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Using biomarkers to predict healthcare costs: Evidence from a UK household panel

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  • Davillas, Apostolos
  • Pudney, Stephen

Abstract

We investigate the extent to which healthcare service utilisation and costs can be predicted from biomarkers, using the UK Understanding Society panel. We use a sample of 2314 adults who reported no history of diagnosed long-lasting health conditions at baseline (2010/11), when biomarkers were collected. Five years later, their GP, outpatient (OP) and inpatient (IP) utilisation was observed. We develop an econometric technique for count data observed within ranges and a method of combining administrative reference cost data with the survey data without exact individual-level matching. Our composite biomarker index (allostatic load) is a powerful predictor of costs: for those with a baseline allostatic load of at least one standard deviation (1-s.d.) above mean, a 1-s.d. reduction reduces GP, OP and IP costs by around 18%.

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  • Davillas, Apostolos & Pudney, Stephen, 2020. "Using biomarkers to predict healthcare costs: Evidence from a UK household panel," Journal of Health Economics, Elsevier, vol. 73(C).
    • Handle: RePEc:eee:jhecon:v:73:y:2020:i:c:s0167629619308495
    DOI: 10.1016/j.jhealeco.2020.102356
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    1. Cameron,A. Colin & Trivedi,Pravin K., 2013. "Regression Analysis of Count Data," Cambridge Books, Cambridge University Press, number 9781107667273, January.
    2. Sarah Brown & Alan Duncan & Mark N. Harris & Jennifer Roberts & Karl Taylor, 2015. "A Zero-Inflated Regression Model for Grouped Data," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 77(6), pages 822-831, December.
    3. Bruce D. Meyer & Nikolas Mittag, 2019. "Using Linked Survey and Administrative Data to Better Measure Income: Implications for Poverty, Program Effectiveness, and Holes in the Safety Net," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 176-204, April.
    4. Davillas, Apostolos & Pudney, Stephen, 2020. "Biomarkers as precursors of disability," Economics & Human Biology, Elsevier, vol. 36(C).
    5. Seeman, Teresa E. & Crimmins, Eileen & Huang, Mei-Hua & Singer, Burton & Bucur, Alexander & Gruenewald, Tara & Berkman, Lisa F. & Reuben, David B., 2004. "Cumulative biological risk and socio-economic differences in mortality: MacArthur Studies of Successful Aging," Social Science & Medicine, Elsevier, vol. 58(10), pages 1985-1997, May.
    6. Davillas, Apostolos & Pudney, Stephen, 2017. "Concordance of health states in couples: Analysis of self-reported, nurse administered and blood-based biomarker data in the UK Understanding Society panel," Journal of Health Economics, Elsevier, vol. 56(C), pages 87-102.
    7. Howdon, Daniel & Rice, Nigel, 2018. "Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population," Journal of Health Economics, Elsevier, vol. 57(C), pages 60-74.
    8. Carl-Johan Dalgaard & Holger Strulik, 2014. "Optimal Aging And Death: Understanding The Preston Curve," Journal of the European Economic Association, European Economic Association, vol. 12(3), pages 672-701, June.
    9. Chernew, Michael E. & Newhouse, Joseph P., 2011. "Health Care Spending Growth," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 1-43, Elsevier.
    10. Geronimus, A.T. & Hicken, M. & Keene, D. & Bound, J., 2006. ""Weathering" and age patterns of allostatic load scores among blacks and whites in the United States," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 826-833.
    11. Sara Allin & Cristina Masseria & Elias Mossialos, 2011. "Equity in health care use among older people in the UK: an analysis of panel data," Applied Economics, Taylor & Francis Journals, vol. 43(18), pages 2229-2239.
    12. de Meijer, Claudine & Koopmanschap, Marc & d' Uva, Teresa Bago & van Doorslaer, Eddy, 2011. "Determinants of long-term care spending: Age, time to death or disability?," Journal of Health Economics, Elsevier, vol. 30(2), pages 425-438, March.
    13. Brilleman, Samuel L. & Gravelle, Hugh & Hollinghurst, Sandra & Purdy, Sarah & Salisbury, Chris & Windmeijer, Frank, 2014. "Keep it simple? Predicting primary health care costs with clinical morbidity measures," Journal of Health Economics, Elsevier, vol. 35(C), pages 109-122.
    14. Thomas McDade & Sharon Williams & J. Snodgrass, 2007. "What a drop can do: Dried blood spots as a minimally invasive method for integrating biomarkers into population-based research," Demography, Springer;Population Association of America (PAA), vol. 44(4), pages 899-925, November.
    15. Hsin-I Lee & Hungyen Chen & Hirohisa Kishino & Chen-Tuo Liao, 2016. "A Reference Population-Based Conformance Proportion," Journal of Agricultural, Biological and Environmental Statistics, Springer;The International Biometric Society;American Statistical Association, vol. 21(4), pages 684-697, December.
    16. Bound, John & Brown, Charles & Mathiowetz, Nancy, 2001. "Measurement error in survey data," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 59, pages 3705-3843, Elsevier.
    17. Marc Carreras & Pere Ibern & José María Inoriza, 2018. "Ageing and healthcare expenditures: Exploring the role of individual health status," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 865-876, May.
    18. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    19. Gabriella Conti & James Heckman & Sergio Urzua, 2010. "The Education-Health Gradient," American Economic Review, American Economic Association, vol. 100(2), pages 234-238, May.
    20. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496, September.
    21. Dana A. Glei & Noreen Goldman & Germán Rodríguez & Maxine Weinstein, 2014. "Beyond Self-Reports: Changes in Biomarkers as Predictors of Mortality," Population and Development Review, The Population Council, Inc., vol. 40(2), pages 331-360, June.
    22. Vincenzo Carrieri & Andrew M. Jones, 2017. "The Income–Health Relationship ‘Beyond the Mean’: New Evidence from Biomarkers," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 937-956, July.
    23. Morciano, Marcello & Hancock, Ruth M. & Pudney, Stephen E., 2015. "Birth-cohort trends in older-age functional disability and their relationship with socio-economic status: Evidence from a pooling of repeated cross-sectional population-based studies for the UK," Social Science & Medicine, Elsevier, vol. 136, pages 1-9.
    24. Vie, Tina Løkke & Hufthammer, Karl Ove & Holmen, Turid Lingaas & Meland, Eivind & Breidablik, Hans Johan, 2014. "Is self-rated health a stable and predictive factor for allostatic load in early adulthood? Findings from the Nord Trøndelag Health Study (HUNT)," Social Science & Medicine, Elsevier, vol. 117(C), pages 1-9.
    25. Sibley, Lyn M. & Glazier, Richard H., 2012. "Evaluation of the equity of age–sex adjusted primary care capitation payments in Ontario, Canada," Health Policy, Elsevier, vol. 104(2), pages 186-192.
    26. Turner, R. Jay & Thomas, Courtney S. & Brown, Tyson H., 2016. "Childhood adversity and adult health: Evaluating intervening mechanisms," Social Science & Medicine, Elsevier, vol. 156(C), pages 114-124.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 5th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-05 11:00:05

