Commentary: Methodological Biases in Estimating the Burden of Out-of-Pocket Expenses

by Dana P. Goldman, James P. Smith


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Estimates of the burden of out-of-pocket expenses among the elderly are very sensitive to the methods used. This arises because burden, as measured by the share of income devoted to health expenses, is noisily measured at the individual level. Methods that do not account for these errors will give biased results. Using data from the Medicare Current Beneficiary Survey, we show that the flawed methods used in a previous study substantially dramatically overstates the burden on the elderly, especially the poor elderly.

Originally published in: Health Services Research, v. 35, no. 6, pp. 1357-1365.

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