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1.
Health Aff (Millwood) ; 43(1): 6-17, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38091522

RESUMO

Health care spending in the US grew 4.1 percent to reach $4.5 trillion in 2022, which was still a faster rate of growth than the increase of 3.2 percent in 2021 but was much slower than the rate of 10.6 percent seen in 2020. In 2022, strong Medicaid and private health insurance spending growth, including a turnaround in the net cost of insurance, was somewhat offset by continued declines in federal spending associated with the COVID-19 pandemic. The insured share of the population reached a historic high of 92.0 percent in 2022 as enrollment in private health insurance increased at a faster rate relative to 2021 and Medicaid enrollment continued to experience strong growth. The share of the economy accounted for by the health sector was 17.3 percent in 2022, which was down from a peak of 19.5 percent in 2020 but was more consistent with the average share of 17.5 percent during 2016-19.


Assuntos
Gastos em Saúde , Pandemias , Estados Unidos , Humanos , Seguro Saúde , Medicaid , Atenção à Saúde
2.
Health Aff (Millwood) ; 42(1): 6-17, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36516360

RESUMO

Health care spending in the US grew 2.7 percent to reach $4.3 trillion in 2021, a much slower rate than the increase of 10.3 percent seen in 2020. The slower rate of growth in 2021 was driven by a 3.5 percent decline in federal government expenditures for health care after a spike in 2020 that occurred largely in response to the COVID-19 pandemic. Alongside this decline, the use of medical goods and services increased in 2021. The share of the economy accounted for by the health sector fell from 19.7 percent in 2020 to 18.3 percent in 2021, but it was still higher than the 17.6 percent share in 2019. In 2021 the number of uninsured people declined for the second consecutive year as Medicaid enrollment increased.


Assuntos
COVID-19 , Gastos em Saúde , Estados Unidos , Humanos , Pandemias , Atenção à Saúde , Medicaid
3.
Health Aff (Millwood) ; 41(1): 13-25, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34910596

RESUMO

US health care spending increased 9.7 percent to reach $4.1 trillion in 2020, a much faster rate than the 4.3 percent increase seen in 2019. The acceleration in 2020 was due to a 36.0 percent increase in federal expenditures for health care that occurred largely in response to the COVID-19 pandemic. At the same time, gross domestic product declined 2.2 percent, and the share of the economy devoted to health care spending spiked, reaching 19.7 percent. In 2020 the number of uninsured people fell, while at the same time there were significant shifts in types of coverage.


Assuntos
COVID-19 , Gastos em Saúde , Atenção à Saúde , Humanos , Seguro Saúde , Medicare , Pandemias/prevenção & controle , Patient Protection and Affordable Care Act , SARS-CoV-2 , Estados Unidos
4.
Health Aff (Millwood) ; 40(1): 14-24, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33326300

RESUMO

US health care spending increased 4.6 percent to reach $3.8 trillion in 2019, similar to the rate of growth of 4.7 percent in 2018. The share of the economy devoted to health care spending was 17.7 percent in 2019 compared with 17.6 percent in 2018. In 2019 faster growth in spending for hospital care, physician and clinical services, and retail purchases of prescription drugs-which together accounted for 61 percent of total national health spending-was offset mainly by expenditures for the net cost of health insurance, which were lower because of the suspension of the health insurance tax in 2019.


Assuntos
Gastos em Saúde , Medicamentos sob Prescrição , Atenção à Saúde , Instalações de Saúde , Humanos , Seguro Saúde , Estados Unidos
5.
Health Aff (Millwood) ; 39(1): 8-17, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31804875

RESUMO

US health care spending increased 4.6 percent to reach $3.6 trillion in 2018, a faster growth rate than the rate of 4.2 percent in 2017 but the same rate as in 2016. The share of the economy devoted to health care spending declined to 17.7 percent in 2018, compared to 17.9 percent in 2017. The 0.4-percentage-point acceleration in overall growth in 2018 was driven by faster growth in both private health insurance and Medicare, which were influenced by the reinstatement of the health insurance tax. For personal health care spending (which accounted for 84 percent of national health care spending), growth in 2018 remained unchanged from 2017 at 4.1 percent. The total number of uninsured people increased by 1.0 million for the second year in a row, to reach 30.7 million in 2018.


