{"@context":"http://iiif.io/api/presentation/2/context.json","@id":"https://repo.library.stonybrook.edu/cantaloupe/iiif/2/manifest.json","@type":"sc:Manifest","label":"Health Returns to Medical Expenditures and Medical \nExpenditure Components across Age Groups","metadata":[{"label":"dc.description.sponsorship","value":"This work is sponsored by the Stony Brook University Graduate School in compliance with the requirements for completion of degree."},{"label":"dc.format","value":"Monograph"},{"label":"dc.format.medium","value":"Electronic Resource"},{"label":"dc.identifier.uri","value":"http://hdl.handle.net/11401/71613"},{"label":"dc.language.iso","value":"en_US"},{"label":"dc.publisher","value":"The Graduate School, Stony Brook University: Stony Brook, NY."},{"label":"dcterms.abstract","value":"Medical expenditures as a \npercentage of GDP have doubled during the past three decades, reflecting \ntechnology advancement and an aging population. Understanding how \nmedical expenditures affect health, and whether this relationship \ndiffers by important sociodemographic characteristics such as age, are \nimportant for the appropriate allocation of scarce health care \nresources. Given the current environment of health care reform, further \nevidence on the health returns to medical investment is both timely and \npolicy-relevant. This study focuses on health returns to medical \nspending for the adult population in the United States. It assesses \nhealth benefits from overall medical expenditures as well as medical \nexpenditure components (pharmaceutical expenditure and spending on \nphysician services). I consider both objective (EuroQoL) and subjective \n(rating scale) measures of health. The conceptual point of departure for \nthis study is Grossman \u2019 classic model of health investment. This \nstudy employs two-stage least squares estimation techniques to address \nthe endogeneity of individual medical expenditures (e.g., that sicker \npeople spend more). Using the objective health measure, the elasticity \nof overall medical expenditure with respect to health is approximately \n0.26. That is, a 10% increase in medical expenditures increases health \nby 2.6%. For subjective measure, the elasticity of overall medical \nexpenditure is 0.19. However, the returns to medical expenditures differ \nby age group and whether I use an objective or subjective health \nmeasure. Using the objective measure, the returns to medical expenditure \nare greatest for the middle-aged group (e.g., 46 to 64 years of age). \nHowever, using the subjective measure, I find that the perceived returns \nto health are greatest for seniors (e.g., > 64 years of age) cohort. \nIf objective health measures provide better evidence of actual gains in \nhealth, these findings suggest that reallocation of spending from \nseniors towards middle-aged cohorts can improve overall health without \naffecting expenditures. Given the strong perceived benefit for medical \nexpenditures among seniors, however, such a reallocation may meet with \nconsiderable resistance. To better understand the source of health \nbenefit for different age groups, health returns to medical expenditure \ncomponents are further examined (prescription drug expenditure and \nphysician services expenditure). I find that middle-age group and \nyounger population gain positive health returns (captured by objective \nmeasure: health-related quality of life) from prescription expenditure, \nwhile no statistically significant correlation has been found between \nhealth benefit and prescription drug expenditures for seniors. The \nperiod of this study was before the Medicare Part D plan was \nimplemented. Prescription compliance among seniors may have been \nadversely affected by limited coverage during this period, which could \naccount for this result. Considering the relationship between physician \nservices spending and health outcome, the results suggest that senior \ngroup gains higher health returns (captured by subjective health \nmeasure: self-rated health status) comparing to the middle-age and \nyounger group. It indicates that senior group may yield higher \n“ perceived ” health benefit from office-based \nvisits , where the type of care is “ face-to-face ” \ncontact. These findings could inform public policies designed to more \nclosely match specific types of care with those groups likely to benefit \nthe most from them."},{"label":"dcterms.available","value":"2015-04-24T14:48:15Z"},{"label":"dcterms.contributor","value":"John A. Rizzo."},{"label":"dcterms.creator","value":"Han, Meiying"},{"label":"dcterms.dateAccepted","value":"2012-05-17T12:20:43Z"},{"label":"dcterms.dateSubmitted","value":"2015-04-24T14:48:15Z"},{"label":"dcterms.description","value":"Department of Economics"},{"label":"dcterms.format","value":"Application/PDF"},{"label":"dcterms.identifier","value":"http://hdl.handle.net/11401/71613"},{"label":"dcterms.issued","value":"2011-05-01"},{"label":"dcterms.language","value":"en_US"},{"label":"dcterms.provenance","value":"Made available in DSpace on 2012-05-17T12:20:43Z (GMT). No. of bitstreams: 1\nHan_grad.sunysb_0771E_10482.pdf: 344570 bytes, checksum: 7044fcd72ad511f5fcaf3717fb69f6fa (MD5)\n  Previous issue date:    1"},{"label":"dcterms.publisher","value":"The Graduate School, Stony Brook University: Stony Brook, NY."},{"label":"dcterms.subject","value":"Economics"},{"label":"dcterms.title","value":"Health Returns to Medical Expenditures and Medical \nExpenditure Components across Age Groups"},{"label":"dcterms.type","value":"Dissertation"},{"label":"dc.type","value":"Dissertation"}],"description":"This manifest was generated dynamically","viewingDirection":"left-to-right","sequences":[{"@type":"sc:Sequence","canvases":[{"@id":"https://repo.library.stonybrook.edu/cantaloupe/iiif/2/canvas/page-1.json","@type":"sc:Canvas","label":"Page 1","height":1650,"width":1275,"images":[{"@type":"oa:Annotation","motivation":"sc:painting","resource":{"@id":"https://repo.library.stonybrook.edu/cantaloupe/iiif/2/55%2F13%2F21%2F55132136054887176957963837644772280832/full/full/0/default.jpg","@type":"dctypes:Image","format":"image/jpeg","height":1650,"width":1275,"service":{"@context":"http://iiif.io/api/image/2/context.json","@id":"https://repo.library.stonybrook.edu/cantaloupe/iiif/2/55%2F13%2F21%2F55132136054887176957963837644772280832","profile":"http://iiif.io/api/image/2/level2.json"}},"on":"https://repo.library.stonybrook.edu/cantaloupe/iiif/2/canvas/page-1.json"}]}]}]}