The Great Recession of 2007 to 2009 brought households across the nation face-to-face with difficult financial decisions and put pressure on many Americans to make sacrifices in their spending, even in vital areas like health care, which saw historically low growth in spending during the recession. But new research out of the University of Maryland School of Public Health found that not all health care spending was affected by the recession in the same way. Led by Dr. Jie Chen, assistant professor in the department of health services administration, the study determined that the recession had a greater impact on less expensive health care expenditures, like primary care visits and prescription drug purchases. Higher cost health care expenditures, such as treatment for chronic illness and high-technology care, were not significantly affected, indicating that the health care spending of people requiring a large amount of health care resources did not change, and that these people may have been less willing or able to sacrifice or substitute. The research is published online in the October 17 early view of the Health Services Research Journal.