Skip to main content
SpringerLink
Log in

Healthcare expenditure and ageing

A comment

  • Opinion
  • Published:
Applied Health Economics and Health Policy Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Notes

  1. 1HCE in the last 3 months of life represents, on average, 44–50% of the HCE incurred during the last year of life. This is consistent with the findings of Zweifel et al.,[1] i.e. 42–48% for Switzerland in contrast to 62% for Medicare in the US as reported by Lubitz and Riley.[10]

  2. 2Studies on costs at the end of life by van Acht and Stooker[11] and Stooker et al.[12] report that the assumption of high costs at the end of life does not hold true in the Netherlands, except for long-term care. This interpretation is contested by Scuffham and Taylor.[13] In a debate on euthanasia, they argue that, under private funding, it is conceivable that a patient could be kept alive against his/her will, whereas the opposite could happen in a public system.[13] There is no evidence on this matter to date.

  3. Our study found that hospital costs incurred in the 3 months prior to death represent 70–80% of all hospital costs over the last year of life, with the exception of the last group, aged 90–99 years. For this group, hospital costs represent only 57% of the overall costs.

References

  1. Zweifel P, Felder S, Meiers M. Ageing of population and healthcare expenditure: a red herring? Health Econ 1999; 8(6): 485–96

    Article  PubMed  CAS  Google Scholar 

  2. Emanuel EJ, Emanuel LL. The economics of dying: the illusion of cost savings at the end of life. N Engl J Med 1994; 330: 540–4

    Article  PubMed  CAS  Google Scholar 

  3. Emanuel EJ, Battin MP. What are the potential cost savings from legalizing physician-assisted suicide? N Engl J Med 1998; 339: 167–72

    Article  PubMed  CAS  Google Scholar 

  4. Lamers LM, vanVliet RC. The high cost of death: should plans get higher payments when members die? Med Care 1998; 36: 1451–60

    Article  PubMed  Google Scholar 

  5. Felder S, Meir M, Schmitt H. Health care expenditure in the last months of life. J Health Econ 2000; 19: 679–95

    Article  PubMed  CAS  Google Scholar 

  6. Levinsky NG, Yu W, Ash A, et al. Influence of age on Medicare expenditures and medical care in the last year of life. JAMA 2001; 286: 1346–55

    Article  Google Scholar 

  7. Hogan C, Lunney J, Gabel J, et al. Medicare beneficiaries’ costs of care in the last year of life. Health Aff 2001; 20: 188–95

    Article  CAS  Google Scholar 

  8. Seshamani M, Gray A. Health care expenditures and ageing: an international comparison. Appl Health Econ Health Policy 2003; 2(1): 9–16

    PubMed  Google Scholar 

  9. Outreville JF. Ageing of the population and the future of healthcare plans [paper presentation]. Meeting of the UN Health Insurance Officers III; 2003 May 5–6; Vienna.

    Google Scholar 

  10. Lubitz JD, Riley GF. Trends in medicare payments in the last year of life. N Engl J Med 1993; 328: 1092–6

    Article  PubMed  CAS  Google Scholar 

  11. van Acht JW, Stooker T. Decisions at the end of life. Appl Health Econ Health Policy 2002; 1(1): 10–2

    PubMed  Google Scholar 

  12. Stooker T, van Acht JW, van Barneveld EM, et al. Costs in the last year of life in the Netherlands. Inquiry 2001; 38: 73–80

    Article  PubMed  CAS  Google Scholar 

  13. Scuffham PA, Taylor MJ. Economics and decisions to end life: van Acht and Stooker revisited. Appl Health Econ Health Policy 2002; 1(3): 123–8

    PubMed  Google Scholar 

  14. Seshamani M, Gray AM. A longitudinal study of the effects of age and time to death on hospital costs. J Health Econ 2004; 23: 217–35

    Article  PubMed  Google Scholar 

  15. Busse R, Krauth C, Schwartz FW. Use of acute hospital beds does not increase as the population ages: results from a seven years cohort study in Germany. J Epidemiol Community Health 2002; 56: 289–93

    Article  PubMed  CAS  Google Scholar 

  16. Jacobzone S. Coping with aging: international challenges. Health Aff 2000; 19(3): 213–25

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The opinions expressed in this article are those of the author and do not necessarily reflect the views of the organisation. No sources of funding were used to assist in the preparation of this opinion piece. The author has no conflicts of interest that are directly relevant to the content of this opinion piece.

Author information

Authors and Affiliations

  1. Palais des Nations, UNCTAD, CH 1211, Geneva, Switzerland

    J. François Outreville

Authors
  1. J. François Outreville
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. François Outreville.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Outreville, J.F. Healthcare expenditure and ageing. Appl Health Econ Health Policy 3, 121–123 (2004). https://doi.org/10.2165/00148365-200403030-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00148365-200403030-00001

Keywords

Search

Navigation