The effect of population aging on health expenditure growth: a critical review
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Open Access
- 15 May 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in European Journal of Ageing
- Vol. 10 (4), 353-361
- https://doi.org/10.1007/s10433-013-0280-x
Abstract
Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in Western countries by combining insights from epidemiological and health economics research. Based on a conceptual model of health care use, we first review evidence on the relationship between age and health expenditures to provide insight into the direct effect of aging on health expenditure growth. Second, we discuss the interaction between aging and the main societal drivers of health expenditures. Aging most likely influences growth in health expenditures indirectly, through its influence on these societal factors. The literature shows that the direct effect of aging depends strongly on underlying health and disability. Commonly used approximations of health, like age or mortality, insufficiently capture complex dynamics in health. Population aging moderately increases expenditures on acute care and strongly increases expenditures on long-term care. The evidence further shows that the most important driver of health expenditure growth, medical technology, interacts strongly with age and health, i.e., population aging reinforces the influence of medical technology on health expenditure growth and vice versa. We therefore conclude that population aging will remain in the centre of policy debate. Further research should focus on the changes in health that explain the effect of longevity gains on health expenditures, and on the interactions between aging and other societal factors driving expenditure growth. Keywords: Population aging, Morbidity, Technology, Health expenditures, Acute care, Long-term carKeywords
This publication has 72 references indexed in Scilit:
- Sharp upturn of life expectancy in the Netherlands: effect of more health care for the elderly?European Journal of Epidemiology, 2011
- Ageing populations: the challenges aheadThe Lancet, 2009
- Does informal care from children to their elderly parents substitute for formal care in Europe?Journal of Health Economics, 2009
- Aging, health expenditure, proximity to death, and income in FinlandHealth Economics, Policy and Law, 2008
- Counting Backward to Health Care's Future: Using Time‐to‐Death Modeling to Identify Changes in End‐of‐Life Morbidity and the Impact of Aging on Health Care ExpendituresThe Milbank Quarterly, 2007
- Aging and Future Healthcare Expenditure: A Consistent ApproachForum for Health Economics and Policy, 2007
- Change in chronic disability from 1982 to 2004/2005 as measured by long-term changes in function and health in the U.S. elderly populationProceedings of the National Academy of Sciences of the United States of America, 2006
- The Value of Medical Spending in the United States, 1960–2000The New England Journal of Medicine, 2006
- Explaining income‐related inequalities in doctor utilisation in EuropeHealth Economics, 2004
- Aging, Natural Death, and the Compression of MorbidityThe New England Journal of Medicine, 1980