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A Three -Essay Empirical Analysis of Health Care Expenditures In the Economic Development of the United States, 2000 - 2009.

机译：2000-2009年美国经济发展中医疗保健支出的三项实证分析。

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摘要

Therefore the purpose of this study was to empirically demonstrate state-level variations in financing of healthcare, hospital expenditures and health outcomes.;Precisely, aims of the three studies were to: (1) evaluate the state-level variations in healthcare financing and the factors that affect financing of healthcare, (2) examine the state-level variations in hospital expenditures with an application of spatial regression, and (3) assess the determinants of state-level mortality rates using a spatial Durbin fixed effect model. This research used panel data from 2000 through 2009, extracted from publicly available data files.;Findings from the first study were that state-level variations in public financing of health care (Medicare and Medicaid) are associated with demographic composition (proportion of the female population, percentage of individuals over age 65, percentage of Hispanic population), economic factors (unemployment rate, per capita gross domestic product (GDP) of the state, per capita state tax revenue, FMAP rate), political climate (percentage of individuals enrolled in Medicare or Medicaid, rate of enrollment in HMO), healthcare supply factors (active physicians per 100,000 population, number of hospitals and beds) and healthcare needs (obesity rate). Additionally, variations in state-level private insurance financing was proportional to the economic factors (rate of federal funding, per capita state GDP), a supply side factor (active physicians per 100,000 population), political climate (percentage of individuals enrolled in Medicare or Medicaid) and healthcare needs (obesity rate). Lastly, state-level variations in out of pocket expenditures were associated with economic factors (per capita state tax revenue, per capita state GDP), demographic factors (percentage of African-Americans, percentage of female population, percentage of elderly population (aged 65 and above), percentage of Hispanic individuals, proportion of the population below age 17), a supply side factor (active physicians per 100,000 population), political characteristics (percentage of individuals enrolled in Medicare or Medicaid) and healthcare needs (obesity rate).;The second study reported the presence of a positive spatial dependence of hospital spending within one state on its adjacent states. This study also highlighted that rate of binge drinking, total number of hospital beds and hospitals per 1,000 residents, the unemployment rate, the percentage of African-Americans, proportion of active physicians and state gross domestic product (GDP) had positive impacts on its neighboring states' rates of hospital expenses. Moreover, the increasing rate of male population, Hispanic population and the rate of un-insurance of a state had negative impacts on its own rate of hospital costs but positive impacts on its bordering states' rate of hospital spending.;The third study also revealed a significant positive spatial dependence of the mortality rate among neighboring states. Population composition (percentage of African-Americans and percentage of individuals over 65 years of age) significantly increased the mortality rate of a state, while the percentage of Hispanic population, number of active physicians, percentage of married population and percentage with a college degree (bachelors or higher) reduced mortality rates. Higher rates of Hispanic population and better hospital infrastructure of an individual state increased the mortality rates of the neighboring states and higher the education level of the state decreased the mortality rate of the neighboring states. (Abstract shortened by UMI.).
机译：因此，本研究的目的是通过经验证明医疗保健，医院支出和健康结局的州水平差异。准确地，这三项研究的目的是：（1）评价医疗保健融资和医疗费用的州水平差异。影响医疗保健筹资的因素，（2）应用空间回归研究州一级医院支出的变化，（3）使用空间杜宾固定效应模型评估州级死亡率的决定因素。这项研究使用了2000年至2009年的面板数据，这些数据是从可公开获得的数据文件中提取的；第一项研究的发现是，国家级医疗保健公共筹资（Medicare和Medicaid）的差异与人口构成（女性的比例）有关。人口，65岁以上人口的百分比，西班牙裔人口的百分比），经济因素（失业率，州人均国内生产总值（GDP），人均州税收收入，FMAP率），政治气候（入学人数的百分比）在Medicare或Medicaid中，在HMO中的注册率），医疗保健供给因素（每100,000个人口中的活跃医生，医院和床位数）和医疗保健需求（肥胖率）。此外，州一级私人保险筹资的变化与经济因素（联邦资金的比率，人均州GDP），供应方面的因素（每10万人的活跃医生），政治环境（参加Medicare或医疗保险的个人百分比）成正比。医疗补助）和医疗保健需求（肥胖率）。最后，州一级的自付费用与经济因素（人均州税收，人均国内生产总值），人口因素（非裔美国人百分比，女性人口百分比，老年人口百分比（65岁）及以上），西班牙裔个体的百分比，17岁以下人口的比例，供应方面的因素（每100,000个人口中活跃的医生），政治特征（参加Medicare或Medicaid的个体百分比）和医疗需求（肥胖率）。 ；第二项研究报告了一个州内与其相邻州之间医院支出存在正空间依赖性。这项研究还强调指出，暴饮暴食率，每千名居民的病床总数和医院总数，失业率，非裔美国人百分比，在职医生的比例以及各州的国内生产总值（GDP）对其邻国产生了积极影响州的医院费用率。此外，男性人口，西班牙裔人口的增加以及一个州的无保险率对该州自身的医院费用率产生负面影响，但对周边各州的医院支出率产生积极影响。邻国之间死亡率的显着正空间相关性。人口构成（非裔美国人的百分比和65岁以上的个人的百分比）显着提高了一个州的死亡率，而西班牙裔人口的百分比，在职医生的数量，已婚人口的百分比以及具有大学学历的百分比（单身汉或更高学历）可降低死亡率。各个州的西班牙裔人口比例较高和医院基础设施改善，增加了邻近州的死亡率，而该州的教育水平较高，则降低了邻近州的死亡率。 （摘要由UMI缩短。）。

著录项

  • 作者

    Bose, Srimoyee.;

  • 作者单位

    West Virginia University.;

  • 授予单位 West Virginia University.;
  • 学科 Economics.;Public health.;Statistics.;Health care management.
  • 学位 Ph.D.
  • 年度 2015
  • 页码 159 p.
  • 总页数 159
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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