Determinants of total family charges for health care: United States, 1980.

Abstract

This report addresses a question of importance for policymakers: "What are the determinants of the total charges for health care that U.S. families face?" Policymakers' concerns about this question have two main grounds. First, U.S. health care costs are large and growing rapidly. They now exceed 11 percent of the gross national product, and the answer to the question can shed some light on their troubling growth. Second, total family charges for health care reflect the quantity of health care received by families, and it is important to know whether the determinants of total charges are principally the need for health care, or involve other factors less related to need. In this report, the determinants of total charges and their importance are identified principally through multiple regression analysis. Total charges are defined as the full amount charged for all types of health care for all family members regardless of whether these amounts are paid out of pocket, paid by insurance (or public health care coverage programs), or go unpaid. The data used are from the family data files of the 1980 National Medical Care Utilization and Expenditure Survey (NMCUES). This report presents data on the approximately 5,000 multiple-person families interviewed in this year-long longitudinal survey. The report provides a separate analysis for each of three socioeconomic family populations that have consistently been of interest to policymakers. These are (1) older families (defined for this report as all U.S. multiple-person families with a member 65 years of age or over); (2) younger, lower income families (all U.S. multiple-person families below 200 percent of the poverty level in 1980 and with all members under 65 years of age); and (3) younger, better off families (all U.S. multiple-person families at 200 percent of the poverty level or higher in 1980 and with all members under 65). Multiple regression analysis was used to investigate the effect on total family charges of family demographic and sociocultural characteristics, family illnesses, special health events (such as births, deaths, and hospitalizations of family members), general family health status, family income, family health insurance characteristics, and family geographic and urbanization characteristics. Regressions were run separately for each of the three socio-economic family populations, with total family charges as the dependent variable and approximately 45 variables measuring these family characteristics as independent variables. Because of the large number of independent variables involved, a multiple-step regression process (described in appendix I) was used.(ABSTRACT TRUNCATED AT 400 WORDS)