Advertisement

Social Indicators Research

, Volume 86, Issue 2, pp 303–321 | Cite as

Projecting Long-Term Care Expenditure in Four European Union Member States: The Influence of Demographic Scenarios

  • Joan Costa-FontEmail author
  • Raphael Wittenberg
  • Concepció Patxot
  • Adelina Comas-Herrera
  • Cristiano Gori
  • Alessandra di Maio
  • Linda Pickard
  • Alessandro Pozzi
  • Heinz Rothgang
Article

Abstract

This study examines the sensitivity of future long-term care demand and expenditure estimates to official demographic projections in four selected European countries: Germany, Spain, Italy and the United Kingdom. It uses standardised methodology in the form of a macro-simulation exercise and finds evidence for significant differences in assumptions about demographic change and its effect on the demand for long-term care, and on relative and absolute long-term care expenditure. It concludes that mortality-rate assumptions can have a considerable influence on welfare policy planning. Relative dispersion between country-specific and Eurostat official estimates was found to be higher for the United Kingdom and Germany than for Italy and Spain, suggesting that demographic projections had a greater influence in those countries.

Keywords

Population projections Long-term care Life Expectancy and mortality 

Notes

Acknowledgements

We acknowledge the comments from the participants to our Barcelona and London Seminars in 2001–2002. This study was partly funded by the European Commission Employment and Social Affairs DG. Grant number VS/2001/0272. Referee's comments are acknowledged.