Assuntos
Atenção à Saúde/economia , Gastos em Saúde , Seguro Saúde/economia , Medicare/economia , Setor Privado , Produto Interno Bruto/estatística & dados numéricos , Humanos , Estados Unidos
6.
Health Aff (Millwood) ; 38(1): 101377hlthaff201805085, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30521399

RESUMO

Total nominal US health care spending increased 3.9 percent to $3.5 trillion in 2017, slowing from growth of 4.8 percent in 2016. The rate of growth in 2017 was similar to the increases between 2008 and 2013, which preceded the faster growth experienced during 2014-15-a period that was marked by insurance coverage expansion and large increases in prescription drug spending. Slower growth in health care spending in 2017 was mainly attributable to the use and intensity of goods and services, particularly for hospital care, physician and clinical services, and retail prescription drugs. Nearly all major sources of insurance and sponsors of health care experienced slower growth in 2017. On a per capita basis, spending on health care increased 3.2 percent and reached $10,739 in 2017. The share of gross domestic product devoted to health care spending was 17.9 percent in 2017, similar to the share in 2016.


Assuntos
Produto Interno Bruto/tendências , Gastos em Saúde , Cobertura do Seguro , Seguro Saúde , Atenção à Saúde/métodos , Humanos , Medicaid , Patient Protection and Affordable Care Act , Medicamentos sob Prescrição , Estados Unidos
7.
Health Aff (Millwood) ; 37(1): 150-160, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29211503

RESUMO

Total nominal US health care spending increased 4.3 percent and reached $3.3 trillion in 2016. Per capita spending on health care increased by $354, reaching $10,348. The share of gross domestic product devoted to health care spending was 17.9 percent in 2016, up from 17.7 percent in 2015. Health spending growth decelerated in 2016 following faster growth in 2014 and 2015 associated with coverage expansions under the Affordable Care Act (ACA) and strong retail prescription drug spending growth. In 2016 the slowdown was broadly based, as spending for the largest categories by payer and by service decelerated. Enrollment trends drove the slowdown in Medicaid and private health insurance spending growth in 2016, while slower per enrollee spending growth influenced Medicare spending. Furthermore, spending for retail prescription drugs slowed, partly as a result of lower spending for drugs used to treat hepatitis C, while slower use and intensity of services drove the slowdown in hospital care and physician and clinical services.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Medicare/estatística & dados numéricos , Definição da Elegibilidade , Gastos em Saúde/tendências , Humanos , Cobertura do Seguro/economia , Seguro Saúde/economia , Medicaid/economia , Medicare/economia , Patient Protection and Affordable Care Act , Estados Unidos
8.
Health Aff (Millwood) ; 36(7): 1318-1327, 2017 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-28615193

RESUMO

As the US health sector evolves and changes, it is informative to estimate and analyze health spending trends at the state level. These estimates, which provide information about consumption of health care by residents of a state, serve as a baseline for state and national-level policy discussions. This study examines per capita health spending by state of residence and per enrollee spending for the three largest payers (Medicare, Medicaid, and private health insurance) through 2014. Moreover, it discusses in detail the impacts of the Affordable Care Act implementation and the most recent economic recession and recovery on health spending at the state level. According to this analysis, these factors affected overall annual growth in state health spending and the payers and programs that paid for that care. They did not, however, substantially change state rankings based on per capita spending levels over the period.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Medicare/estatística & dados numéricos , Atenção à Saúde/economia , Recessão Econômica/estatística & dados numéricos , Gastos em Saúde/tendências , Humanos , Medicaid/economia , Medicare/economia , Estados Unidos
9.
Health Aff (Millwood) ; 36(1): 166-176, 2017 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-27913569

RESUMO

Total nominal US health care spending increased 5.8 percent and reached $3.2 trillion in 2015. On a per person basis, spending on health care increased 5.0 percent, reaching $9,990. The share of gross domestic product devoted to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014. Coverage expansions that began in 2014 as a result of the Affordable Care Act continued to affect health spending growth in 2015. In that year, the faster growth in total health care spending was primarily due to accelerated growth in spending for private health insurance (growth of 7.2 percent), hospital care (5.6 percent), and physician and clinical services (6.3 percent). Continued strong growth in Medicaid (9.7 percent) and retail prescription drug spending (9.0 percent), albeit at a slower rate than in 2014, contributed to overall health care spending growth in 2015.


