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The Concentration of Hospital-Based Medical Spending: Evidence from Canada?

Aurélie Côté-Sergent, Damien Échevin and Pierre-Carl Michaud

CIRANO Working Papers from CIRANO

Abstract: In this paper, we present evidence on the concentration of hospital-based medical spending in Canada. We use longitudinal administrative data from the province of Quebec to document how medical spending is concentrated cross-sectionally, over time and finally near the end-of-life when death occurs at the hospital. Average expenditures rise rapidly with age, starting around the age of 50, and are concentrated in a small fraction of high-cost users. For example, the top 1% of men and women in terms of hospital spending account for 55.5% and 54.8% of total spending respectively. Persistence among high-users is rather low. Fewer than 3% of those in the top quintile of hospital spending stay in the same quintile the following year, fewer than 5% have any spending the following year. Finally, hospital spending among those in their last year of life and who die at the hospital can account for 11.1% of total hospital spending in the population. Most of that end-of-life spending, more than 80%, occurs in the last month of life.

Keywords: Medical spending; concentration; end-of-life (search for similar items in EconPapers)
JEL-codes: I10 I13 I18 (search for similar items in EconPapers)
Date: 2015-09-16
New Economics Papers: this item is included in nep-hea
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https://cirano.qc.ca/files/publications/2015s-41.pdf

Related works:
Journal Article: The Concentration of Hospital‐Based Medical Spending: Evidence from Canada (2016) Downloads
Working Paper: The concentration of hospital-based medical spending: evidence from Canada (2015) Downloads
Working Paper: The Concentration of Hospital-Based Medical Spending: Evidence from Canada (2015) Downloads
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Persistent link: https://EconPapers.repec.org/RePEc:cir:cirwor:2015s-41

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