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Published in: The European Journal of Health Economics 9/2014

Open Access 01-12-2014 | Original Paper

The impact of ageing on health care expenditures: a study of steepening

Author: Fredrik Alexander Gregersen

Published in: The European Journal of Health Economics | Issue 9/2014

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Abstract

Some researchers claim that health care expenditures for older people are growing faster than for the rest of the population. This process is referred to as steepening. The aim of this paper is to test steepening, applying new data and revised methods. Furthermore, we explain the connection between the terms red herring hypothesis, i.e., that time to death and not age per se drives the health care expenditures, and steepening. We also present the mechanisms that may induce steepening, as presented in the literature. When testing steepening, we apply data from all inpatient stays in somatic hospitals in Norway in the period 1998–2009, i.e., the data has no self-selection and covers the entire population of Norway (5 million). Our analysis does not reject steepening, with the exception of the 0-year-olds. The results also hold when controlling for mortality-related expenditures. Furthermore, we observe an increase in expenditures for the 0-year-olds. Finally, we find increasing mortality-related expenditures over time. We find the link between steepening and the red herring hypothesis to be vague, and we find steepening and the red herring hypothesis to be independent.
Footnotes
1
Note that g denotes a cell in the data set applied in this study, characterized by age, gender, time and municipality.
 
2
\(\begin{aligned} \frac{{\partial \overline{Y}_{g} }}{{\partial \phi_{g} }} & = \kappa_{1} + 2\kappa_{2} \phi_{g} + 3\kappa_{3} \phi_{g}^{2} + 4\kappa_{4} \phi_{g}^{3} = 131416 - 2*446127*\phi_{g} \\ & \quad + 3*640520*\phi_{g}^{2} - 4*310920*\phi_{g}^{3} > 0\forall \phi_{g}. \\ \end{aligned}\)
 
