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Behavioral health expenditures and state organizational structure.

The authors present a study on expenditures by state mental health, substance abuse, and developmental disability agencies in the United States for the period between 1981 and 1993. The relationship between agency spending and organizational structure of state bureaucracy was examined. Results indicate that organizational structure is a determinant of agency spending. The more independent an agency, the higher its spending; conversely, the more independent its competitor, the lower the agency's spending. The number of levels between an agency and the governor's office was not significant in explaining agency expenditures.

Data Collection↗

National health expenditures, 1994.

This article presents data on health care spending for the United States, covering expenditures for various types of medical services and products and their sources of funding from 1960 to 1994. Although these statistics for 1994 show the slowest growth in more than three decades, health spending continued to grow faster than the overall economy. The Federal Government continued to fund an increasing share of health care expenditures in 1994, offset by a falling share from out-of-pocket sources. Shares paid by State and local governments and by other private payers including private health insurance remained unchanged from 1993.

Ambulatory Care↗

[Analysis of public health expenditures in the area of Guadalajara during the fiscal year 1989].

In the health care area of Guadalajara health expenses are met by three agencies, although there are no local data on the participation of each of them. The present paper studies public expenditures in Guadalajara, as well as their distribution by agency, by budget items and by type of service during 1989, and their relationship with population size and the gross provincial product. Total expenditures amounted 9.085.343.426 ptas. of which the National Health Institute (INSALUD) provided 80.5%, the Regional Health Council 15.5% and the County Council 4%. This implies a health expenditure of 61.385 ptas per year (21.424 ptas for primary care, 36.278 ptas for specialized care 3.683 ptas for overheads and administrative costs). The gross provincial product amounted to 122.5 billion ptas of which 7.65% were allocated to health care. Guadalajara is a large area with a small but widely dispersed and regressive population moderately depressed from the economic point of view, and with overall health resources above national average. Distribution of health care expenditure coincides with the overall data provided by the direct management of INSALUD. The expenditure/inhabitant ratio is higher than the national average, both in absolute terms and in percentage of the gross provincial product, which is understandable when demographic characteristics and existing resources are considered.

Catchment Area, Health↗

Health expenditure.

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Health Expenditures↗

Regression-based sampling for persons with high health expenditures: evaluating accuracy and yield with the 1997 MEPS.

BACKGROUND: Given the high concentration of health care expenditures among a relatively small percentage of the population, the 1997 Medical Expenditure Panel Survey was designed to learn more about these high expenditure individuals by oversampling them. OBJECTIVE: Oversampling high expenditure individuals enables more precise estimation of what the nation's health care dollar buys and who pays it. It also enhances the ability to discern the causes of high health care expenses and the characteristics of the individuals who incur them. METHOD: Using the 1987 National Medical Expenditure Survey, a probabilistic model was developed to select households from the 1996 National Health Interview Survey likely to contain individuals incurring high levels of medical expenditures in the 1997 MEPS. The accuracy of the selection model, and the degree to which the high expenditure population was oversampled, are assessed with the 1997 MEPS data. RESULTS: Over half of the persons selected by the regression model were expected to have high health expenditures. Of the 456 persons selected by the model for oversampling, 257 individuals or 56.4% did, in fact, have high expenditures. Regression-based sampling increased the proportion of MEPS individuals with high expenditures from 14.3% without oversampling to 17.2% of the total cohort with oversampling (or from 938-1,126 persons). CONCLUSION: This paper demonstrates that a model-based approach to oversampling a high expenditure population, or any population with dynamic characteristics, can be highly successful in terms of sampling yield and accuracy.

Adult↗

A note on cointegration of health expenditures and income.

Utilizing a panel data set of 50 US states, this note investigates nonstationarity and cointegration of health care expenditures and gross state products (GSP). Both the individual state-based method and the recent panel data method are applied. Allowing for structural breaks in the test, we find that health care expenditures and GSP are both nonstationary. The evidence also suggests that the two series form a cointegrating relationship. The income elasticities of health spending vary over states and became smaller in the 1990s.

Data Interpretation, Statistical↗

National health expenditures, fiscal year 1977.

The Nation spent $163 billion for health care in fiscal year 1977 or $737 per person, according to preliminary figures compiled by the Health Care Financing Administration. This figure was 12 percent higher than spending for such purposes in the previous 12 months and represented an 8.8-percent share of the GNP. Public spending, which financed 42 percent of all health care in 1977, increased 11 percent while private spending rose 13 percent. Spending for hospital care went up 14 percent to $68.4 billion, and the total spent for physicians' services ($32.2 billion) reflected a 13-percent rise. Third-party payments financed 70 percent of all personal health care in the country.

Delivery of Health Care↗

Health expenditures by age group, 1977 and 1987.

In recent years, concern has increased over the rapid growth of health care spending, especially spending on behalf of the aged. In 1987, those 65 years or over comprised 12 percent of the population but consumed 36 percent of total personal health care. This article is an examination of the current and future composition of the population and effects on health care spending. National health accounts aggregates for 1977 and 1987 are split into three age groups, and the consumption patterns of each group are discussed. The variations in spending within the aged cohort are also examined.

Adolescent↗