References

  1. Alho, J. M. (1990). Stochastic methods in population forecasting. International Journal of Forecasting, 6, 521–530.CrossRefGoogle Scholar
  2. Alho, J. M. (2002). The population of Finland in 2050 and beyond. Discussion Paper No. 826. The Research Institute of the Finnish Economy.Google Scholar
  3. Alho, J. M. (2003) Demographic risks: A European perspective. ENERPI Network Working Paper No 12.Google Scholar
  4. Benjamin, B. (1988). Demographic aspects of ageing. Annals of Human Biology, 16, 185–235.CrossRefGoogle Scholar
  5. Billari, F. C., & Koler, H.-P. (2004). Patterns of lowest-low fertility in Europe. Population Studies, 58, 161–176.CrossRefGoogle Scholar
  6. Brody, J. A. (1985). Prospects for an aging population. Nature, 315, 463–466.CrossRefGoogle Scholar
  7. Comas-Herrera, A., Wittenberg, R., Costa-Font, J., Gori, C., Di Maio, A., Patxot, C., Pickard, L., Pozzi, A., & Rothgang, H. (2006). Future long-term care expenditure in Germany, Spain, Italy and the United Kingdom. Ageing & Society, 26, 285–302.CrossRefGoogle Scholar
  8. Costa-Font, J., & Patxot, C. (2004). The intergenerational impact of long-term care financing alternatives in Spain. The Geneva Papers of Risk and Insurance, pp. 599–620.Google Scholar
  9. Costa-Font, J., & Font-Vilalta, M. (2006). Design limitations of long term care insurance schemes. International Social Security Review, 59, 91–110.CrossRefGoogle Scholar
  10. Economic Policy Committee (2006). Impact of ageing populations on public spending, on pensions, health and long-term care, education and unemployment benefits for the elderly. Brussels, 6 February 2006.Google Scholar
  11. European Policy Committee (2001). Budgetary challenges posed by ageing populations. Brussels, 24 October 2001.Google Scholar
  12. Fernández-Cordon, J. A. (2000). Progecciones de la poblacioń Española, 1998–2051. Fedea, Madrid.Google Scholar
  13. Fries, J. F. (1980). Ageing, natural death and compression of morbidity. New England Journal of Medicine, 303, 130–135.CrossRefGoogle Scholar
  14. Hayflick, L. (1981). Prospects of human extension by genetic manipulation. In G. Danon, N. W. Shock, & M. Marois (Eds.), Ageing: Challenge to science and society (Vol. 1, pp. 162–169). Oxford: Oxford University Press.Google Scholar
  15. Hugo, G. (2000). Declining fertility and policy intervention in Europe: Some lessons for Australia? Journal of Population Research, 17, 175–198.CrossRefGoogle Scholar
  16. Kinsella, K., & Philips, D. R. (2005). Global aging: The challenge of success. Population Bulletin, 60(1), 1–73.Google Scholar
  17. Lassila, J., & Valkonen, T. (2004). Pre-funding expenditure on health and long-term care under demographic change. The Geneva Papers of Risk and Insurance, 29, 620–639.CrossRefGoogle Scholar
  18. Lee, R. D., & Tuljapurkar, S. (1998). Uncertain demographic futures and social security finances. American Economic Review, 88, 237–41.Google Scholar
  19. Lutz, W., & Goldstein, J. R. (2004). Introduction: How to deal with uncertainty in population forecasting? International Statistical Review, 72(1), 1–4.CrossRefGoogle Scholar
  20. Manton, K. G., Stallard, E., & Tolley, H. D. (1991). Limits to human life expectancy: Evidence, prospects and implications. Population and Development Review, 17, 603–637.CrossRefGoogle Scholar
  21. Murphy, M. (1995a). The prospect of mortality: England and Wales and the United States of America 1962–1989. British Actuarial Journal, 1(2), 43–49.Google Scholar
  22. Murphy, M. (1995b). The prospect of mortality: England and Wales and the United States of America, 1962–89. British Actuarians Journal, 1(11), 330–350.Google Scholar
  23. Nusselder, W. J., & Mackenbach, J. P. (2000). Lack of improvement of life expectancy at advanced ages in the Netherlands. International Journal of Epidemiology, 29, 140–148.Google Scholar
  24. Nusselder, W. J., van der Velden, K., van Sonsbeek, J. L., Lenior, M. E., & van der Bos, G. A. (1996). The elimination of selected chronic diseases in a population: the compression and expansion of morbidity. American Journal of Public Health, 86, 187–194.Google Scholar
  25. OECD (1998). Maintaining prosperity in an ageing society, Paris.Google Scholar
  26. Olshansky, S. J., Carnes, B. A., & Cassel, C. K. (1993) The aging of the human species. Scientific American April, 18–24.Google Scholar
  27. Pickard, L., Comas-Herrera, A., Costa-Font, J., Gori, C., Di Maio, A., Patxot, C., Pozzi, A., Rothgang, H., & Wittenberg, R. (2006). Modelling an entitlement to long-term care services for older people in Europe: projections for long-term care expenditure to 2050. Journal of European Social Policy, 17, 33–48.CrossRefGoogle Scholar
  28. Poulain, M. (1993). Confrontation des statistiques de migrations intra-Européennes: vers plus d’harmonisation? European Journal of Population, 9, 353–381.CrossRefGoogle Scholar
  29. Rothgang, H. (2002a). Pflegebedürftigkeit und demographischer Wandel. In Mai, Ralf/Bundesinstitut für Bevölkerungsforschung: Die Alten der Zukunft. Schriftenreihe des Bundesministeriums für Familie, Senioren, Frauen und Jugend. Wiesbaden: Kohlhammer, i.E.Google Scholar
  30. Rothgang, H. (2002b). Providing long-term care for the elderly in Germany. Projections on public long-term care insurance financing. In G. Hullen (Ed.), Living arrangements and householdsmethods and results of demographic projections (pp. 95–112). Materialien zur Bevölkerungswissenschaft. Bundesinstitut für Bevölkerungsforschung: Wiesbaden [forthcoming].Google Scholar
  31. Rothgang, H. (2002c). Projections on public long-term care insurance financing. In H. Conrad & R. Lützeler (Eds.), Aging and social policyA German–Japanese comparison (pp. 251–273). München: Iudicum [forthcoming].Google Scholar
  32. Rothgang, H., & Comas, A. (2003). Dependency rates and health expectancy. In Comas, et al. (Eds.), European study of long-term care expenditure. Report to the European Commission, Employment and Social Affairs DG. Grant number VS/2001/0272.Google Scholar
  33. Schulz, E., Leidl, R., & Koning, H. H. (2004). The impact of ageing on hospital care and long-term care-the example of Germany. Health Policy, 67, 57–74.CrossRefGoogle Scholar
  34. Seshamani, M., & Gray, A. (2004) Ageing and health care expenditure: The red herring argument revisited. Health Economics, 13, 303–314.CrossRefGoogle Scholar
  35. Shaw, C. (1994) Accuracy and uncertainty of the national population projections for the United Kingdom. Population Trends, 77, 24–32.Google Scholar
  36. Spillmann, B. C., & Lubitz, J. (2000). The effect of longevity on spending for acute and long-term care. New England Journal of Medicine, 342, 1409–1415.CrossRefGoogle Scholar
  37. Uitenbroek, D. G., & Verhoeff, A. (2002). Life expectancy and mortality differences between migrant groups living in Amsterdam, the Netherlands. Social Science and Medicine, 54(9), 1379–1388.CrossRefGoogle Scholar
  38. Vaupel, J. W., & Gowan, A. E. (1986). Passage to Methuselah: Some demographic consequences of continued progress against mortality. American Journal of Public Health, 76, 430–433.Google Scholar
  39. Vaupel, J. W., & Lundstrom, H. (1994). The future of mortality at older ages in developed countries. In W. Lutz (Ed.), The future population of the world. What can we assume today? (pp. 295–315). London, UK: Earthscan Publications.Google Scholar
  40. Zweifel, P., Felder, S., & Meier, M. (1999). Ageing of population and health care expenditure: A red herring? Health Economics, 8, 485–496.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Joan Costa-Font
    • 1
    • 2
    Email author
  • Raphael Wittenberg
    • 3
  • Concepció Patxot
    • 1
  • Adelina Comas-Herrera
    • 3
  • Cristiano Gori
    • 4
  • Alessandra di Maio
    • 4
  • Linda Pickard
    • 3
  • Alessandro Pozzi
    • 4
  • Heinz Rothgang
    • 5
  1. 1.Research Centre on the Economics of Social Policy (CAEPS)Universitat the BarcelonaBarcelonaSpain
  2. 2.LSE Health and Social CareLondon School of EconomicsLondonUK
  3. 3.PSSRU, LSE Health and Social CareLondon School of EconomicsLondonUK
  4. 4.Istituto per la Ricerca SocialeBolognaItaly
  5. 5.Centre for Social Policy ResearchBremen University BremenGermany

Personalised recommendations