Literature
1.
go back to reference Hartwig, J.: What drives health care expenditure?—Baumol’s model of ‘unbalanced growth’ revisited. J. Health Econ. 27(3), 603–623 (2008)PubMedCrossRef Hartwig, J.: What drives health care expenditure?—Baumol’s model of ‘unbalanced growth’ revisited. J. Health Econ. 27(3), 603–623 (2008)PubMedCrossRef
2.
go back to reference Stearns, S.C., Norton, E.C.: Time to include time to death? The future of health care expenditure predictions. Health Econ. 13(4), 315–327 (2004)PubMedCrossRef Stearns, S.C., Norton, E.C.: Time to include time to death? The future of health care expenditure predictions. Health Econ. 13(4), 315–327 (2004)PubMedCrossRef
3.
go back to reference Zweifel, P., Felder, S., Meier, M.: Ageing of population and health care expenditure: a red herring? Health Econ. 8(6), 485–496 (1999)PubMedCrossRef Zweifel, P., Felder, S., Meier, M.: Ageing of population and health care expenditure: a red herring? Health Econ. 8(6), 485–496 (1999)PubMedCrossRef
4.
go back to reference Buchner, F., Wasem, J.: “Steeping” of health expenditure profiles. Geneva Papers Risk Insur. Issues Pract. 31(4), 581–599 (2006)CrossRef Buchner, F., Wasem, J.: “Steeping” of health expenditure profiles. Geneva Papers Risk Insur. Issues Pract. 31(4), 581–599 (2006)CrossRef
5.
go back to reference Felder, S., Werblow, A.: Does the age profile of health care expenditure really steepen over time? New evidence from Swiss cantons. Geneva Papers Risk Insur. Issues Pract. 33(4), 710–727 (2008)CrossRef Felder, S., Werblow, A.: Does the age profile of health care expenditure really steepen over time? New evidence from Swiss cantons. Geneva Papers Risk Insur. Issues Pract. 33(4), 710–727 (2008)CrossRef
6.
go back to reference Johnsen, J.R.: Health systems in transition: Norway. In: Bankauskaite, V. (ed.) WHO regional office for Europe on behalf of the European observatory on health systems and policies, vol. 8, No. 1, Copenhagen (2006) Johnsen, J.R.: Health systems in transition: Norway. In: Bankauskaite, V. (ed.) WHO regional office for Europe on behalf of the European observatory on health systems and policies, vol. 8, No. 1, Copenhagen (2006)
7.
go back to reference Seshamani, M., Gray, A.: The impact of ageing on expenditures in the National Health Service. Age Ageing 31(4), 287–294 (2002)PubMedCrossRef Seshamani, M., Gray, A.: The impact of ageing on expenditures in the National Health Service. Age Ageing 31(4), 287–294 (2002)PubMedCrossRef
8.
9.
go back to reference Mendelson, D.N., Schwartz, W.B.: The effects of aging and population growth on health care costs. Health Aff. 12(1), 119–125 (1993)CrossRef Mendelson, D.N., Schwartz, W.B.: The effects of aging and population growth on health care costs. Health Aff. 12(1), 119–125 (1993)CrossRef
10.
go back to reference Cutler, D.M., Meara, E.: The medical costs of the young and old: a forty-year perspective. In: David, A.W. (ed.) Frontiers in the economics of aging, pp. 215–246. University of Chicago Press (1998) Cutler, D.M., Meara, E.: The medical costs of the young and old: a forty-year perspective. In: David, A.W. (ed.) Frontiers in the economics of aging, pp. 215–246. University of Chicago Press (1998)
11.
go back to reference Barer, M.L., Evans, R.G., Hertzman, C., Lomas, J.: Aging and health care utilization: new evidence on old fallacies. Soc. Sci. Med. 24(10), 851–862 (1987)PubMedCrossRef Barer, M.L., Evans, R.G., Hertzman, C., Lomas, J.: Aging and health care utilization: new evidence on old fallacies. Soc. Sci. Med. 24(10), 851–862 (1987)PubMedCrossRef
12.
go back to reference Melberg, H., Godager, G., Gregersen, F.: Hospital expenses towards the end of life. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke 133(8), 841–844 (2013)CrossRef Melberg, H., Godager, G., Gregersen, F.: Hospital expenses towards the end of life. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke 133(8), 841–844 (2013)CrossRef
13.
go back to reference Gregersen, F.A., Godager, G.: Hospital expenditures and the red herring hypothesis: Evidence from a complete national registry. Health Economics Research Program (Hero). University of Oslo, Oslo (2013) Gregersen, F.A., Godager, G.: Hospital expenditures and the red herring hypothesis: Evidence from a complete national registry. Health Economics Research Program (Hero). University of Oslo, Oslo (2013)
14.