Assuntos
Produto Interno Bruto/estatística & dados numéricos , Gastos em Saúde/tendências , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Produto Interno Bruto/tendências , Humanos , Medicaid/economia , Medicare/economia , Patient Protection and Affordable Care Act/economia , Estados Unidos
10.
Proteomics ; 16(18): 2480-90, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27546229

RESUMO

Current approaches to protein identification rely heavily on database matching of fragmentation spectra or precursor peptide ions. We have developed a method for MALDI TOF-TOF instrumentation that uses peptide masses and their measurement errors to confirm protein identifications from a first pass MS/MS database search. The method uses MS1-level spectral data that have heretofore been ignored by most search engines. This approach uses the distribution of mass errors of peptide matches in the MS1 spectrum to develop a probability model that is independent of the MS/MS database search identifications. Peptide mass matches can come from both precursor ions that have been fragmented as well as those that are tentatively identified by accurate mass alone. This additional corroboration enables us to confirm protein identifications to MS/MS-based scores that are otherwise considered to be only of moderate quality. Straightforward and easily applicable to current proteomic analyses, this tool termed "ProteinProcessor" provides a robust and invaluable addition to current protein identification tools.


Assuntos
Algoritmos , Mapeamento de Peptídeos/métodos , Proteômica/métodos , Espectrometria de Massas em Tandem/métodos , Animais , Bases de Dados de Proteínas , Humanos , Camundongos , Modelos Estatísticos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
11.
Health Aff (Millwood) ; 35(1): 150-60, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26631494

RESUMO

US health care spending increased 5.3 percent to $3.0 trillion in 2014. On a per capita basis, health spending was $9,523 in 2014, an increase of 4.5 percent from 2013. The share of gross domestic product devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. The faster growth in 2014 that followed five consecutive years of historically low growth was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance, which contributed to an increase in the insured share of the population. Additionally, the introduction of new hepatitis C drugs contributed to rapid growth in retail prescription drug expenditures, which increased by 12.2 percent in 2014. Spending by the federal government grew at a faster rate in 2014 than spending by other sponsors of health care, leading to a 2-percentage-point increase in its share of total health care spending between 2013 and 2014.


Assuntos
Gastos em Saúde/tendências , Cobertura do Seguro/tendências , Seguro de Serviços Farmacêuticos/economia , Seguro de Serviços Farmacêuticos/tendências , Patient Protection and Affordable Care Act/economia , Feminino , Custos de Cuidados de Saúde/tendências , Reforma dos Serviços de Saúde/economia , Humanos , Cobertura do Seguro/economia , Cobertura do Seguro/estatística & dados numéricos , Seguro de Serviços Farmacêuticos/estatística & dados numéricos , Masculino , Medicaid/economia , Medicare/economia , Medicamentos sob Prescrição/economia , Medicamentos sob Prescrição/uso terapêutico , Melhoria de Qualidade , Estados Unidos
12.
Health Aff (Millwood) ; 34(1): 150-60, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25472958

RESUMO

In 2013 US health care spending increased 3.6 percent to $2.9 trillion, or $9,255 per person. The share of gross domestic product devoted to health care spending has remained at 17.4 percent since 2009. Health care spending decelerated 0.5 percentage point in 2013, compared to 2012, as a result of slower growth in private health insurance and Medicare spending. Slower growth in spending for hospital care, investments in medical structures and equipment, and spending for physician and clinical care also contributed to the low overall increase.


Assuntos
Controle de Custos/economia , Controle de Custos/tendências , Produto Interno Bruto/tendências , Custos de Cuidados de Saúde/tendências , Gastos em Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Seguro Saúde/economia , Seguro Saúde/tendências , Medicare/economia , Medicare/tendências , Previsões , Humanos , Patient Protection and Affordable Care Act/economia , Patient Protection and Affordable Care Act/tendências , Estados Unidos
13.
Health Aff (Millwood) ; 33(5): 815-22, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24799579

RESUMO

This article presents estimates of personal health care spending by age and gender in selected years during the period 2002-10 and an analysis of the variation in spending among children, working-age adults, and the elderly. Our research found that in this period, aggregate spending on children's health care increased at the slowest rate. However, per capita spending for children grew more rapidly than that for working-age adults and the elderly. Per capita spending for the elderly remained about five times higher than spending for children. Overall, females spent more per capita than males, but the gap had decreased by 2010. The implementation of Medicare Part D, the effects of the recent recession, and the aging of the baby boomers affected the spending trends and distributions during the period of this study.


