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The Avalanche Hypothesis and Compression of Morbidity: Testing Assumptions through Cohort-Sequential Analysis

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  • Jordan Silberman
  • Chun Wang
  • Shawn T Mason
  • Steven M Schwartz
  • Matthew Hall
  • Jason L Morrissette
  • Xin M Tu
  • Janet Greenhut

Abstract

Background: The compression of morbidity model posits a breakpoint in the adult lifespan that separates an initial period of relative health from a subsequent period of ever increasing morbidity. Researchers often assume that such a breakpoint exists; however, this assumption is hitherto untested. Purpose: To test the assumption that a breakpoint exists—which we term a morbidity tipping point—separating a period of relative health from a subsequent deterioration in health status. An analogous tipping point for healthcare costs was also investigated. Methods: Four years of adults’ (N = 55,550) morbidity and costs data were retrospectively analyzed. Data were collected in Pittsburgh, PA between 2006 and 2009; analyses were performed in Rochester, NY and Ann Arbor, MI in 2012 and 2013. Cohort-sequential and hockey stick regression models were used to characterize long-term trajectories and tipping points, respectively, for both morbidity and costs. Results: Morbidity increased exponentially with age (P

Suggested Citation

  • Jordan Silberman & Chun Wang & Shawn T Mason & Steven M Schwartz & Matthew Hall & Jason L Morrissette & Xin M Tu & Janet Greenhut, 2015. "The Avalanche Hypothesis and Compression of Morbidity: Testing Assumptions through Cohort-Sequential Analysis," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-16, May.
    • Handle: RePEc:plo:pone00:0123910
    DOI: 10.1371/journal.pone.0123910
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    References listed on IDEAS

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    2. Lewis, Jeffrey B. & Linzer, Drew A., 2005. "Estimating Regression Models in Which the Dependent Variable Is Based on Estimates," Political Analysis, Cambridge University Press, vol. 13(4), pages 345-364.
    3. Laura Romeu Gordo, 2011. "Compression of morbidity and the labour supply of older people," Applied Economics, Taylor & Francis Journals, vol. 43(4), pages 503-513.
    4. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
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    1. Siegfried Geyer & Sveja Eberhard & Bernhard Magnus W Schmidt & Jelena Epping & Juliane Tetzlaff, 2018. "Morbidity compression in myocardial infarction 2006 to 2015 in terms of changing rates and age at occurrence: A longitudinal study using claims data from Germany," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-19, August.

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