go back to reference Levinsky, N.G., Yu, W., Ash, A., Moskowitz, M., Gazelle, G., Saynina, O., Emanuel, E.J.: Influence of age on medicare expenditures and medical care in the last year of life. JAMA J. Am. Med. Assoc. 286(11), 1349–1355 (2001)CrossRef Levinsky, N.G., Yu, W., Ash, A., Moskowitz, M., Gazelle, G., Saynina, O., Emanuel, E.J.: Influence of age on medicare expenditures and medical care in the last year of life. JAMA J. Am. Med. Assoc. 286(11), 1349–1355 (2001)CrossRef
15.
go back to reference Fries, J.F.: The compression of morbidity. The Milbank Memorial Fund quarterly. Health Soc, 397–419 (1983) Fries, J.F.: The compression of morbidity. The Milbank Memorial Fund quarterly. Health Soc, 397–419 (1983)
16.
go back to reference Fries, J.F., Crapo, L.M.: Vitality and aging: implications of the rectangular curve. WH Freeman, San Francisco, (1981) Fries, J.F., Crapo, L.M.: Vitality and aging: implications of the rectangular curve. WH Freeman, San Francisco, (1981)
17.
go back to reference Fuchs, V.R.: “Though much is taken”: reflections on aging, health, and medical care. Milbank Mem. Fund Q. Health Soc. 62, 143–166 (1984) Fuchs, V.R.: “Though much is taken”: reflections on aging, health, and medical care. Milbank Mem. Fund Q. Health Soc. 62, 143–166 (1984)
18.
go back to reference Colombier, C., Weber, W.: Projecting health-care expenditure for Switzerland: further evidence against the ‘red-herring’ hypothesis. Int. J. Health Plan. Manag. 26(3), 246–263 (2011)CrossRef Colombier, C., Weber, W.: Projecting health-care expenditure for Switzerland: further evidence against the ‘red-herring’ hypothesis. Int. J. Health Plan. Manag. 26(3), 246–263 (2011)CrossRef
19.
go back to reference Zweifel, P., Felder, S., Werblow, A.: Population ageing and health care expenditure: new evidence on the “red herring”. Geneva Pap. Risk. Insur. Issues Pract. 29(4), 652–666 (2004)CrossRef Zweifel, P., Felder, S., Werblow, A.: Population ageing and health care expenditure: new evidence on the “red herring”. Geneva Pap. Risk. Insur. Issues Pract. 29(4), 652–666 (2004)CrossRef
20.
go back to reference Salas, C., Raftery, J.P.: Econometric issues in testing the age neutrality of health care expenditure. Health Econ. 10(7), 669–671 (2001)PubMedCrossRef Salas, C., Raftery, J.P.: Econometric issues in testing the age neutrality of health care expenditure. Health Econ. 10(7), 669–671 (2001)PubMedCrossRef
21.
go back to reference Zweifel, P., Felder, S., Meier, M.: Reply to: econometric issues in testing the age neutrality of health care expenditure. Health Econ. 10(7), 673–674 (2001)PubMedCrossRef Zweifel, P., Felder, S., Meier, M.: Reply to: econometric issues in testing the age neutrality of health care expenditure. Health Econ. 10(7), 673–674 (2001)PubMedCrossRef
22.
go back to reference Häkkinen, U.H.A., Martikainen, P., Noro, A., Nihtila, E., Peltola, M.: Aging, health expenditure, proximity to death, and income in Finland. Health Econ. Policy Law 3, 165–195 (2008)PubMedCrossRef Häkkinen, U.H.A., Martikainen, P., Noro, A., Nihtila, E., Peltola, M.: Aging, health expenditure, proximity to death, and income in Finland. Health Econ. Policy Law 3, 165–195 (2008)PubMedCrossRef
23.
go back to reference Bratlid, D., Nordermoen, A.: Behandlingen av svært for tidlig fødte barn de siste 40 år. Tidsskrift for den Norske legeforening 130(11), 1127 (2010)PubMedCrossRef Bratlid, D., Nordermoen, A.: Behandlingen av svært for tidlig fødte barn de siste 40 år. Tidsskrift for den Norske legeforening 130(11), 1127 (2010)PubMedCrossRef
24.
go back to reference Nordermoen, A., Bratlid, D.: Kostnader ved behandling av svært for tidlig fødte barn. Tidsskrift for den Norske legeforening 130(11), 1130 (2010)PubMedCrossRef Nordermoen, A., Bratlid, D.: Kostnader ved behandling av svært for tidlig fødte barn. Tidsskrift for den Norske legeforening 130(11), 1130 (2010)PubMedCrossRef
26.
go back to reference Polder, J.J., Barendregt, J.J., Oers, H.: Health care costs in the last year of life–the Dutch experience. Soc. Sci. Med. 63(7), 1720–1731 (2006)PubMedCrossRef Polder, J.J., Barendregt, J.J., Oers, H.: Health care costs in the last year of life–the Dutch experience. Soc. Sci. Med. 63(7), 1720–1731 (2006)PubMedCrossRef
Metadata
Title
The impact of ageing on health care expenditures: a study of steepening
Author
Fredrik Alexander Gregersen
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 9/2014
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-013-0541-9

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