Long-term care was responsible for 30% of the growth in Medicaid spending between fiscal years 2000-2003, a new study says.

Medicaid spending increased by one-third during that period, to $26 billion, according to a report that appeared in the journal Health Affairs. Acute care services accounted for 68% of the growth in spending during that four-year period.

Although the elderly and disabled represent a minority of Medicaid beneficiaries, they account for most of the costs of the program because of their intensive use of services, the report said. Between 2000 and 2003, only 10% of enrollment growth was from the elderly and people with disabilities, but the same groups were responsible for 56% of the spending growth.

The study said the Medicaid spending increase was largely driven by increases in enrollment during the economic downturn. Between fiscal year 2000 and 2003, 90% of Medicaid’s total enrollment of 8.4 million was from families.