Working Paper: NBER ID: w23117
Authors: Abe Dunn; Eli B. Liebman; Adam Hale Shapiro
Abstract: Medical-care expenditures have been rising rapidly, accounting for over 17 percent of GDP in 2012. In this study, we assess the sources of the rising medical-care expenditures in the commercial sector. We employ a novel framework for decomposing expenditure growth into four components at the disease level: service price growth, service utilization growth, treated disease prevalence growth, and demographic shift. The decomposition shows that growth in prices and treated prevalence are the primary drivers of medical-care expenditure growth over the 2003 to 2007 period. There was no growth in service utilization at the aggregate level over this period. Price and utilization growth were especially large for the treatment of malignant neoplasms. For many conditions, treated prevalence has shifted towards preventive treatment and away from treatment for late-stage illnesses.
Keywords: medical care; expenditure growth; healthcare costs; disease prevalence; service prices
JEL Codes: I10; I11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| treated disease prevalence (I12) | medical care expenditures (H51) |
| service prices (P22) | medical care expenditures (H51) |
| demographic shifts (J11) | medical care expenditures (H51) |
| service utilization (I11) | medical care expenditures (H51) |
| service prices (P22) | cancer treatment costs (Q52) |
| service prices (P22) | treated disease prevalence (I12) |