Using Quantile Regression to Examine Health Care Expenditures during the Great Recession
Version of Record online: 17 OCT 2013
© Health Research and Educational Trust
Health Services Research
Volume 49, Issue 2, pages 705–730, April 2014
How to Cite
Chen, J., Vargas-Bustamante, A., Mortensen, K. and Thomas, S. B. (2014), Using Quantile Regression to Examine Health Care Expenditures during the Great Recession. Health Services Research, 49: 705–730. doi: 10.1111/1475-6773.12113
- Issue online: 27 MAR 2014
- Version of Record online: 17 OCT 2013
- Manuscript Accepted: 14 AUG 2013
- Eunice Kennedy Shriver National Center for Child Health and Human Development. Grant Number: R24-HD041041
- Maryland Population Research Center
- MPRC Seed Grant Program
- Health care expenditures;
- quantile regression;
- economic recession;
- racial and ethnic disparities
To examine the association between the Great Recession of 2007–2009 and health care expenditures along the health care spending distribution, with a focus on racial/ethnic disparities.
Data Sources/Study Setting
Secondary data analyses of the Medical Expenditure Panel Survey (2005–2006 and 2008–2009).
Quantile multivariate regressions are employed to measure the different associations between the economic recession of 2007–2009 and health care spending. Race/ethnicity and interaction terms between race/ethnicity and a recession indicator are controlled to examine whether minorities encountered disproportionately lower health spending during the economic recession.
The Great Recession was significantly associated with reductions in health care expenditures at the 10th–50th percentiles of the distribution, but not at the 75th–90th percentiles. Racial and ethnic disparities were more substantial at the lower end of the health expenditure distribution; however, on average the reduction in expenditures was similar for all race/ethnic groups. The Great Recession was also positively associated with spending on emergency department visits.
This study shows that the relationship between the Great Recession and health care spending varied along the health expenditure distribution. More variability was observed in the lower end of the health spending distribution compared to the higher end.