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Measuring the Output of Health in the United States

Measuring the Output of Health in the United States. Workshop on Measurement of Non-Market Output in Education and Health. Michael S. Christian U.S. Bureau of Economic Analysis October 4, 2006. Two Projects in Health Economics. Home and volunteer production Direct volume measurement.

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Measuring the Output of Health in the United States

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  1. Measuring the Output of Health in the United States Workshop on Measurement of Non-Market Output in Education and Health Michael S. Christian U.S. Bureau of Economic Analysis October 4, 2006

  2. Two Projects in Health Economics • Home and volunteer production • Direct volume measurement

  3. Direct Volume Measurement • Real health care services measured in U.S. GDP accounts by price deflation • CPI, PPI, input price indexes • Based on prices of procedures • Direct volume measurement is an interesting alternative

  4. Inpatient Hospital Services (1) • Volume of inpatient hospital services • Simple count of discharges • Fisher index of discharges by condition • Fisher index adjusted by survival rate • Measuring by condition measures some cost savings as price decreases • Substitution to less expensive procedures

  5. Inpatient Hospital Services (2) • Survival rate adjustment adapted from Dawson et al (2006) • Two sources on volume, survival rates • Nationwide Inpatient Sample (NIS) • National Hospital Discharge Survey (NHDS) • Fisher weights are mean charges by condition from NIS

  6. Inpatient Hospital Services (3)

  7. NIS Inpatient Discharges

  8. NHDS Inpatient Discharges

  9. Aggregate Survival Adjustment

  10. Inpatient Hospital Services (4) • Large effects from survival adjustment • Indexes only account for cost-saving substitutions within inpatient services • Ignores potentially important substitutions across service categories • Aizcorbe and Nestoriak (2006)

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