title: Using quantile regression to examine health care expenditures during the Great Recession.
abstract: OBJECTIVE
  To examine the association between the Great Recession of 2007-2009 and health care expenditures along the health care spending distribution, with a focus on racial/ethnic disparities.
  
  
  METHODS
  Secondary data analyses of the Medical Expenditure Panel Survey (2005-2006 and 2008-2009).
  
  
  METHODS
  Quantile multivariate regressions are employed to measure the different associations between the economic recession of 2007-2009 and health care spending. Race/ethnicity and interaction terms between race/ethnicity and a recession indicator are controlled to examine whether minorities encountered disproportionately lower health spending during the economic recession.
  
  
  RESULTS
  The Great Recession was significantly associated with reductions in health care expenditures at the 10th-50th percentiles of the distribution, but not at the 75th-90th percentiles. Racial and ethnic disparities were more substantial at the lower end of the health expenditure distribution; however, on average the reduction in expenditures was similar for all race/ethnic groups. The Great Recession was also positively associated with spending on emergency department visits.
  
  
  CONCLUSIONS
  This study shows that the relationship between the Great Recession and health care spending varied along the health expenditure distribution. More variability was observed in the lower end of the health spending distribution compared to the higher end.
authors.affiliation: Department of Health Services Administration, School of Public Health, University of Maryland, College Park, College Park, MD.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Arturo
authors.initials: A
authors.lastname: Vargas-Bustamante
authors.forename: Karoline
authors.initials: K
authors.lastname: Mortensen
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D057172:Economic Recession / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006304:Health Status; D054625:Healthcare Disparities / Q000191:economics / Q000208:ethnology / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Health care expenditures; economic recession; quantile regression; racial and ethnic disparities