In this paper, we present evidence on the concentration of hospital-based medical spending in Canada. We use longitudinal administrative data from the province of Quebec to document how medical spending is concentrated cross-sectionally, over time and finally near the end-of-life when death occurs at the hospital. Average expenditures rise rapidly with age, starting around the age of 50, and are concentrated in a small fraction of high-cost users. For example, the top 1% of men and women in terms of hospital spending account for 55.5% and 54.8% of total spending respectively. Persistence among high-users is rather low. Fewer than 3% of those in the top quintile of hospital spending stay in the same quintile the following year, fewer than 5% have any spending the following year. Finally, hospital spending among those in their last year of life and who die at the hospital can account for 11.1% of total hospital spending in the population. Most of that end-of-life spending, more than 80%, occurs in the last month of life.

Voir le document

Centre interuniversitaire de recherche en analyse des organisations
1130 rue Sherbrooke Ouest, suite 1400
Montréal, Québec (Canada) H3A 2M8
(514) 985-4000
(514) 985-4039

© 2019 CIRANO. Tous droits réservés.

Partenaire de :

Website Security Test