TY - BOOK
T1 - Medical spending and hospital inpatient care in England
T2 - An analysis over time
AU - Aragon Aragon, Maria Jose Monserratt
AU - Chalkley, Martin John
AU - Rice, Nigel
PY - 2016/3/21
Y1 - 2016/3/21
N2 - Health care in England is predominantly provided free at the point of service through the publicly funded
National Health Service (NHS). Total NHS expenditure, which has risen in real terms by an average
of 3.7% per annum since the inception of the NHS in 1948, constituted 7.9% of GDP in 2012. This
paper presents a summary of the trends in medical expenditure in England and then using detailed
administrative data presents analysis of the growth over 15 years of expenditure and activity in hospital
inpatient health care, which represents around 20-25% of all NHS expenditure. We document the
coincidence of observed trends in expenditure with reported activity, morbidity and the proximity of
individuals to death. We find that; (i) expenditure for both elective and emergency inpatient care broadly
follows activity so expenditure is mostly driven by activity rather than unit costs; (ii) expenditure is
concentrated in individuals with multiple diseases so that the prevalence and identification of complex
medical conditions are important drivers of expenditure and (iii) health care activity rises substantially
for individuals in the period before death so that expenditure is driven substantially by mortality in the
population. Taken together these findings indicate that this element of health care expenditure in England
has been substantially driven by the underlying morbidity and age of the population in conjunction with
improving health care technology
AB - Health care in England is predominantly provided free at the point of service through the publicly funded
National Health Service (NHS). Total NHS expenditure, which has risen in real terms by an average
of 3.7% per annum since the inception of the NHS in 1948, constituted 7.9% of GDP in 2012. This
paper presents a summary of the trends in medical expenditure in England and then using detailed
administrative data presents analysis of the growth over 15 years of expenditure and activity in hospital
inpatient health care, which represents around 20-25% of all NHS expenditure. We document the
coincidence of observed trends in expenditure with reported activity, morbidity and the proximity of
individuals to death. We find that; (i) expenditure for both elective and emergency inpatient care broadly
follows activity so expenditure is mostly driven by activity rather than unit costs; (ii) expenditure is
concentrated in individuals with multiple diseases so that the prevalence and identification of complex
medical conditions are important drivers of expenditure and (iii) health care activity rises substantially
for individuals in the period before death so that expenditure is driven substantially by mortality in the
population. Taken together these findings indicate that this element of health care expenditure in England
has been substantially driven by the underlying morbidity and age of the population in conjunction with
improving health care technology
KW - English National Health Service
KW - health care expenditure
KW - health care activity
KW - end of life expenditures
M3 - Other report
T3 - CHE Research Paper
BT - Medical spending and hospital inpatient care in England
PB - Centre for Health Economics, University of York
CY - York, UK
ER -