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    Cited by:

    1. Xavier D'Haultf{oe}uille & Christophe Gaillac & Arnaud Maurel, 2022. "Partially Linear Models under Data Combination," Papers 2204.05175, arXiv.org, revised Aug 2023.
    2. Davillas, Apostolos & Pudney, Stephen, 2020. "Biomarkers, disability and health care demand," Economics & Human Biology, Elsevier, vol. 39(C).
    3. Atkins, Rose & Turner, Alex James & Chandola, Tarani & Sutton, Matt, 2020. "Going beyond the mean in examining relationships of adolescent non-cognitive skills with health-related quality of life and biomarkers in later-life," Economics & Human Biology, Elsevier, vol. 39(C).
    4. Sinha, Kompal & Davillas, Apostolos & Jones, Andrew M. & Sharma, Anurag, 2021. "Do socioeconomic health gradients persist over time and beyond income? A distributional analysis using UK biomarker data," Economics & Human Biology, Elsevier, vol. 43(C).
    5. Barry, L.E. & O'Neill, S. & Heaney, L.G. & O'Neill, C., 2021. "Stress-related health depreciation: Using allostatic load to predict self-rated health," Social Science & Medicine, Elsevier, vol. 283(C).
    6. Fernando Antonio Slaibe Postali & Maria Dolores M Diaz, Adriano Dutra Teixeira, Natalia Nunes Ferreira Batista, Rodrigo Moreno Serra, 2021. "Impact of primary care coverage on individual health: evidence from biomarkers in Brazil," Working Papers, Department of Economics 2021_01, University of São Paulo (FEA-USP).

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    More about this item

    Keywords

    Healthcare costs; Socioeconomic gradient; Biomarkers; Allostatic load; Understanding society;
    All these keywords.

    JEL classification:

    • C3 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables
    • C8 - Mathematical and Quantitative Methods - - Data Collection and Data Estimation Methodology; Computer Programs
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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