The effect of population aging on health expenditure growth: a critical review

European Journal of Ageing - Tập 10 - Trang 353-361 - 2013
Claudine de Meijer1,2, Bram Wouterse3,4, Johan Polder3,4, Marc Koopmanschap1,2
1Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
2Institute for Medical Technology Assessment, Rotterdam, The Netherlands
3National Institute for Public Health and the Environment, Bilthoven, The Netherlands
4Tranzo, Tilburg University, Tilburg, the Netherlands

Tóm tắt

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.

Tài liệu tham khảo

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