Satellite National Health Accounts - Publications

Research in the area of Tracking Productivity compares changes in health and spending over time, to estimate the value of spending in terms of health outcomes.

Research in the area of Tracking Population Health measures changes in population health over time in a way that accounts for both mortality and quality of life, that considers specific symptoms and impairments, risk factors, and diseases that affect health, and that can be used to predict the likely impact of different policy interventions. We have developed a measure of Quality Adjusted Life Expectancy (QALE) that uses impairments and symptoms measured in national health data over time. 

Research in the area of Tracking Medical Spending measures spending over time, estimating the portion attributable to different diseases and risk factors. Understanding the cost of disease is central to national health accounting. Part of the rationale for national health accounts stems from the observation that medical spending in the United States is higher than in most other countries, and that it is rising so rapidly. Between 1960 and 2004, for example, real, per person medical spending in the United States increased by 4.4 percent annually. The growth rate was 4.1 percent from 1987 through 2004. Given the rapid increase in spending and higher level of spending in the US than elsewhere, the obvious question is where the money is going.

Current National Health Expenditure Accounts (NHEAs) measure total spending on medical care and divide that spending into payers (Medicare, private insurance, out-of-pocket, etc.) and service providers (hospitals, physicians, pharmaceutical companies, etc.). These divisions are useful but not the only ones of interest. To measure the value of care, we need to relate spending on medical treatments to health outcomes. The most obvious way to do this is at the disease level. To take just one example, it is difficult to determine if spending for breast cancer is worth it without being able to link hospital and pharmaceutical costs for this disease. The central goal of this project is to understand medical spending at the disease level and the level of service category (treatment, screening, or prevention) as an input into detailed analysis of the costs and benefits of medical advance

To better understand our macro-level results, the project also involves Looking In-Depth at Specific Diseases Physicians and researchers specializing in specific diseases are undertaking a detailed study of the costs and benefits of medical interventions in the care of three common conditions: cardiovascular disease (including both heart disease and stroke); cancer (lung, colorectal, and breast); and depression.