年龄、发病率还是其他因素?利用微观数据衡量技术进步对医疗支出影响的剩余法研究。

Age, morbidity, or something else? A residual approach using microdata to measure the impact of technological progress on health care expenditure.

机构信息

Danish Centre for Health Economics - DaCHE, University of Southern Denmark, Odense, Denmark.

Economics Department, University of Palermo, Palermo, Italy.

出版信息

Health Econ. 2022 Jun;31(6):1184-1201. doi: 10.1002/hec.4500. Epub 2022 Mar 31.

Abstract

This study measures the increment of health care expenditure (HCE) that can be attributed to technological progress and change in medical practice by using a residual approach and microdata. We examine repeated cross-sections of individuals experiencing an initial health shock at different point in time over a 10-year window and capture the impact of unobservable technology and medical practice to which they are exposed after allowing for differences in health and socioeconomic characteristics. We decompose the residual increment in the part that is due to the effect of delaying time to death, that is, individuals surviving longer after a health shock and thus contributing longer to the demand of care, and the part that is due to increasing intensity of resource use, that is, the basket of services becoming more expensive to allow for the cost of innovation. We use data from the Danish National Health System that offers universal coverage and is free of charge at the point of access. We find that technological progress and change in medical practice can explain about 60% of the increment of HCE, in line with macroeconomic studies that traditionally investigate this subject.

摘要

本研究使用残差法和微观数据来衡量医疗技术进步和医疗实践变化所导致的医疗保健支出(HCE)增量。我们考察了在 10 年的时间窗口内,不同时间点经历初始健康冲击的个体的重复横截面,并在考虑到健康和社会经济特征差异后,捕捉到他们接触到的不可观测技术和医疗实践的影响。我们将残差增量分解为两部分,一部分是由于延迟死亡时间的影响,即健康冲击后个体存活时间更长,从而对护理需求的贡献时间更长,另一部分是由于资源使用强度的增加,即为了适应创新成本,服务篮子变得更加昂贵。我们使用丹麦国家卫生系统的数据,该系统提供全民覆盖,并且在使用时免费。我们发现,技术进步和医疗实践的变化可以解释 HCE 增量的约 60%,这与传统上研究这一主题的宏观经济研究一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e940/9314678/5e3657f5e198/HEC-31-1184-g001.jpg

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