What we say and what we do: County-level public spending for health care

The purpose oft his study is to examine county-level public spending for he alth care services in Kansas and to explain variation in spending levels wi th a model composed of population density population age and per capita inc ome. Data are abstracted from budget documents for all 105 counties in Kans as for the years 1994, 1995 and 1996. Health care expenditures are defined as county tax revenues spent for ambulance, hospitals, ambulatory care, hom e health services, nursing homes, and mental health and substance abuse ser vices. Results show that Kansas counties spent between 12.1 percent and 13. 6 percent of their budgets to fund local health care services between 1994 and 1996, spending more than $133 million in 1996 alone. In 10 counties, on e-quarter to one-third of the budget went for health services. Low populati on density and relatively high per capita income explained nearly one-third of the variation in how much counties spent and an even greater proportion when analysis was limited to the most rural counties. Findings from this s tudy suggest there may be a significant local commitment in the United Stat es to publicly supported health care services, more support than typically recognized and perhaps more than is estimated in national health care spend ing data. Future research on the economic effects of the health sector on l ocal communities should take account of local spending for health care, esp ecially at the county level.