摘要：Introduction: There are serious fiscal concerns about Medicare. Medicare expenditures have increased several-fold since its creation in 1965. Although the sources of Medicare spending growth were analyzed in various studies, there was limited information on the demand-side factors on this spending growth. This study aims to analyze the effects of individual characteristics on total health spending among those age 65 years and over under Medicare. Method: this study first uses the regression model to estimate the effects of individual characteristics on Medicare spending from 1996 to 2008 with the Medical Expenditure Panel Survey (MEPS) data sets. Then, this model was used to predict the amount of total individual spending associated with each characteristic. Finally, the Medicare spending growth was estimated based on the multiplication of the number of population and spending associated with each characteristic. Results: Compared to the actual growth of national Medicare spending, annual 5.8% or 100% increase from 1996 to 2008, the individual characteristics associated with higher adjusted growth rates included races other than the whites and blacks, Hispanic, high income, residence in the West, and very good health status. Discussion: the policies that aim to curb the Medicare spending growth through demand-side factors, such as the above-mentioned ones, should think about three dimensions: prevention versus treatment; individual versus population approach; reducing initial treatment cost versus controlling the growth rates.
关键词：health care financing; health economics; health services research;cost inflation; demand-side factors; Medicare; Medical Expenditure Panel Survey
