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Primary care spending lags behind growth of other healthcare expenditures

As healthcare spending in the U.S. continues to rise, primary care services are accounting for a lower percentage of expenses, a new study has found. Photo by Anne Karakash/Pixabay
As healthcare spending in the U.S. continues to rise, primary care services are accounting for a lower percentage of expenses, a new study has found. Photo by Anne Karakash/Pixabay

May 18 (UPI) -- Spending on primary care services -- including routine doctor visits -- is on the rise in the United States, though not at the same rate as hospital care and prescription drugs, an analysis published Monday by JAMA Internal Medicine has found.

Researchers say expenses for visits to doctors practicing family medicine, general medicine, geriatrics, general internal medicine and general pediatrics declined from 6.5 percent of overall healthcare spending in 2002 to 5.4 percent in 2016.

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The drop, they report, occurred at the same time that overall annual healthcare spending rose nationally in the United States from $810 billion to $1,617 billion during the same period, based on data from the Medical Expenditure Panel Survey, or MEPS.

"Insufficient investment in primary care is one reason that the U.S. healthcare system continues to under perform relative to the health systems in other high-income countries," wrote the authors.

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"States and countries with greater access to primary care clinicians and more robust primary care services have better outcomes and lower costs," they added.

The United States' health system ranks 37th worldwide in overall efficiency, a metric that includes cost, access, treatment outcomes and death rates, among other factors, according to the World Health Organization.

For the analysis, the researchers analyzed MEPS data collected between 2002 and 2016, estimating total annual expenditures for inpatient or hospital services, outpatient services, doctors' office-based care, prescriptions, dental services, vision services, mental healthcare, home healthcare, emergency department services and other medical services.

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Overall, they found that hospital services, at nearly 26 percent, still accounted for the bulk of hospital spending in 2016, down from nearly 32 percent in 2002. Office-based services, including primary care and mental health, also rose from just over 22 percent of overall to just under 25 percent of overall spending over the same period.

While expenditures on primary care services rose from $53.1 billion in 2002 to $87.1 billion in 2016, however, the percentage of overall spending attributable to these services actually declined by about 15 percent.

Conversely, prescription expenditures increased significantly, from just under 19 percent of overall spending to just under 24 percent over the same period -- or from roughly $151 billion to $381 billion.

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"Primary care accounted for 4.2 percent of the total increase in health care expenditures, while declining as a proportion of all expenditures," the authors noted. "There are many reasons to increase investment in primary care, including its beneficial effects on quality of care, access to care, and mortality."

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