title: Geographic variation in commercial medical-care expenditures: a framework for decomposing price and utilization.
abstract: This study introduces a new framework for measuring and analyzing medical-care expenditures. The framework focuses on expenditures at the disease level that are decomposed between price and utilization. We find that both price and utilization differences are important contributors to expenditure differences across commercial markets. Further examination shows that for some diseases utilization drives variation while for others price is more important. Finally, when disease-specific measures are aggregated across diseases, much of the important disease-specific variation is masked, leading to much smaller measures of aggregate variation.
authors.affiliation: Bureau of Economic Analysis, 1441 L Street NW, Washington, DC, United States. Electronic address: abe.dunn@bea.gov.
authors.forename: Abe
authors.initials: A
authors.lastname: Dunn
authors.forename: Adam Hale
authors.initials: AH
authors.lastname: Shapiro
authors.forename: Eli
authors.initials: E
authors.lastname: Liebman
mesh_terms: D016208:Databases, Factual; D005249:Fees and Charges; D062306:Geography, Medical; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D012189:Retrospective Studies; D014481:United States
keywords: C43; Geographic variation in health care spending; Health care spending variation; O47; Price indexes; Productivity; R12; Regional price indexes