[Ageing, Medical Progress and the Growth of Healthcare Expenditure]

Overview

Journal Urologe A

Specialty Urology

Date 2013 Apr 26

PMID 23616171

Authors

F Breyer

Affiliations

Soon will be listed here.

Abstract

As healthcare expenditure typically rises during a person's lifetime, there are widespread fears that the ageing of the German population together with technical progress in medicine will be a serious threat to future healthcare financing. The relationship between ageing and growth of healthcare expenditure has been intensively studied over the past 15 years both theoretically and empirically. In this article it will be demonstrated that the highest expenditure is not due to age per se but rather to proximity to death. However, even taking this effect into account simulations show that the increase in life expectancy as well as medical progress will contribute to the growth of per capita expenditure in the German healthcare insurance system.

References

Seshamani M, Gray A . Ageing and health-care expenditure: the red herring argument revisited. Health Econ. 2004; 13(4):303-14. DOI: 10.1002/hec.826. View

Felder S, Werblow A, Zweifel P . Do red herrings swim in circles? Controlling for the endogeneity of time to death. J Health Econ. 2009; 29(2):205-12. DOI: 10.1016/j.jhealeco.2009.11.014. View

Zweifel P, Steinmann L, Eugster P . The Sisyphus syndrome in health revisited. Int J Health Care Finance Econ. 2005; 5(2):127-45. DOI: 10.1007/s10754-005-1864-6. View

Seshamani M, Gray A . A longitudinal study of the effects of age and time to death on hospital costs. J Health Econ. 2004; 23(2):217-35. DOI: 10.1016/j.jhealeco.2003.08.004. View

Stearns S, Norton E . Time to include time to death? The future of health care expenditure predictions. Health Econ. 2004; 13(4):315-27. DOI: 10.1002/hec.831. View

Lubitz J, BEEBE J, Baker C . Longevity and Medicare expenditures. N Engl J Med. 1995; 332(15):999-1003. DOI: 10.1056/NEJM199504133321506. View

Salas C, Raftery J . Econometric issues in testing the age neutrality of health care expenditure. Health Econ. 2001; 10(7):669-71. DOI: 10.1002/hec.638. View

Felder S, Meier M, Schmitt H . Health care expenditure in the last months of life. J Health Econ. 2001; 19(5):679-95. DOI: 10.1016/s0167-6296(00)00039-4. View

Fuchs V . "Though much is taken": reflections on aging, health, and medical care. Milbank Mem Fund Q Health Soc. 1984; 62(2):143-66. View

10.

Barros P . The black box of health care expenditure growth determinants. Health Econ. 1998; 7(6):533-44. DOI: 10.1002/(sici)1099-1050(199809)7:6<533::aid-hec374>3.0.co;2-b. View

11.

Breyer F, Felder S . Life expectancy and health care expenditures: a new calculation for Germany using the costs of dying. Health Policy. 2005; 75(2):178-86. DOI: 10.1016/j.healthpol.2005.03.011. View

12.

Zweifel P, Ferrari M . Is there a Sisyphus syndrome in health care?. Dev Health Econ Public Policy. 1991; 1:311-30. DOI: 10.1007/978-94-011-2392-1_15. View

13.

Zweifel P, Felder S, Meiers M . Ageing of population and health care expenditure: a red herring?. Health Econ. 1999; 8(6):485-96. DOI: 10.1002/(sici)1099-1050(199909)8:6<485::aid-hec461>3.0.co;2-4. View

14.

Lubitz J, Riley G . Trends in Medicare payments in the last year of life. N Engl J Med. 1993; 328(15):1092-6. DOI: 10.1056/NEJM199304153281506. View

15.

Strech D, Synofzik M, Marckmann G . How physicians allocate scarce resources at the bedside: a systematic review of qualitative studies. J Med Philos. 2008; 33(1):80-99. DOI: 10.1093/jmp/jhm007. View

16.

Fries J . Aging, natural death, and the compression of morbidity. N Engl J Med. 1980; 303(3):130-5. DOI: 10.1056/NEJM198007173030304. View

17.

Polder J, Barendregt J, van Oers H . Health care costs in the last year of life--the Dutch experience. Soc Sci Med. 2006; 63(7):1720-31. DOI: 10.1016/j.socscimed.2006.04.018. View

18.

Shang B, Goldman D . Does age or life expectancy better predict health care expenditures?. Health Econ. 2007; 17(4):487-501. DOI: 10.1002/hec.1295. View