Assuntos
Gastos em Saúde/tendências , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Custos de Medicamentos/tendências , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Masculino , Medicaid/economia , Medicare/economia , Pessoa de Meia-Idade , Fatores Sexuais , Estados Unidos , Adulto Jovem
14.
Health Aff (Millwood) ; 33(1): 67-77, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24395937

RESUMO

For the fourth consecutive year, growth in health care spending remained low, increasing by 3.7 percent in 2012 to $2.8 trillion. At the same time, the share of the economy devoted to health fell slightly (from 17.3 percent to 17.2 percent) as the nominal gross domestic product (GDP) grew by 4.6 percent. Faster growth in hospital services and in physician and clinical services was mitigated by slower growth in prices for prescription drugs and nursing home services. Despite an uptick in enrollment growth, Medicare spending growth slowed slightly in 2012, mainly due to lower payment updates. For Medicaid, slowing enrollment growth kept spending growth near historic lows. Growth in private health insurance spending also remained near historically low rates in 2012, largely influenced by the nation's modest economic recovery and its impact on enrollment.


Assuntos
Atenção à Saúde/economia , Gastos em Saúde/tendências , Atenção à Saúde/tendências , Recessão Econômica/tendências , Emprego/economia , Emprego/tendências , Previsões , Produto Interno Bruto/tendências , Humanos , Renda/tendências , Seguro Saúde/economia , Seguro Saúde/tendências , Estados Unidos
15.
Health Aff (Millwood) ; 32(1): 87-99, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23297275

RESUMO

In 2011 US health care spending grew 3.9 percent to reach $2.7 trillion, marking the third consecutive year of relatively slow growth. Growth in national health spending closely tracked growth in nominal gross domestic product (GDP) in 2010 and 2011, and health spending as a share of GDP remained stable from 2009 through 2011, at 17.9 percent. Even as growth in spending at the national level has remained stable, personal health care spending growth accelerated in 2011 (from 3.7 percent to 4.1 percent), in part because of faster growth in spending for prescription drugs and physician and clinical services. There were also divergent trends in spending growth in 2011 depending on the payment source: Medicaid spending growth slowed, while growth in Medicare, private health insurance, and out-of-pocket spending accelerated. Overall, there was relatively slow growth in incomes, jobs, and GDP in 2011, which raises questions about whether US health care spending will rebound over the next few years as it typically has after past economic downturns.


Assuntos
Atenção à Saúde/economia , Atenção à Saúde/tendências , Gastos em Saúde/tendências , Reembolso de Seguro de Saúde/economia , Reembolso de Seguro de Saúde/tendências , Custos de Medicamentos/tendências , Planos de Assistência de Saúde para Empregados/economia , Planos de Assistência de Saúde para Empregados/tendências , Custos de Cuidados de Saúde/tendências , Humanos , Medicaid/economia , Medicaid/tendências , Medicare/economia , Medicare/tendências , Patient Protection and Affordable Care Act/economia , Patient Protection and Affordable Care Act/tendências , Assistência Individualizada de Saúde/economia , Assistência Individualizada de Saúde/tendências , Medicamentos sob Prescrição/economia , Estados Unidos
16.
Health Aff (Millwood) ; 31(1): 208-19, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22232112

RESUMO

Medical goods and services are generally viewed as necessities. Even so, the latest recession had a dramatic effect on their utilization. US health spending grew more slowly in 2009 and 2010-at rates of 3.8 percent and 3.9 percent, respectively-than in any other years during the fifty-one-year history of the National Health Expenditure Accounts. In 2010 extraordinarily slow growth in the use and intensity of services led to slower growth in spending for personal health care. The rates of growth in overall US gross domestic product (GDP) and in health spending began to converge in 2010. As a result, the health spending share of GDP stabilized at 17.9 percent.


