demonstrated greater per capita spending growth on hospital care than Medicaid (8.49% vs 1.99%, respectively). Conversely, per capita spending on home health care grew more for Medicaid (6.79%) than for private insurance (3.18%). Trends in private insurance and Medicaid overall and per capita spending differ. Medicaid experienced higher annual growth in total spending than per capita spending, while private insurance had greater annual growth in per capita spending than total spending. Growth in private insurance per capita spending was higher than growth in Medicaid per capita spending, but growth in Medicaid total spending was higher than growth in private insurance total spending. These data suggest that Medicaid and private insurance may have different drivers of spending growth, highlighting the need for policy makers to examine spending patterns by payer. Further research to determine why such differences in spending growth exist will better inform efforts to increase health care value.
鉴于对医疗支出的关注度不断提高，本研究旨在比较 2002 年至 2014 年期间，小儿医疗补助和私人保险在服务类型上的支出趋势，以为政策和研究提供信息。对 2002 年至 2014 年《国家卫生支出账户》数据进行了重复横断面分析。在全国范围内，确定了 0 至 18 岁儿童的总支出、人均支出和按服务类型计算的复合年增长率。私人保险的人均支出增长率高于医疗补助，私人保险和医疗补助的高人均支出增长率领域也不同。虽然医疗补助在医院护理方面的人均支出高于私人保险，但私人保险在医院护理方面的人均支出增长率高于医疗补助（分别为 8.49%和 1.99%）。相反，医疗补助在家庭保健方面的人均支出增长率（6.79%）高于私人保险（3.18%）。私人保险和医疗补助的总体和人均支出趋势不同。医疗补助的总支出年增长率高于人均支出增长率，而私人保险的人均支出年增长率高于总支出增长率。私人保险的人均支出增长率高于医疗补助的人均支出增长率，但医疗补助的总支出增长率高于私人保险的总支出增长率。这些数据表明，医疗补助和私人保险的支出增长可能有不同的驱动因素，这凸显了政策制定者需要按支付方来检查支出模式。进一步研究确定支出增长差异存在的原因，将更好地为提高医疗保健价值的努力提供信息。
