US state health expenditure convergence: A revisited analysis

Abstract

This paper studies the evolution of US state health expenditure for a sample that covers 1966-2014. Our results provide evidence against the existence of a single pattern of behavior of personal health care expenditure across the US states. Rather, we can observe the existence of two statistically different convergence clubs. We cannot find evidence of convergence when we disaggregate health expenditure into its three main payers: Medicare, Medicaid and private health insurance expenditure, whilst we again find evidence of convergence clubs. However, the estimated clubs for Medicaid and private health insurance expenditure are statistically different that estimated for total health expenditure. Consequently, our results offer strong evidence of heterogeneity in the evolution of US health expenditure. The analysis of the forces that drive club creation shows that economic situation and some supply-side factors are important. We can also appreciate that some healthcare outcome variables are only related to private insurance health expenditure. The other health expenditures, thus, show a certain lack of efficiency which may be due to practices that have little benefit for patient health.

Does the Great Recession Contribute to the Convergence of Health Care Expenditures in the US States?

“…The annual data of Personal Health Care from 1980 to 2014 have been obtained from the Center of Medicare and Medicaid Services (CMS) for the 50 US states plus the ones of the District of Columbia. Unlike Clemente et al [5], this variable is measured by State of Provider. We have transformed the data into real per capita terms by using the population of each state and the US consumer price index, the data for which have been obtained from the US Bureau of Economic Analysis.…”

“…Finally, it is clearly free of the criticism received by the beta-convergence analysis in De Long [16] and Quah [17]. As a consequence, the use of this methodology has recently become very popular in convergence analysis, including some applications for the case of health variables as we can see in Clemente et al [5], Panopupoulou and Pantelidis [7] and Nghiem and Connelly [12].…”

“…Some recent papers have analyzed these disparities, putting special emphasis on the convergence of the US regional health expenditure. For instance, Cuckler et al [3] and, more recently, Apergis et al [4] and Clemente et al [5], study convergence with State of Residence health data. Similarly, Wang [6] and Panopoulou and Pantelidis [7] consider State of Provider health data.…”

Does the Great Recession Contribute to the Convergence of Health Care Expenditures in the US States?

“…They develop a procedure that allows, first, to test the total convergence hypothesis and, if this hypothesis is rejected, to subsequently estimate the number of different convergence clubs. Details of this methodology are omitted but they can be found in the above-mentioned papers as well as in Panopoulou and Pantelidis and Clemente et al [7,5].…”

2018-2050 Yıllarını Kapsayan Türkiye'nin Sağlık Harcamalarına İlişkin Tahminler

“…In some studies, the status of healthcare to be fast and quality is attributed to the higher HE. 9 However, how effective and efficient HE by countries is still a hot topic of discussion in terms of waste in the economy of healthcare in reports. The HE of developed countries is increasing in proportion to their economies.…”