Assuntos
Produto Interno Bruto/tendências , Gastos em Saúde/tendências , Financiamento Pessoal/economia , Serviços de Assistência Domiciliar/economia , Seguro Saúde/economia , Medicaid/economia , Medicare/economia , Patient Protection and Affordable Care Act/legislação & jurisprudência , Setor Privado , Instituições Residenciais/economia , Estados Unidos
17.
Artigo em Inglês | MEDLINE | ID: mdl-24800157

RESUMO

OBJECTIVE: Provide a comparison of health care expenditure estimates for 2007 from the Medical Expenditure Panel Survey (MEPS) and the National Health Expenditure Accounts (NHEA). Reconciling these estimates serves two important purposes. First, it is an important quality assurance exercise for improving and ensuring the integrity of each source's estimates. Second, the reconciliation provides a consistent baseline of health expenditure data for policy simulations. Our results assist researchers to adjust MEPS to be consistent with the NHEA so that the projected costs as well as budgetary and tax implications of any policy change are consistent with national health spending estimates. DATA SOURCES: The Medical Expenditure Panel Survey produced by the Agency for Healthcare Research and Quality, and the National Health Center for Health Statistics and the National Health Expenditures produced by the Centers for Medicare & Medicaid Service's Office of the Actuary. RESULTS: In this study, we focus on the personal health care (PHC) sector, which includes the goods and services rendered to treat or prevent a specific disease or condition in an individual. The official 2007 NHEA estimate for PHC spending is $1,915 billion and the MEPS estimate is $1,126 billion. Adjusting the NHEA estimates for differences in underlying populations, covered services, and other measurement concepts reduces the NHEA estimate for 2007 to $1,366 billion. As a result, MEPS is $240 billion, or 17.6 percent, less than the adjusted NHEA total.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Atenção à Saúde/economia , Atenção à Saúde/estatística & dados numéricos , Humanos , Medicaid/estatística & dados numéricos , Medicare/estatística & dados numéricos , Estados Unidos/epidemiologia , United States Agency for Healthcare Research and Quality/estatística & dados numéricos
18.
Health Aff (Millwood) ; 30(1): 11-22, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21209433

RESUMO

In 2009, US health care spending grew 4.0 percent--a historically low rate of annual increase--to $2.5 trillion, or $8,086 per person. Despite the slower growth, the share of the gross domestic product devoted to health spending increased to 17.6 percent in 2009 from 16.6 percent in 2008. The growth rate of health spending continued to outpace the growth of the overall economy, which experienced its largest drop since 1938. The recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capital investments by health care providers. The recession also placed increased burdens on households, businesses, and governments, which meant that fewer financial resources were available to pay for health care. Declining federal revenues and strong growth in federal health spending increased the health spending share of total federal revenue from 37.6 percent in 2008 to 54.2 percent in 2009.


Assuntos
Recessão Econômica , Gastos em Saúde/tendências , Serviços de Saúde/economia , Seguro Saúde/economia , Patient Protection and Affordable Care Act/economia , Serviços de Saúde/estatística & dados numéricos , Humanos , Seguro Saúde/tendências , Medicaid/economia , Medicaid/tendências , Medicare/economia , Medicare/tendências , Patient Protection and Affordable Care Act/normas , Desemprego/tendências , Estados Unidos
19.
Health Aff (Millwood) ; 30(1): 153-60, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21148180

RESUMO

This paper examines differences in national health care spending by gender and age. Our research found significant variations in per person spending by gender across age groups, health services, and types of payers. For example, in 2004 per capita health care spending for females was 32 percent more than for males. Per capita differences were most pronounced among the working-age population, largely because of spending for maternity care. Except for children, total spending for and by females was greater than that for and by males, for most services and payers. The gender difference in total spending was most pronounced in the elderly, as a result of the longer life expectancy of women.


Assuntos
Gastos em Saúde , Seguro Saúde , Expectativa de Vida , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estados Unidos , Adulto Jovem
20.
Health Aff (Millwood) ; 29(1): 147-55, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20048374

RESUMO

In 2008, U.S. health care spending growth slowed to 4.4 percent--the slowest rate of growth over the past forty-eight years. The deceleration was broadly based for nearly all payers and health care goods and services, as growth in both price and nonprice factors slowed amid the recession. Despite the slowdown, national health spending reached $2.3 trillion, or $7,681 per person, and the health care portion of gross domestic product (GDP) grew from 15.9 percent in 2007 to 16.2 percent in 2008. These developments reflect the general pattern that larger increases in the health spending share of GDP generally occur during or just after periods of economic recession. Despite the overall slowdown in national health spending growth, increases in this spending continue to outpace growth in the resources available to pay for it.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Custos de Cuidados de Saúde/tendências , Gastos em Saúde/estatística & dados numéricos , Humanos , Estados Unidos
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