Residents in the Northeast spend more on personal health care than those in western states like Utah, Idaho and Arizona, the government says, because of higher incomes and higher costs in cities.
Per capita health spending was 15 percent higher in Massachusetts, New York, Connecticut and Rhode Island than in the rest of the country in 1998, according to the Department of Health and Human Services' Centers for Medicare and Medicaid Services survey. and Medicaid.
“Urban areas generally tend to have higher prices than rural areas,” said Anne Martin, one of the report's authors. “There is also a greater concentration of population that can support teaching hospitals and other specialized facilities that may cost more.”
Katie Levitt, who is in charge of national health statistics for the agency, cautioned that the numbers cannot be used to determine whether residents of one state are receiving better health care than those of another.
“People in lower-cost states may be younger, they may be healthier, they may live in lower-cost areas,” Levit said. “It doesn't necessarily mean they're not receiving adequate or effective care. More research needs to be done to uncover all of these effects.”
Personal health care costs include amounts a person and their health plan pay for things like hospital care, doctor services, and prescription drugs.
Agency economists conducted the study by examining Internal Revenue Service receipts for for-profit health care businesses, the American Hospital Association's Annual Hospital Survey and other population, wage and salary data. The study is published Tuesday in the journal Health Affairs.
In 1998, personal health care expenditures in the United States totaled $1 trillion. The national average per resident was $3,759.
In Massachusetts, which led all states, spending was $4,810 per resident. The New York average was $4,706. Connecticut, $4,656; and Rhode Island, $4,497.
Washington, DC, had per capita spending of $6,656.
On the other hand, Utah had the lowest health expenditures for 1998 – just $2,731 per resident. Idaho's spending was $3,035 per capita. Arizona, $3,100; Nevada, $3,147; and New Mexico, $3,209.
Health spending in Washington state was $3,382, compared to $2,545 in 1991, the last time the Centers for Medicare and Medicaid Services reviewed state health spending data.
Tuesday's report showed that the slowest growth in spending occurred in the West. California's per capita health care expenditures increased at an average annual rate of 3.5%, from $2,690 in 1991 to $3,429 in 1998.
Some states saw tremendous growth. Maine's health care expenditures per resident increased 7.3 percent annually, from $2,464 in 1991 to $4,025 in 1998.
Overall, however, the Plains region — which includes Kansas, Minnesota and Missouri — had the fastest average annual growth, at 5.9 percent.
The report also looked at per-person spending in states for Medicare, the government health insurance program for the elderly, and Medicaid, the health insurance program for the poor.
Nationally, Medicare enrollees represented 14 percent of the total population in 1998.
Florida had the largest share of enrollees — 19 percent — but Louisiana had the highest Medicare spending per enrollee at $7,219. Florida's spending per enrollee was $6,147 for 1998. South Dakota had the lowest Medicare spending that year at $3,936 per enrollee.
Economists said the higher number in Louisiana is due to higher-than-average use and payments for home health services in that state. Medicare beneficiaries in Louisiana also paid more than average for short-term hospital stays, the report said.
Medicare spending numbers include the amount the federal government pays to health providers either through traditional Medicare or through HMOs that participate in its managed care program.
By Janelle Carter
