Trends in Mortality, Morbidity and Healthcare Utilization: Does It Make Sense to Use Healthcare As a Proxy for Health?

89 Pages Posted: 13 Jun 2019

See all articles by Bryan Tysinger

Bryan Tysinger

University of Southern California - Schaeffer Center for Health Policy and Economics

Seth A. Seabury

University of Southern California - Keck School of Medicine; University of Southern California - Schaeffer Center for Health Policy and Economics

Henu Zhao

University of Southern California - Sol Price School of Public Policy

Gwyn Pauley

University of Southern California

Yifan Wei

University of Southern California - Sol Price School of Public Policy

Dana Goldman

University of Southern California - Schaeffer Center for Health Policy and Economics

Date Written: June 2019

Abstract

Medical utilization, such as a count of hospitalizations, is routinely used as a health proxy for both policy and research purposes. Over time, trends in how medicine is practiced has impacted this relationship, as technological improvements or policy changes have altered hospitalizations at the same level of health. In this work, we document how hospitalizations have evolved as a marker for subsequent health (mortality and morbidity) and subsequent utilization (hospitalizations, emergency department visits, physician visits, and others). We assess these trends in the DI population (both fee-for-service and managed care), the aged Medicare fee-for-service population, and a commercial managed care population. We find that hospitalizations continue to predict subsequent mortality well, but that the relationship is more nuanced for morbidity. We find that hospitalizations are declining over time, but that they decline less for those with a prior hospitalization. Other types of utilization are increasing with time, with mixed evidence of the relationship with prior hospitalizations. We conclude that the relationship between hospitalizations and health continues to evolve and that the utility of this proxy depends on what measures of health one is assessing

JEL Classification: I100, I180

Suggested Citation

Tysinger, Bryan and Seabury, Seth A. and Zhao, Henu and Pauley, Gwyn and Wei, Yifan and Goldman, Dana, Trends in Mortality, Morbidity and Healthcare Utilization: Does It Make Sense to Use Healthcare As a Proxy for Health? (June 2019). CESR-Schaeffer Working Paper No. 2019-001, Available at SSRN: https://ssrn.com/abstract=3403381 or http://dx.doi.org/10.2139/ssrn.3403381

Bryan Tysinger (Contact Author)

University of Southern California - Schaeffer Center for Health Policy and Economics ( email )

635 Downey Way
Los Angeles, CA 90089-3333
United States

Seth A. Seabury

University of Southern California - Keck School of Medicine ( email )

2250 Alcazar Street
Los Angeles, CA 90089
United States

University of Southern California - Schaeffer Center for Health Policy and Economics ( email )

635 Downey Way
Los Angeles, CA 90089-3333
United States

Henu Zhao

University of Southern California - Sol Price School of Public Policy ( email )

Los Angeles, CA 90089-0626
United States

Gwyn Pauley

University of Southern California ( email )

2250 Alcazar Street
Los Angeles, CA 90089
United States

Yifan Wei

University of Southern California - Sol Price School of Public Policy ( email )

Los Angeles, CA 90089-0626
United States

Dana Goldman

University of Southern California - Schaeffer Center for Health Policy and Economics ( email )

635 Downey Way
Los Angeles, CA 90089-3333
United States

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