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The impact of ageing on health care expenditures: a study of steepening

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  • Fredrik Gregersen

Abstract

Some researchers claim that health care expenditures for older people are growing faster than for the rest of the population. This process is referred to as steepening. The aim of this paper is to test steepening, applying new data and revised methods. Furthermore, we explain the connection between the terms red herring hypothesis, i.e., that time to death and not age per se drives the health care expenditures, and steepening. We also present the mechanisms that may induce steepening, as presented in the literature. When testing steepening, we apply data from all inpatient stays in somatic hospitals in Norway in the period 1998–2009, i.e., the data has no self-selection and covers the entire population of Norway (5 million). Our analysis does not reject steepening, with the exception of the 0-year-olds. The results also hold when controlling for mortality-related expenditures. Furthermore, we observe an increase in expenditures for the 0-year-olds. Finally, we find increasing mortality-related expenditures over time. We find the link between steepening and the red herring hypothesis to be vague, and we find steepening and the red herring hypothesis to be independent. Copyright The Author(s) 2014

Suggested Citation

  • Fredrik Gregersen, 2014. "The impact of ageing on health care expenditures: a study of steepening," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 979-989, December.
    • Handle: RePEc:spr:eujhec:v:15:y:2014:i:9:p:979-989
    DOI: 10.1007/s10198-013-0541-9
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    1. Hartwig, Jochen, 2008. "What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited," Journal of Health Economics, Elsevier, vol. 27(3), pages 603-623, May.
    2. Gregersen, Fredrik Alexander & Godager, Geir, 2013. "Hospital expenditures and the red herring hypothesis: Evidence from a complete national registry," HERO Online Working Paper Series 2013:3, University of Oslo, Health Economics Research Programme.
    3. Peter Zweifel & Stefan Felder & Andreas Werblow, 2004. "Population Ageing and Health Care Expenditure: New Evidence on the “Red Herring”," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(4), pages 652-666, October.
    4. Victor R. Fuchs, 2018. "“Though Much Is Taken”: Reflections on Aging, Health, and Medical Care," World Scientific Book Chapters, in: Health Economics and Policy Selected Writings by Victor Fuchs, chapter 33, pages 403-424, World Scientific Publishing Co. Pte. Ltd..
    5. David M. Cutler & Ellen Meara, 1998. "The Medical Costs of the Young and Old: A Forty-Year Perspective," NBER Chapters, in: Frontiers in the Economics of Aging, pages 215-246, National Bureau of Economic Research, Inc.
    6. Florian Buchner & Jürgen Wasem, 2006. "“Steeping” of Health Expenditure Profiles," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 31(4), pages 581-599, October.
    7. Seshamani, Meena & Gray, Alastair M., 2004. "A longitudinal study of the effects of age and time to death on hospital costs," Journal of Health Economics, Elsevier, vol. 23(2), pages 217-235, March.
    8. Hã„Kkinen, Unto & Martikainen, Pekka & Noro, Anja & Nihtilã„, Elina & Peltola, Mikko, 2008. "Aging, health expenditure, proximity to death, and income in Finland," Health Economics, Policy and Law, Cambridge University Press, vol. 3(2), pages 165-195, April.
    9. Sally C. Stearns & Edward C. Norton, 2004. "Time to include time to death? The future of health care expenditure predictions," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 315-327, April.
    10. Colombier, Carsten & Weber, Werner, 2009. "Projecting health-care expenditure for Switzerland: further evidence against the 'red-herring' hypothesis," MPRA Paper 26747, University Library of Munich, Germany, revised Nov 2009.
    11. 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.
    12. Barer, Morris L. & Evans, Robert G. & Hertzman, Clyde & Lomas, Jonathan, 1987. "Aging and health care utilization: New evidence on old fallacies," Social Science & Medicine, Elsevier, vol. 24(10), pages 851-862, January.
    13. Felder, Stefan & Werblow, Andreas, 2008. "Do the age profiles of health care expenditure really steepen over time? New evidence from Swiss cantons," Dresden Discussion Paper Series in Economics 05/08, Technische Universität Dresden, Faculty of Business and Economics, Department of Economics.
    14. Christian Salas & James P. Raftery, 2001. "Econometric issues in testing the age neutrality of health care expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 669-671, October.
    15. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    16. Polder, Johan J. & Barendregt, Jan J. & van Oers, Hans, 2006. "Health care costs in the last year of life--The Dutch experience," Social Science & Medicine, Elsevier, vol. 63(7), pages 1720-1731, October.
    17. Stefan Felder & Andreas Werblow, 2008. "Does the Age Profile of Health Care Expenditure Really Steepen over Time? New Evidence from Swiss Cantons," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 33(4), pages 710-727, October.
    18. Peter Zweifel & Stefan Felder & Markus Meier, 2001. "Reply to: econometric issues in testing the age neutrality of health care expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 673-674, October.
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    4. Maciej Lis, 2016. "Age or time-to-death – what drives health care expenditures? Panel data evidence from the OECD countries," IBS Working Papers 04/2016, Instytut Badan Strukturalnych.
    5. SeungHoon Han & Hosung Sohn, 2023. "The short-term effects of fixed copayment policy on elderly health spending and service utilization: evidence from South Korea’s age-based policy using exact date of birth," International Journal of Health Economics and Management, Springer, vol. 23(2), pages 255-279, June.
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    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. Breyer Friedrich, 2015. "Demographischer Wandel und Gesundheitsausgaben: Theorie, Empirie und Politikimplikationen," Perspektiven der Wirtschaftspolitik, De Gruyter, vol. 16(3), pages 215-230, October.
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    13. Nico Keilman & Dinh Q. Pham & Astri Syse, 2018. "Mortality shifts and mortality compression. The case of Norway, 1900-2060," Discussion Papers 884, Statistics Norway, Research Department.
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    More about this item

    Keywords

    Red herring hypothesis ; Hospital expenditure; Trends in health care expenditures; Steepening ; Ageing; A19; I15; I19;
    All these keywords.

    JEL classification:

    • A19 - General Economics and Teaching - - General Economics - - - Other
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I19 - Health, Education, and Welfare - - Health - - - Other

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