Cross-country comparability in well being care value progress: 2000-2020 – Healthcare Economist


How did well being care costs change over the previous 2 many years. That’s the query a paper by Papanicolas (2024) goals to reply, evaluating US costs to these from Australia, Canada, France, and the Netherlands between 2000 and 2020.

Earlier than we get to the outcomes, we first want to find out what kinds of value indices are on the market? The authors cite three fundamental sorts:

  1. Economic system large value indices: Examples embrace a GDP value index
  2. Value indices protecting all items and providers consumed by households: Examples embrace the precise particular person consumption (AIC) value index
  3. Nationwide well being deflators. These are health-specific costs indices and are produced by a wide range of authorities entities (e.g., within the US Heart for Medicare and Medicaid Providers (CMS), the Bureau of Financial Evaluation (BEA) and the Bureau of Labor Statistics (BLS) all produce nationwide well being deflators)

The authors argue that economy-wide and AIC deflators do a poor job for capturing adjustments in well being care costs.

Though they’re extensively used to deflate well being expenditures for worldwide comparisons, the GDP and AIC value indices seize adjustments in costs general—not adjustments in healthcare-specific costs. Provided that well being care is usually supplied by non-market producers comparable to governments (the place costs could also be imperfect indicators of market worth), healthcare costs are more likely to differ markedly from economy-wide or AIC costs

The information sources the authors used are listed beneath:

Nation Title of Index  Producer
Australia Complete Well being Value Index (THPI) Australian Institute for Well being and Welfare (AIHW)
Canada Complete Well being Care Implicit Value Index Statistics Canada
France Value Index for Well being Route de la recherche, des études de l’évaluation et des statistiques (DRESS)
The Netherlands Value Index for Well being Statistics Netherlands (Centraal Bureau voor de Statistiek, CBS)
U.S. Private Well being Care Value Index Facilities for Medicare and Medicaid Providers (CMS)

Outcomes:

The well being care spending progress fee was highest in Australia (5.7%) and the U.S. (4.9%) and lowest for France (2.7%). Nevertheless, whereas a bigger share off the elevated spending was as a result of value will increase in U.S. (55% of spending progress), this determine was a giant decrease for different nations (48%). Additional:

By wanting on the ratio of the consumption-based health-specific index to the consumption-based common value index (AIC) over the research interval, we discover that america exhibits the best relative cumulative “extra” progress in well being costs over the research interval (14%), adopted by Canada (12%). Australia and the Netherlands additionally exhibit larger cumulative well being value progress over the research interval in comparison with common value progress, though barely decrease (7%–6%) than the primary cluster of nations. Lastly, France exhibits the bottom cumulative value progress, with well being costs rising solely barely above common costs (2%).

Within the Determine beneath, spending progress is decomposed into costs and quantity, the place Panel A appears to be like at consumption deflators for public payers and panel B appears to be like at consumption deflators for personal payers. One can clearly see that value progress was sooner for well being care bought by public payers in comparison with these bought by households (i.e., out-of-pocket prices or personal insurance coverage).

The total paper could be learn right here.

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