今天，澳博官方网站app研究所(澳博官方网站app 研究所)首次公布了美国消费者每月实际金融交易的自付医疗支出情况, 在国家, 地铁, 县级, with data showing how spending habits changed over a four-year period from 2013-2016.

这份报告, Paying Out-of-Pocket: The 医疗保健 支出 of 2 Million US Families, 显示家庭一直推迟医疗支付，直到他们有更多的流动资产可供支配. 医疗保健 payments noticeably spiked in the months of March and April, when the majority of American households receive their tax refunds.

“现实情况是，许多美国家庭没有现金缓冲来承受自付医疗费用带来的波动, 我们需要更好地理解财务健康和身体健康之间的关系,戴安娜·法雷尔说, 总裁兼首席执行官, 澳博官方网站app 研究所. "For the first time ever, 我们能够看到医疗保健支付对美国家庭钱包的实际影响，以及这些支出如何适应他们更大的财务状况. These data can serve as a resource for policymakers at the federal, 状态, 在地方层面，更好地了解医疗政策决定如何以非常切实的方式影响他们的选民."

Some of the report’s key takeaways include:

• 医疗保健支付的时间与账户持有人的支付能力之间存在明显的相关性最大的付款发生在流动资产增加的年份和月份. 这一发现强调了家庭财务状况与其获得医疗保健服务之间的明显联系.
  • The report found a clear spike in payments during the months of March and April, when nearly 80 percent of tax filers receive tax refunds.
• There is significant variation of out-of-pocket expenses among and within 状态s, emphasizing the important role of 状态s in shaping healthcare policy. Colorado families spent the most out of pocket, while families in Louisiana spent the most as a percent of income. 加州在原始金额和支付占收入的比例方面都是最低的.
  • As part of this report, the 澳博官方网站app 研究所 has created online data visualization assets 为了说明这些差异，并提供了可下载的支付数据，其中的信息细分为城市和县级.
• Out-of-pocket payments grew each year since 2013, but have remained a stable share of income, 又称“负担”.” However, women, 低收入 families and pre-seniors are bearing the highest cost burden. 这一发现值得进一步研究，以确定这些较高的支付是否代表更广泛的医疗保健利用，还是对负担能力最低的人群构成明显的费用负担.
• 在某一年医疗保健支出排名前10%的家庭往往仍是年度支出最高的家庭, emphasizing the substantial cost of chronic conditions and long-term healthcare needs.
• 医生、牙医和住院费用占自付费用的一半以上. While doctor payments accounted for the greatest volume of expenditures, 牙科 and hospital payments were much more significant in terms of expense.

医疗保健支付的时间与账户持有人的支付能力之间存在明显的相关性最大的付款发生在流动资产增加的年份和月份. 这一发现强调了家庭财务状况与其获得医疗保健服务之间的明显联系.The report found a clear spike in payments during the months of March and April, when nearly 80 percent of tax filers receive tax refunds.

There is significant variation of out-of-pocket expenses among and within 状态s, emphasizing the important role of 状态s in shaping healthcare policy. Colorado families spent the most out of pocket, while families in Louisiana spent the most as a percent of income. 加州在原始金额和支付占收入的比例方面都是最低的.
As part of this report, the 澳博官方网站app 研究所 has created online data visualization assets 为了说明这些差异，并提供了可下载的支付数据，其中的信息细分为城市和县级.

The 澳博官方网站app 研究所 report is based on a new data asset, the 澳博官方网站app 研究所 医疗保健 Out-of-Pocket 支出 Panel (JPMCI HOSP). The asset was constructed using a sample of 2.2013年1月至2016年12月期间，有300万名年龄在18岁至64岁之间的大通银行常客. 该研究所将自费医疗保健支出定义为向医疗保健提供者和药店支付的任何观察到的付款, 包括共同支付, 共同保险, 免赔额, and other point-of-service medical, 牙科, 或者毒品消费.

主要结论: Paying Out-of-Pocket: The 医疗保健 支出 of 2 Million US Families

• 自付医疗支出在2013年至2016年期间有所增长，但在税后收入中所占的比例相对稳定.
  • The average out-of-pocket healthcare spending in 2016 was $714 and the median was $276. Out-of-pocket healthcare spending grew at an average annual rate of 4.3 percent and a total of 13.5 percent from $629 in 2013 to $714 in 2016.
  • 以财务负担衡量的医疗支出在2013年至2016年期间相对稳定, 徘徊在1附近.6 percent as a share of take-home income and 1.2 percent of total spending.
• The financial burden of out-of-pocket healthcare spending was highest for older, 低收入, and female account holders.
  • Female account holders spent 1.8 percent of take-home income in 2016 on healthcare compared to 1.5 among male account holders.
  • The bottom income quintile of account holders spent 2.2016年，实得收入的8%用于自付医疗费用，而这一比例仅为1%.0 percent of take-home income for the top income quintile of households.
  • Eighteen to 25-year-olds spent just 1.实得收入的2%用于自付医疗费用，而55岁至64岁的人则花费1%.9%.
• 医生, 牙科, and hospital payments accounted for more than half of observed spending, with 牙科 and hospital payments less frequent but larger in magnitude.
  • Payments to 医生’ offices (22 percent), 牙科 offices (21 percent), and hospitals (12 percent) accounted for 55 percent of healthcare spending in 2016.
  • 医生s' office and 牙科 payments varied notably in frequency and magnitude, 超过一半的家庭(52%)在某一年向医生办公室支付了费用(平均293美元), 相比之下，32%的家庭平均自付465美元的牙科费用.
  • 支付给医院的款项, 医生, 按摩师, 其他医疗费用是2013年至2016年期间增长最快的医疗支出类别.
• 医疗保健 spending appears to be highly concentrated, 收入最高的10%的人在医疗保健方面的支出，占到实得收入总额的9%.
  • In absolute dollar terms, 2016年，前10%的消费者占总自付支出的49%, with an average spend total of $3,482.
  • High-burden accounts tended to remain high-burden accounts. 2015年医疗保健支出负担前10%的账户中，几乎有一半是在第二年.
• 医疗保健 payments were highest in the months and years when inflows were highest.
  • 医疗支出较高的月份和年份往往与实得收入和流动资产较高的月份和年份相吻合, indicating that ability to pay was associated with demand for healthcare services.
  • In each of the four years studied, healthcare spending was highest in March and April, which coincides with when roughly 80 percent of tax filers receive a tax refund.
• 报告中研究的23个州之间和州内的自费医疗支出差异很大.
  • 2016年，科罗拉多州的平均自付医疗支出最高(916美元)，加利福尼亚州最低(596美元)。. 医疗保健支出水平较高的州，其医疗保健支出负担相对于收入而言通常较高.
  • Large geographic variation also occurred within 状态s. 例如, among five target 状态s studied – California, 佛罗里达, 纽约, 俄亥俄州, 和德克萨斯州——支出最高的县和支出最低的县之间的差距超过两倍.

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