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Population ageing and health care expenditure: a school of 'red herrings'?

  • Andreas Werblow

    (Faculty of Business Management and Economics, Technical University Dresden, Magdeburg, Germany)

  • Stefan Felder

    (Institute of Social Medicine and Health Economics, Otto-von-Guericke University, Magdeburg, Germany)

  • Peter Zweifel

    (Socioeconomic Institute, University of Zurich, Switzerland)

This paper revisits the debate on the 'red herring', viz. the claim that population ageing will not have a significant impact on health care expenditure (HCE). It decomposes HCE into seven components, includes both survivors and deceased individuals, and estimates a two-part model of the demand for health care services, using a large Swiss data set for 1999. It finds no or weak age effects on HCE for the components of HCE when proximity to death is controlled for, and points to differences between users and non-users of long-term care (LTC). For deceased non-users of LTC services, a falling age curve for all components of HCE except for inpatient care is observed, while survivors show a weak age effect in ambulatory and inpatient care once proximity to death is controlled for. As to surviving users of LTC services, their probability of incurring LTC expenses markedly increases in old age, while most of the components of their conditional HCE show a decreasing age profile. Thus, a 'school of red herrings' can be claimed to exist-with the possible exception of LTC, where ageing might matter regardless of proximity to death. Copyright © 2007 John Wiley & Sons, Ltd.

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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 16 (2007)
Issue (Month): 10 ()
Pages: 1109-1126

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Handle: RePEc:wly:hlthec:v:16:y:2007:i:10:p:1109-1126
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Willard G. Manning & Anirban Basu & John Mullahy, 2003. "Generalized Modeling Approaches to Risk Adjustment of Skewed Outcomes Data," Working Papers 0313, Harris School of Public Policy Studies, University of Chicago.
  2. Ciaran O'Neill & Lindsay Groom & Anthony J. Avery & Daphne Boot & Karine Thornhill, 2000. "Age and proximity to death as predictors of GP care costs: results from a study of nursing home patients," Health Economics, John Wiley & Sons, Ltd., vol. 9(8), pages 733-738.
  3. Martin Schellhorn & Andreas E. Stuck & Christoph E. Minder & John C. Beck, 2000. "Health services utilization of elderly Swiss: evidence from panel data," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 533-545.
  4. 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, The International Association for the Study of Insurance Economics, vol. 29(4), pages 652-666, October.
  5. Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth : reassessing the threat of ageing," Post-Print halshs-00181605, HAL.
  6. 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.
  7. Felder, Stefan & Meier, Markus & Schmitt, Horst, 2000. "Health care expenditure in the last months of life," Journal of Health Economics, Elsevier, vol. 19(5), pages 679-695, September.
  8. 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.
  9. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
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