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The effect of age and time to death on primary care costs: The Italian experience

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  • Atella, Vincenzo
  • Conti, Valentina

Abstract

A large body of literature shows that time to death (TTD) is by far a better predictor of health spending than age. In this paper, we investigate if this finding holds true also in presence of primary care costs (pharmaceuticals, diagnostic tests and specialist visits) in Italy, where they represent an important share (about 30%) of the total health care expenditure (HCE). Our analysis is based on a large sample of the Italian population (about 750,000 individuals), obtained from the Health Search-SiSSI database, which contains patient-level data collected routinely by General Practitioners in Italy since 2002. We study individuals aged 19 and older, over the period 2006–2009. By means of a two-part model which accounts for the presence of zero expenditure, our findings show that age represents the most important driver of primary care costs in Italy, although TTD remains a good predictor. These results suggest that age and TTD can have a different role in shaping health care costs according to the component of health expenditure examined. Therefore, our advice to policy makers is to use disaggregated models to better disentangle these contributions and to produce more reliable health spending forecasts.

Suggested Citation

  • Atella, Vincenzo & Conti, Valentina, 2014. "The effect of age and time to death on primary care costs: The Italian experience," Social Science & Medicine, Elsevier, vol. 114(C), pages 10-17.
  • Handle: RePEc:eee:socmed:v:114:y:2014:i:c:p:10-17
    DOI: 10.1016/j.socscimed.2014.05.029
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    2. Breyer, Friedrich & Lorenz, Normann & Ihle, Peter, 2020. "Aging and Health Care Expenditure: A non-parametric approach," VfS Annual Conference 2020 (Virtual Conference): Gender Economics 224635, Verein für Socialpolitik / German Economic Association.
    3. Vincenzo Atella & Federico Belotti & Valentina Conti & Claudio Cricelli & Joanna Kopinska & Andrea Piano Mortari, 2016. "Modeling public health care expenditure using patient level data: Empirical evidence from Italy," CEIS Research Paper 367, Tor Vergata University, CEIS, revised 10 Feb 2016.
    4. Federico Belotti & Joanna Kopinska & Alessandro Palma & Andrea Piano Mortari, 2022. "Health status and the Great Recession. Evidence from electronic health records," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1770-1799, August.
    5. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    6. Sungje Moon & Mankyu Choi, 2018. "The Effect of Usual Source of Care on the Association of Annual Healthcare Expenditure with Patients’ Age and Chronic Disease Duration," IJERPH, MDPI, vol. 15(9), pages 1-11, August.
    7. Friedrich Breyer & Normann Lorenz, 2021. "The “red herring” after 20 years: ageing and health care expenditures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 661-667, July.
    8. Maynou, Laia & Street, Andrew & García−Altés, Anna, 2023. "Living longer in declining health: Factors driving healthcare costs among older people," Social Science & Medicine, Elsevier, vol. 327(C).
    9. Domenico Depalo & Jay Bhattacharya & Vincenzo Atella & Federico Belotti, 2019. "When Technological Advance Meets Physician Learning in Drug Prescribing," NBER Working Papers 26202, National Bureau of Economic Research, Inc.
    10. Wenqiang Qian & Xiangyu Cheng & Guoying Lu & Lijun Zhu & Fei Li, 2019. "Fiscal Decentralization, Local Competitions and Sustainability of Medical Insurance Funds: Evidence from China," Sustainability, MDPI, vol. 11(8), pages 1-21, April.
    11. Caravaggio, Nicola & Resce, Giuliano, 2023. "Enhancing Healthcare Cost Forecasting: A Machine Learning Model for Resource Allocation in Heterogeneous Regions," Economics & Statistics Discussion Papers esdp23090, University of Molise, Department of Economics.
    12. Anne Mason & Idaira Rodriguez Santana & María José Aragón & Nigel Rice & Martin Chalkley & Raphael Wittenberg & Jose-Luis Fernandez, 2019. "Drivers of health care expenditure: Final report," Working Papers 169cherp, Centre for Health Economics, University of York.

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