Cost of Services Driving Up Health Care Spending

HealthDay News — Factors including increases in health care service price and intensity are associated with increases in US health care spending from 1996-2013, according to a study published in the Journal of the American Medical Association.

Joseph L. Dieleman, PhD, from the Institute for Health Metrics and Evaluation in Seattle, and colleagues quantified changes in spending associated with population size, population age structure, disease prevalence or incidence, service utilization, and service price and intensity. Data were obtained for 155 health conditions.

The researchers found that annual health care spending on inpatient, ambulatory, retail pharmaceutical, nursing facility, emergency department, and dental care increased by $933.5 billion between 1996 and 2013 after adjustments for price inflation, from $1.2 to $2.1 trillion. 

There was a 23.1%, or $269.5 billion, spending increase in association with increases in US population size and an 11.6%, or $135.7 billion, spending increase in association with aging of the population. A spending reduction of 2.4%, or $28.2 billion, was associated with changes in disease prevalence or incidence, whereas no significant change in spending was seen for changes in service utilization. A 50%, or $583.5 billion, spending increase was associated with changes in service price and intensity.

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“Understanding these factors and their variability across health conditions and types of care may inform policy efforts to contain health care spending,” the authors wrote.


Dieleman JL, Squires E, Bui AL, et al. Factors associated with increases in US health care spending, 1996-2013. JAMA. 2017;318(17):1668-1678.