IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v13y2023i1d10.1186_s13561-023-00449-4.html
   My bibliography  Save this article

Out-of-pocket expenditure on community healthcare services at end-of-life among decedents from cardiovascular disease in six European countries and Israel

Author

Listed:
  • Aviad Tur-Sinai

    (The Max Stern Yezreel Valley College
    University of Rochester Medical Center
    University of Haifa)

  • Netta Bentur

    (Tel-Aviv University)

Abstract

Objectives Most people who develop chronic diseases, including cardiovascular disease (CVD), live in their homes in the community in their last year of life. Since cost-sharing is common in most countries, including those with universal health insurance, these people incur out of pocket expenditure (OOPE). The study aims to identify the prevalence and measure the size of OOPE among CVD decedents at end-of-life (EOL) explore differences among countries in OOPE, and examine whether the decedents’ characteristics or their countries’ health policy affects OOPE more. Methods SHARE data among people aged 50 + from seven European countries (including Israel) who died from CVD are analyzed. Decedents’ family members are interviewed to learn about OOPE on their relatives’ account. Results We identified 1,335 individuals who had died from CVD (average age 80.8 years, 54% men). More than half of CVD-decedent people spend OOPE on community services at EOL and their expenditure varies widely among countries. About one-third of people in France and Spain had OOPE, rising to around two-thirds in Israel and Italy and almost all in Greece. The average OOPE is 391.9 PPT, with wide variance across countries. Significant odds of OOPE exist in the country variable only, and significant differences exist in the amount of OOPE among countries and duration of illness preceding death. Conclusions Since improving CVD care efficiency and effectiveness are key aims, healthcare policymakers should broaden the investigation into expanding public funding for community services in order to mitigate OOPE, alleviate the economic burden on households, mitigate forgoing of community services due to price, and reduce rehospitalization.

Suggested Citation

  • Aviad Tur-Sinai & Netta Bentur, 2023. "Out-of-pocket expenditure on community healthcare services at end-of-life among decedents from cardiovascular disease in six European countries and Israel," Health Economics Review, Springer, vol. 13(1), pages 1-13, December.
    • Handle: RePEc:spr:hecrev:v:13:y:2023:i:1:d:10.1186_s13561-023-00449-4
    DOI: 10.1186/s13561-023-00449-4
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-023-00449-4
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1186/s13561-023-00449-4?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. 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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pieter H. M. van Baal & Talitha L. Feenstra & Johan J. Polder & Rudolf T. Hoogenveen & Werner B. F. Brouwer, 2011. "Economic evaluation and the postponement of health care costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 432-445, April.
    2. Ishizaki, Tatsuro & Imanaka, Yuichi & Oh, Eun-Hwan & Sekimoto, Miho & Hayashida, Kenshi & Kobuse, Hiroe, 2008. "Association between patient age and hospitalization resource use in a teaching hospital in Japan," Health Policy, Elsevier, vol. 87(1), pages 20-30, July.
    3. Afschin Gandjour, 2009. "Aging diseases – do they prevent preventive health care from saving costs?," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 355-362, March.
    4. Kyung‐Rae Hyun & Sungwook Kang & Sunmi Lee, 2016. "Population Aging and Healthcare Expenditure in Korea," Health Economics, John Wiley & Sons, Ltd., vol. 25(10), pages 1239-1251, October.
    5. Eva Kibele & Fanny Janssen, 2013. "Distortion of regional old-age mortality due to late-life migration in the Netherlands?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 29(5), pages 105-132.
    6. 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.
    7. Leena Forma & Mari Aaltonen & Jutta Pulkki & Jani Raitanen & Pekka Rissanen & Marja Jylhä, 2017. "Care service use in 2 years preceding suicide among older adults: comparison with those who died a natural death and those who lived longer," European Journal of Ageing, Springer, vol. 14(2), pages 143-153, June.
    8. Murphy, Michael & Martikainen, Pekka, 2013. "Use of hospital and long-term institutional care services in relation to proximity to death among older people in Finland," Social Science & Medicine, Elsevier, vol. 88(C), pages 39-47.
    9. Moore, Patrick V. & Bennett, Kathleen & Normand, Charles, 2017. "Counting the time lived, the time left or illness? Age, proximity to death, morbidity and prescribing expenditures," Social Science & Medicine, Elsevier, vol. 184(C), pages 1-14.
    10. Søren Kjærgaard & Vladimir Canudas-Romo, 2017. "Potential support ratios: Cohort versus period perspectives," Population Studies, Taylor & Francis Journals, vol. 71(2), pages 171-186, May.
    11. World Bank, 2015. "What’s Next for Old Europe?," World Bank Publications - Reports 22515, The World Bank Group.
    12. 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).
    13. Eric French & Elaine Kelly & Mariacristina Nardi & Eric French & John Bailey Jones & Jeremy McCauley, 2016. "Medical Spending of the US Elderly," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 717-747, September.
    14. Yu, Tiffany Hui-Kuang & Wang, David Han-Min & Wu, Kuo-Lun, 2015. "Reexamining the red herring effect on healthcare expenditures," Journal of Business Research, Elsevier, vol. 68(4), pages 783-787.
    15. Cohen-Mansfield, Jiska & Brill, Shai, 2016. "Trajectories at the end of life: A controlled investigation of longitudinal Health Services Consumption data," Health Policy, Elsevier, vol. 120(12), pages 1395-1403.
    16. Hamblin, Richard & Minko, Nikolai & Shuker, Carl & Hill, Jennifer & Merry, Alan F., 2018. "What happens at the end of life? Using linked administrative health data to understand healthcare usage in the last year of life in New Zealand," Health Policy, Elsevier, vol. 122(7), pages 783-790.
    17. Aleksander Krasowski & Joachim Krois & Sebastian Paris & Adelheid Kuhlmey & Hendrik Meyer-Lueckel & Falk Schwendicke, 2021. "Costs for Statutorily Insured Dental Services in Older Germans 2012–2017," IJERPH, MDPI, vol. 18(12), pages 1-18, June.
    18. Audrey Tanguy-Melac & Dorian Verboux & Laurence Pestel & Anne Fagot-Campagna & Philippe Tuppin & Christelle Gastaldi-Ménager, 2021. "Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1039-1052, September.
    19. Rolden, Herbert J.A. & van Bodegom, David & Westendorp, Rudi G.J., 2014. "Variation in the costs of dying and the role of different health services, socio-demographic characteristics, and preceding health care expenses," Social Science & Medicine, Elsevier, vol. 120(C), pages 110-117.
    20. van Winssen, K.P.M. & van Kleef, R.C. & van de Ven, W.P.M.M., 2015. "How profitable is a voluntary deductible in health insurance for the consumer?," Health Policy, Elsevier, vol. 119(5), pages 688-695.

    More about this item

    Keywords

    Cardiovascular disease; Out-of-pocket; Economic capacity; Welfare regime; SHARE;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:hecrev:v:13:y:2023:i:1:d:10.1186_s13561-023-00449-4. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.