MARC Record from Library of Congress

LEADER: 02811cam a22003137a 4500
001 2005615189
003 DLC
005 20050113121012.0
007 cr |||||||||||
008 050105s2004 mau sb 000 0 eng
010 $a 2005615189
040 $aDLC$cDLC$dDLC
050 00 $aHB1
100 1 $aSkinner, Jonathan.
245 14 $aThe measurement and evolution of health inequality$h[electronic resource] :$bevidence from the U.S. medicare population /$cJonathan Skinner, Weiping Zhou.
260 $aCambridge, MA :$bNational Bureau of Economic Research,$cc2004.
490 1 $aNBER working paper series ;$vworking paper 10842
538 $aSystem requirements: Adobe Acrobat Reader.
538 $aMode of access: World Wide Web.
500 $aTitle from PDF file as viewed on 1/5/2005.
530 $aAlso available in print.
504 $aIncludes bibliographical references.
520 3 $a"Has U.S. health care for the elderly become more equitable during the past several decades? When inequality is measured by Medicare expenditures, the answer is yes. During 1987-2001, low income households experienced an increase of 78 percent ($2624) in per capita expenditures, double the increase of 34 percent ($1214) in the highest income group. When inequality is measured by life expectancy, the answer is no. Survival for the lowest income decile grew by 0.2 years during the 1990s compared to 0.8 years in the highest income group. That the two measures deliver such discordant messages may reflect their intrinsic shortcomings; expenditures depend on preferences, health status, and prices, while outcomes are strongly affected by health behavior and past illness. We suggest a new approach to measuring inequality: the use of quality-based effective care measures. For these measures, efficacy is well proven and nearly all of the relevant population should be receiving it, regardless of health status or preferences. Using Medicare claims data matched to zip code income, we find greater use of mammography screening, diabetic eye exams, and the use of ́́blockers and reperfusion following heart attacks among higher income households, and these differences appear to be stable or growing slowly over time. In sum, the rapid relative growth in health care expenditures among low income elderly people has not translated into relative improvement either in survival or rates of effective care"--National Bureau of Economic Research web site.
650 0 $aSocial medicine$zUnited States.
650 0 $aOlder people$xHealth and hygiene$zUnited States.
700 1 $aZhou, Weiping.
710 2 $aNational Bureau of Economic Research.
830 0 $aWorking paper series (National Bureau of Economic Research : Online) ;$vworking paper no. 10842.
856 40 $uhttp://papers.nber.org/papers/W10842