Medium Spenders Research Articles

Trends in the Concentration and Distribution of Health Care Expenditures in the US, 2001-2018

The concentration of health care expenditures has important implications for managing risk pools, drug benefit design, and care management. To examine trends in the concentration of health care spending in different population groups and expenditure categories in the US between 2001 and 2018. This study is a cross-sectional analysis of Medical Expenditure Panel Surveys (MEPS) collected between 2001 and 2018. The MEPS is a household survey of medical expenditures weighted to represent national estimates in the US. Respondents were a nationally representative sample of the US civilian noninstitutionalized population. Data analysis was performed from December 2020 to February 2021. The main outcome is the concentration of health care expenditures as measured by the cumulative percentage of health expenditure vs percentage of ranked population. This study reports trends in the distribution of populations across 4 concentration curve parameters: top 50% expenditure (high spenders), next 49% expenditure (medium spenders), next 1% expenditure (low spenders), and nonspenders. The mean sample size of the MEPS surveys used in the analysis was 34 539 individuals, and the sample size varied between 30 461 and 39 165 individuals over the years studied. On the basis of data from 30 461 MEPS respondents (15 867 women [52.1%]; mean [SD] age, 38.9 [24.0] years) in 2018, the top 4.6% (95% CI, 4.3%-4.9%) of the US population by spending accounted for 50% of health care expenditures. Although this fraction varied across population groups or expenditure categories, it remained remarkably stable over time with one exception: the concentration of spending on prescription drugs. In 2001, one-half of all expenditures on prescription drugs were concentrated in 6.0% (95% CI, 5.6%-6.4%) of the US population, but by 2018, this proportion had decreased to 2.3% (95% CI, 2.1%-2.5%). This change does not appear to be associated with a change in the overall share of prescription drug expenses, which increased by only a small amount, from 20.4% in 2001 to 24.8% in 2018. The overall concentration of health care expenditures remained stable between 2001 and 2018, but these findings suggest that there has been a sharp increase in the concentration of spending on prescription drugs in the US. This coincides with the genericization of many primary care drugs, along with a shift in focus of the biopharmaceutical industry toward high-cost specialty drugs targeted at smaller populations. If this trend continues, it will have implications for the minimum scale of risk-bearing and drug management needed to operate efficiently, as well as the optimal cost-sharing features of insurance products.

Revisit to Expenditure-Based Segmentation: The Case of the US Kids Golf World Championship

The current study segments the youth golf event market based on expenditure of families who participated in the US Kids Golf World Championship. Expenditure was analyzed from the perspective of parents of young golfers who played at the event. Analysis confirmed the existence of three dissimilar groups of spenders that included light spenders, medium spenders, and heavy spenders. These spenders significantly differed in 1) the expenditure variables such as lodging, food & beverage, golf, retail, transportation, and entertainment & recreation, 2) the overall satisfaction with the event, and 3) trip characteristics. The findings help better appreciate the expenditure patterns and characteristics of families who attended the special youth golf event, a market that has hitherto been infrequently addressed in the literature. Marketing implications are discussed for golf event marketers and associated businesses.

Expenditure-based segmentation of freight travel markets: Identifying the determinants of freight transport expenditure for developing marketing strategies

There is a substantial body of literature relating to freight transport sector's economic impact at the macro-level, but less is known about how freight demand gets translated to an establishment's expenditures at the micro-level. This paper addresses this research gap by collecting data about expenditure patterns of establishments and applying market segmentation technique based on finite mixture models. Three latent segments - heavy spenders, medium spenders and light spenders – and their associated profiles are identified. The results indicate that significant differences exist between the three expenditure-based segments of establishments in terms of spending patterns, business size indicators, locational characteristics and freight travel patterns. The heavy spenders tend to be strongly influenced by employment, gross-floor area, business age and fleet ownership levels. The length of haul and truck type choice have a strong incremental effect on the volume of expenditures and larger shipment sizes are associated with expenditure reduction due to economies of scale. The diverging characteristics of expenditure segments emphasizes the need of the logistics providers to “identify their markets” and planners to “identify how demand translates to transport expenditures”. The overall conclusion is that segmenting establishments based on unobservable heterogeneity with respect to their freight transport expenditure is preferable and more informative than treating them as one homogeneous group. The study findings provide important information that planners and logistics providers can utilize in developing effective logistics plans and marketing strategies.

Expenditure-based segmentation of sport tourists

Destinations throughout the USA and world compete against each other for the opportunity to host professional and amateur sporting events. The primary motivation for these destinations is the anticipated economic impact generated by sport tourists' expenditures while attending sporting events. Although the economic impact of sporting events has been widely studied, the analysis of individuals' expenditures has been neglected. Since tourists' expenditures are considered one of the most important variables in the economic analysis of a destination's tourism industry, segmenting tourists based on expenditures is a valuable alternative to more common segmentation approaches. In this study, sport tourists attending a Professional Golfers' Association of America tournament were divided into three groups (low, medium, and high spenders) based on their total per day spending. The mean per day total expenditures of the low-spender segment were $69.21, the medium spenders' mean total per day expenditures were $219.25, and the high-spender segment averaged $759.03 in total per day expenditures. The results indicate that a significant difference exists between the three expenditure-based segments of sport tourist spectators in terms of spending patterns, trip characteristics, and trip preferences. Expenditure-based segmentation of sport tourist spectators provides important information that event organizers and local tourism stakeholders can utilize in developing effective and efficient short- and long-term management and marketing strategies.

Country Segmentation of the International Tourism Market Using Propensity to Travel and to Spend Abroad

ABSTRACT Two new segmentation variables for the global international tourism market were operationalized. These variables were used to segment the countries of the world into nine market segments, which include heavy travelers, heavy spenders (HH); heavy travelers, medium spenders (HM); heavy travelers, light spenders (HL); medium travelers, heavy spenders (MH); medium travelers, medium spenders (MM); medium travelers, light spenders (ML); light travelers, heavy spenders (LH); light travelers, medium spenders (LM); and light travelers, light spenders (LL). The profile of these country segments were further examined using discriminant analysis. Implications of findings for targeting and promotion strategies are discussed, and directions for future research are given.

Heavy Spenders, Medium Spenders, and Light Spenders of Japanese Outbound Pleasure Travelers

The two main objectives of this study were to profile expenditure-based segments (heavy, medium, and light spenders) of Japanese outbound pleasure travelers and to identify the determinants of travel expenditure. Identifying groups with different levels of expenditure and comparing the differences among those groups can be a useful method of segmentation for the travel organizers. The main findings indicate that (1) expenditures increase with age, party size and length of trip as expected, (2) those traveling with a spouse, boy or girl friend and parents spend more, (3) summer is the peak expenditure period, (4) travelers to U.S. mainland, Canada, Europe, and Oceania showed greater propensity to spend compared to travelers to Asian countries, but travelers to Hawaii and Guam spent less, and (5) honeymooners and traveling for combined business and pleasure purposes are big spenders.

A Comparison of Pleasure Travelers from the Netherlands and Taiwan

Abstract The Dutch and Taiwanese pleasure travel parties are segmented into three groups based on the amount of their travel expenditures: heavy spenders, medium spenders and light spenders. Comparisons are made between travelers from the two countries, based on the descriptive variables including sociodemographics, travel characteristics, travel activities, travel philosophies, and travel benefits sought. Similarities and differences on the descriptive variables are identified between the two markets and some of these differences are explained by the culture differences of the two countries. Recommendations are provided for the tourism industry interested in the Dutch and Taiwanese pleasure travel markets.