Geography

 

Date of this Version

5-2014

Citation

McMillan, Kevin. 2014. Geographic Variation of Health Care Spending on Heart Failure in Metropolitan Areas. MA Thesis, University of Nebraska-Lincoln.

Comments

A THESIS Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfilment of Requirements For the Degree of Master of Arts, Major: Geography, Under the Supervision of Professor James W. Merchant. Lincoln, Nebraska: May, 2014

Copyright (c) 2014 Kevin McMillan

Abstract

The costs of healthcare have long been a concern in the United States. It is well known that these costs vary geographically, but attempts to explain this variation have been met with limited and varied success. This is partly attributable to the fact that data available have restricted analyses to assessing the issue to using Medicare cost per beneficiary. In June, 2013, the Center for Medicare and Medicaid Services (CMS) released new Medicare data that detailed the charges and payments made to hospitals throughout the United States in 2011. In this thesis, this new dataset was used to examine costs of treatment for heart failure, a widespread and serious health concern in the U.S.. Costs were examined from two perspectives: the average Medicare payments and the average amount hospitals charged within metropolitan areas. Ordinary Least Squares (OLS) regression analysis was used in an attempt to explain geographic variation in the Medicare payments for the treatment of heart failure in Metropolitan Statistical Areas (MSAs) based on six key demographic variables identified from previous research on spending per Medicare beneficiary. Additionally, these demographic variables were applied to the average amount hospitals charged for the treatment of heart failure. These six variables include the percent African American, the percent with a Bachelor’s degree or higher, the average number of hospital discharges for heart failure, the percent female, the percent in poverty, and the percent aged sixty-five and older. Results suggest that variables with a key relationship to Medicare payments for the treatment for heart failure include the percent with a Bachelor’s degree or higher and the percent aged sixty-five or older within a MSA. Key variables correlated with the average amount hospitals charged for the treatment of heart failure in a MSA include the average number of hospital discharges for heart failure, the percent female, and the percent aged sixty-five and older within a MSA.

Advisor: James Merchant

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